Insurance & Payment
FINANCIAL POLICIES
We believe your health is the most important investment you can make. Chrysalis Center is a privately-owned facility that contracts with private insurance companies, Medicare, and Tricare. We offer self-pay rates for clients who do not have insurance or have an insurance policy with an out of network company. We require payment in full at the time of your appointment. Please read over our financial policies and contact our Office Manager, Macon Funderburk with any questions.
Office Procedures and Financial Agreement – this form is in your new client paperwork
INSURANCE
We gladly file insurance claims on your behalf (with the exception of Medicaid) for mental health and nutrition counseling. Coverage is based on your individual policy and benefits are not guaranteed until claims are paid. Our staff will make every effort to confirm your benefits before your first appointment, but you can also check with your insurance provider to verify your coverage for our services. You will be responsible for paying your copay or the contracted rate your insurance company determines.
Chrysalis Center works with many major insurance providers including:
- Aetna
- American Specialty Health
- Blue Cross & Blue Shield
- CIGNA (out of network only)
- Medcost
- Medicare (mental health only)
- Humana Tricare
- United Behavioral Health
- United Healthcare
PAYMENT
For clients paying privately, or paying the remaining balance after insurance, Chrysalis Center accepts cash, check, VISA, or MasterCard. Should you accrue a balance, we offer payment plans that may be paid over the course of 3 months.
We are happy to work with clients who wish for a third party to make payments on their behalf. This may include a relative, employer, or another person. Please be sure to request a Third-Party Payer form or make arrangements to have the form completed before your first visit.
FEES
No-shows and Late Cancellations:
Paperwork:
No provider at Chrysalis will fill out any forms (FMLA, short- or long-term disability, etc.) for clients who are not already established at Chrysalis (5+ sessions with one provider), and at the clinician’s discretion. Providers have the right to decline paperwork requests that they are unable/unwilling to complete. Processing time may vary. Paperwork fees are based on the complexity of the paperwork. Providers may also require an appointment be scheduled to fully complete the paperwork.
The following fee schedule applies:
- Level I: Simple letter or disability initial form requiring less than a paragraph (ex. letter for exemptions for work/jury duty, verification of treatment) = $20.00
- Level II: Moderately complex letter or disability form (ex. request for accommodations, ESA) = $40
- Level III: High complexity letter or disability form (e. FMLA/disability/LOA, anything more detailed than 1-2 pages) = $60″
90791 – Intake: $200.00
90832 – Individual (30 min): $125.00
90834 – Individual (45 min): $150.00
90837 – Individual (60 min): $165.00
90846 – Family without Client: $150.00
90847 – Family/Couples: $150.00
90853 – Group: $60.00
No Show: $90.00
Kelly Broadwater, MA, LPA, LCMHC, NCC, CEDS-S
Kaitlyn Patterson, MA, LPA
Lauren Francis, MA, LPA
Meghan Shapiro, MA, LPA
Macy Baynor, MSW, LCSW
Emily Foster, MA, LCMHC-A
Danielle Couture, MSW, LCSW-A
90791 – Intake: $150.00
90832 – Individual (30 min): $100.00
90834 – Individual (45 min): $125.00
90837 – Individual (60 min): $140.00
90846 – Family without Client: $125.00
90847 – Family/Couples: $125.00
90853 – Group: $50.00
No Show: $90.00
Terri Mozingo, RD, LDN, CEDRD
Jennifer Wolf, MS, RD, LDN
Madelyn Huey, MS, RD, LDN
97802 – Intake: $37.50 per 15 min
97803 – Follow-up: $31.25 per 15 min
97804 – Group: $20.00 per 30 min
MedGem: $65.00 + session
Genetic Direction: $250.00 + session
Grocery Shopping: $35.00 per 15 min
No Show: $22.50 per 15 min scheduled
99201 – E&M of new patient (10 min): $55.00
99202 – E&M of new patient (20 min): $100.00
99203 – E&M of new patient (30 min): $150.00
99204 – E&M of new patient (45 min): $225.00
99205 – E&M of new patient (60 min): $300.00
99211 – E&M of an established patient (5 min): $50.00
99212 – E&M of an established patient (10 min): $75.00
99213 – E&M of an established patient (15 min): $125.00
99214 – E&M of an established patient (25 min): $165.00
99215 – E&M of an established patient (40 min): $225.00
992417 – Prolonged office or other outpatient evaluation and management service(s): $50.00
36415 – Collection of Venous Blood by Venipuncture: $10.00
No Show: $22.50 per 15 min scheduled
GOOD FAITH ESTIMATES
Effective January 1, 2022 under Section 2799B-6 of the Public Health Service Act, aka the “No Surprises Act”, healthcare providers and healthcare facilities are required to inform individuals who are not enrolled in a health insurance plan or not seeking to file a claim with their plan or coverage, both orally and in writing of their ability, upon request or at the time of scheduling health care services, how much their care will cost. You are entitled to receive a “Good Faith Estimate” explaining how much your medical care will cost.
- Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency medical services
- You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill
- Make sure to save a copy or picture of your Good Faith Estimate
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
