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Fees, Insurance and Payments

Fees, Payments, and Insurance

45-Minute Sessions

(Note: For information on fees and payment for Couple Intensives, click here. Dr. Chalmer does not accept insurance for Couple Intensives.)

Dr. Chalmer accepts some insurances for 45-minute sessions (see below). Dr. Chalmer does not accept EAP referrals. Currently, Dr. Chalmer does not have openings for 45-minute sessions for new clients.

 

Initial Session

$180 / 45 min

Subsequent Sessions

$150 / 45 min

Received a Bill?

If you received a bill, click on the button below to pay your bill.

Have A Question?

Please contact Dr. Chalmer with any questions you might have regarding billing.

Insurance information (45-minute sessions only)

Even for 45-minute sessions, there are good reasons why you might prefer to self-payrather than use insurance. However, if you wish to use insurance (only for 45-minute sessions), Dr. Chalmer accepts insurance from many different companies, including Medicare, Medicaid, and most (though not all) insurance plans that serve Vermont. For plans in which Dr. Chalmer is an in-network participating provider, the fee is governed by contract.

Dr. Chalmer is in-network for Blue Cross/Blue Shield, CIGNA, MVP, Medicare, and Medicaid, among others. Dr. Chalmer is out-of-network for United Healthcare/Optum and Tricare.  If you are unsure if sessions with Dr. Chalmer are covered by your plan, please check with your insurance plan. Note: Dr. Chalmer does not accept Employee Assistance Plan (EAP) referrals.

If you are using insurance, please make sure you obtain any necessary referral or authorization for treatment.  Some plans will not pay for sessions that have not been authorized.

You are responsible for deductibles, copays, or, if insurance does not cover the service, the full fee.  Payment is required at the time of service, unless other arrangements have been made. Please note that Dr. Chalmer will submit insurance claims for your primary insurance electronically on your behalf, but in case of difficulties with your insurance you are responsible for following up with the insurance company and ensuring payment in timely fashion. If insurance denies the claim, you are responsible for the full fee.

Cancellations

When you make an appointment, the time is reserved for you.

For 45-minute therapy sessions, if you miss or cancel a session with less than 24 hours notice, you may be billed the full fee for the session. Missed or cancelled sessions cannot be billed to any insurance.

For Couple Intensives, click here.

No Surprises Act notification

The No Surprises Act, as the name indicates, was designed for situations in which you might be surprised by a large medical bill for services for which you did not know the cost in advance. It’s the kind of situation that arises especially in hospitals, when you may be receiving treatment from many providers, sometimes without consulting you first. In the context of your work with Dr. Chalmer, this situation cannot occur, because you always know the cost of his services beforehand, and can choose to use them or not. However, the law requires that even sole practitioners provide a “Good Faith Estimate” of what your work will cost. Dr. Chalmer’s version of that document is at this link.

Why You Might Prefer To Self-Pay Instead Of Using Insurance

Even if you have insurance, you might find that you prefer to self-pay for your sessions. Here are some advantages of self-pay:

  • Increased privacy and confidentiality: When you use insurance, you automatically authorize insurance company personnel to access your records and discuss your treatment with your provider. When you self-pay, the only circumstance in which your records can be released to others without your consent would be a court order–a very rare phenomenon.
  • No need for a diagnosis of a mental disorder: Insurance companies will pay only for treatment of diagnoses listed in the Diagnostic and Statistical Manual (DSM), published by the American Psychiatric Association. In order to bill insurance, your provider must assign a diagnosis, which is transmitted to the insurance company with each billing. This becomes part of your digital record, which is accessible by your insurance company and any other entity with which they share your information.
  • No risk of hacked insurance records: Insurance companies are supposed to safeguard their sensitive digital information, including your diagnosis and treatment history, As the news of the past several years shows, those safeguards are subject to breach.  When you self-pay, you avoid that risk entirely.
  • You and your provider–not the insurance company–decide how long and how often your sessions should be, and what sort of work to do:  Insurance companies will pay only for certain lengths of time and certain modalities of treatment, and can disallow or question longer or more frequent sessions. When you self-pay, you and your provider determine how to work together, without the interference of a third party who has little knowledge of your particular situation, and an incentive to deny treatment.
  • Improved focus and efficiency:  Many people find that self-pay helps them focus on the work more effectively–if you’re paying for it, you value it.

Of course, if you have any questions, please ask Dr. Chalmer.

Note to Medicare subscribers: If you have Medicare, the rules are somewhat different, so be sure to let Dr. Chalmer know if your have Medicare even if you would prefer to self-pay.

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