Why are you billing insurance?
Billing insurance will benefit students by ensuring that mental health access is increased and improved. Our goal is to offer more services to more students in the long-term, and diversify the sources of funding so we can improve the viability of mental health services on campus. We want to continue to offer more mental health services to meet YOUR needs and provide equitable access to mental health services.
What insurance plans are accepted? Do you accept ISHIP for international students and GAIP for graduate student appointees?
We are in-network providers with the following insurance companies:
- Commercial Insurance
- Aetna
- Bridgespan
- Beacon Health Options
- Evernorth (formerly Cigna)
- First Choice Health PPO
- Magellan
- Optum
- PacificSource
- Premera Blue Cross / Lifewise (ISHIP & GAIP)
- Regence Blue Shield (King, Pierce, Snohomish)
- Tricare (HealthNet Federal Services)
- WA State Medicaid
- Coordinated Care of Washington
- Molina Healthcare of Washington
- Amerigroup Washington
- Community Health Plan of Washington
- United Healthcare Community Plan
I am a dependent on someone else’s insurance plan and have concerns about privacy. How can I protect my health information?
- If you are insured in Washington state
- As of January 2020, a new law gives dependents (adult dependents and minors who can agree to care without a parent’s consent) the exclusive right to control who has access to their sensitive health information.
- Sometimes you need to keep your personal health information private, such as when your health insurer sends you an Explanation of Benefits (EOB) statement after you’ve visited the doctor. The EOB shows what your medical provider charged for the visit and the services, what your insurer allowed and paid, and what you may owe out-of-pocket.
- By law, your health plan can’t disclose your information if you tell them in writing that:
- It could put your safety at risk; or
- It’s related to reproductive issues, sexually-transmitted diseases, substance-use disorder, or mental health services
- Under Washington state law, if you’re age 18 or younger and old enough to consent to your own health care services, your health plan should not release any personal health information about those services, unless you tell them in writing it’s OK. This includes:
- Mailing bills or EOBs to a policyholder or other covered people
- Calling the home to confirm appointments
- Mailing appointment notices
- You can fill out the Confidentiality Request Form here.
- Please let your provider know if you have additional concerns about using insurance.
What is an EOB and do I have to pay any balance?
If you receive an Explanation of Benefits (EOB) or other paperwork from your insurance company, this is NOT a bill for UW Counseling Center services. The document shows a review of services performed by UWCC, billed to your insurance company. The report shows the amount the insurance company paid to UWCC and the balance not paid. The insurance company may identify balances as “Amount not Covered” “Amount you May Owe” “Not Covered” and/or “Member Responsibility” in the EOB report.
For counseling services, the Services and Activities Fee will cover the amount not paid by insurance. This means you owe $0. Please note that UWCC will not seek any payments from you for balances shown on patients’ EOBs for counseling services.
For psychiatry services, you are responsible for the amount not paid by insurance. Please log into the Student Portal to see what you owe.
What if I receive a denial letter from my insurance company? Do I have to pay then?
Much like receiving an EOB in the mail, a denial letter is NOT a bill for UWCC services. The denial letter shows that a claim was submitted to your insurance but they are denying the claim, meaning that they will not pay for the services billed.
A claim can be denied for a multitude of reasons such as no pre-authorization submitted, seeing an out-of-network provider, or not being referred by your Primary Care Provider (PCP). Regardless of the denial reasoning, you do not have to pay out-of-pocket as SAF will cover the entire amount of the denied services.
For psychiatry services, you are still responsible for the amount not paid by insurance. Please log into the Student Portal to see what you owe.
What is Surprise Billing Protection?
Federal law protects you against unexpected medical bills. You have the option to give up those protections and pay more for out-of-network care.
Disclaimer
This Good Faith Estimate shows the costs of services that are reasonably expected for the expected services to address your mental health care needs. The estimate is based on the information known to us when we did the estimate.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
If you are billed for $400 more (per provider) than this Good Faith Estimate (GFE), you have the right to dispute the bill
You may contact the University of Washington Counseling Center at 206-543-1240 to let us know the billed charges are at least $400 higher than the GFE. You can ask us to update the bill to match the GFE, ask to negotiate the bill, or ask if there is financial assistance available.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this GFE. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
To learn get a form to start the process, or to learn more about your right to a Good Faith Estimate/the dispute process, visit: www.cms.gov/nosurprises or call CMS at 1-800-985-3059.
This GFE is not a contract. It does not obligate you to accept the services listed.
Keep a copy of your Good Faith Estimate (GFE) in a safe place or take pictures of it. You may need it if you are billed more than $400 than the estimate provided.
If you believe you’ve been wrongly billed, you may file a complaint with the federal government at https://www.cms.gov/nosurprises/consumers or by calling 1-800-985-3059; and/or file a complaint with the Washington State Office of the Insurance Commissioner at their website or by calling 1-800-562-6900.
Visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
Visit the Office of the Insurance Commissioner Balance Billing Protection Act website for more information about your rights under Washington state law.
What are the Good Faith Estimates?
Good Faith Estimate – Counseling
Below are the costs for the counseling services you will likely receive at the Counseling Center without use of insurance. For psychotherapy services, any cost not covered by insurance will be billed to the Services and Activities Fee.
CPT Code
|
Description *
|
Fee
|
90834
|
Psychotherapy, 45 minutes with patient
|
$164
|
90837
|
Psychotherapy, 60 minutes with patient
|
$243
|
90832
|
Psychotherapy, 30 minutes with patient
|
$124
|
90839 |
Psychotherapy for crisis, first 60 minutes
|
$231
|
90840 |
Psychotherapy for crisis; each additional 30 minutes
(List separately in addition to code for primary procedure)
|
$110
|
90853 |
Group psychotherapy
|
$44
|
Your provider will collaborate with you to create a treatment plan, which may include additional sessions. Further sessions will be billed using the above fee schedule.
The Counseling Center will be billing the Services and Activities Fee (fee that students typically pay when paying tuition and fees) for any portion not covered by insurance for psychotherapy. This means that the amount that the student owes out-of-pocket is $0.
Good Faith Estimate – Psychiatry
On average, students are seen approximately 9 psychiatry visits in a 12-month period. The typical range is from 4 sessions as an established patient to 12+ sessions for high risk or complex needs. Your provider will work with you to create a treatment plan, which may include additional sessions and services. Further sessions will be billed using the fee schedule below.
If you do not have insurance, the estimated yearly cost is listed below. If your provider is not considered in-network by your insurance company, you may be responsible for the entire cost of the session. It is your responsibility to check if your psychiatry provider is in-network for your insurance company.
Service
|
Diagnosis Code (once determined)
|
Service code
|
Quantity
(# of sessions)
|
Expected cost
|
Initial Psychiatry diagnostic evaluation with medical services
|
|
90792
|
1
|
$324
|
Outpatient visit for the evaluation and management of established psychiatry patient
|
|
99214S
|
9
|
$2,349
|
Total estimated cost of what you may owe for 12-month (on average)
|
$2,673
|
Here is the cost of additional services and expected charges for psychiatry medication services at the Counseling Center without use of insurance. Office visits are billed based on complexity or amount of time of care.
CPT Code
|
Description *
|
Fee
|
90792
|
Initial psychiatry diagnostic evaluation with medical services
|
$324
|
99214S
|
Outpatient visit for the evaluation and management of established psychiatry patient – moderate complexity; 30-39 minutes (most common)
|
$261
|
99212
|
Outpatient visit for established psychiatry patient – straightforward case; 10-19 minutes
|
$95
|
99213
|
Outpatient visit for established psychiatry patient – low complexity, 20-29 minutes
|
$153
|
99215
|
Outpatient visit for established psychiatry patient – high complexity; 40 minutes
|
$300
|
99417
|
Used for each additional 15 minutes for office visit
|
$48
|
99442
|
Brief telephone evaluation
|
$153
|
99443
|
Telephone evaluation
|
$216
|
90832
|
Psychotherapy with patient (add-on code when performed with an evaluation and management services)
|
$124
|
90840
|
Psychotherapy for Crisis; each additional 30 minutes (List separately in addition to code for primary procedure)
|
$110
|
*Times listed are total time that the provider spends on patient care, including visit time, chart review, history taking, physical exam, counseling, educating patient/family/caregiver, orders, referrals and communication with other providers (not separately reported), documentation, care coordination (not separately reported), independent interpretation of results (not separately reported) and communicating results to patient/family/caregiver.
What if I don’t have insurance?
That’s okay! We will still provide counseling services to students even if you don’t have access to insurance.
However, for psychiatry services, you will be responsible for the entire cost of the session if you do not have insurance. We recommend that you obtain health insurance.
You can learn more about how to get health insurance here (under FAQ- “how do uninsured students get health insurance).
What if I don’t want to use my insurance?
Billing insurance can help the center gain more funds to hire more employees which increases access for the campus. Ultimately it is up to each individual’s discretion to decide whether or not they want to use their insurance for service at UWCC.
If SAF is paying for counseling, will this lead to an increase in my fees?
No. For more information about SAF, please see this page.
What about groups?
Psychotherapy groups are billable to insurance and outreach/workshops are free. Please see this page for our current groups and workshops.
What about psychiatry services?
Psychiatry is an expensive specialty service and beginning July 1, 2022, University of Washington Counseling Center (UWCC) will change its billing structure for Psychiatry Services. UWCC will bill your insurance and will no longer bill SAF for patient costs. This means the patient responsibility will be billed to you as of July 1, 2022. Patient responsibility includes deductible, copay, coinsurance, non-covered charges, etc.
If you were to meet with your provider weekly for one month (using our most common CPT code: 99214S), it would cost:
- 4 sessions x $261 per session (99214S) = $1,044 per month
If you were to meet with your provider once a month for 12 months (using our most common CPT code: 99214S), it would cost:
- 12 sessions x $261 per session (99214S) = $3,132 per year
It is recommended that you contact your insurance to understand what coverage you may have for services at UWCC, what your portion of the cost will be, and to obtain prior authorization, if required by your insurance. If your insurance is out of network, you will likely have a significant out-of-pocket cost. If this is not feasible for you, see here for referrals.
I have a balance for psychiatry services. How do I pay it?
By credit card: you can online by logging into the UWCC student portal, select Account Summary, click “Pay Balance,” and then follow the instructions.
By check: Please include the student ID number on the memo. You can drop it off at Schmitz 401 or mail it to:
1410 NE Campus Pkwy #401
Box 355830
Seattle, WA 98195-5830