I accept insurance and self-pay. I participate with the following insurance plans: Highmark Blue Cross/Blue Shield, UPMC.
ADVANTAGES OF SELF-PAY
1. Paying for psychotherapy out of pocket minimizes the exposure of your protected health information (PHI). Whenever you use insurance benefits to cover psychotherapy, the provider, albeit with your consent, has to release certain types of information to the insurance carrier in order to a) verify your eligibility for coverage, b) pre-authorize services (if applicable), and c) to process claims to obtain payment. As the result, the provider informs the insurance carrier of such personal matters as the nature of the issues you struggle with (presenting problem), psychiatric diagnosis, your treatment plan, and prognosis. In the event of Self-pay, your therapy remains completely private (with the exceptions to confidentiality such as in the event of persistent suicidal ideation, etc.). No reports of your treatment are shared with your insurance and all records remain with the therapist only.
2. Furthermore, the advantage of Self-Pay includes the fact that no records of therapy exist in the Medical Information Bureau.. MIB records of your therapy could potentially compromise your ability to get current or future life, health, disability, or long-term care insurance. Self-Pay, thus, involves no psychiatric diagnosis code. If, however, you were using your insurance benefits, you would have to be assigned a psychiatric diagnosis in order for the provider to justify the medical necessity for the services provided. Once such diagnosis code is recorded by the insurance, it becomes part of your health care record.
3. Since there are certain types of therapy that may not be covered by your insurance, such as relationship or couples therapy or group therapy, and certain modalities of therapy that might not be covered by your insurance, Self-Pay allows you to stay in control of your treatment. Self-pay allows you to also determine the length of your treatment based on your needs rather than on the basis of the allotted session benefits.
CO-PAYS:
If your insurance requires a co-pay, this payment is due at the time of the appointment. I accept cash or check (make checks payable to "Pavel Somov"). I do not accept credit card payments at this office. You may, however, post your co-pay online through my practice website.
I reserve the right to discontinue services if your account is 30 days past due and to forward the following protected health insurance (PHI) to a collection agency if your account is 60 days past due: your name, address, date of birth, your SSN, your phone number, dates of services, and the amount/balance due.
If you paid for the services with a personal check and your check "bounced" because of insufficient funds, an administrative (processing) fee of $30 will be added to your balance. I accept insurance and self-pay.
SELF-PAY RATES/FEES:
$140 per initial assessment (50-55 minutes*)
$120 per 45-50 minutes (standard clinical hour**) of either individual therapy or couples therapy
$150 per extended” 75 minutes of either individual therapy or couple's therapy
$180 per "marathon" sessions of 90 minutes
$60 per 30 minute session (with established clients in need of a follow-up or “booster” sessions)
$ 30 for phone consultations that exceed 5 minutes (and are no greater than 20 minutes)
*corresponds to CPT 90801 (initial evaluation billing code used by insurance companies) ** corresponds to CPT 90806 (a billing code for 45-50 minute long psychotherapy session) Please, note that all rates are subject to change; rates agreed upon at the outset of therapy will remain in effect until the next calendar year. I realize that my fees involve a substantial amount of money, although they are well in line with similar professionals’ charges.
LATE-CANCELLATION/NO-SHOW POLICY:
If you do not show up for your scheduled appointment, and you have not notified Dr. Somova at least 24 "business" hours in advance, you will be charged a no-show fee of $120 (full cost of the clinical hour). Please, refer to the "pay online" page to see available discounts for making timely payments.
Please, note that the reason behind this policy is to protect the provider's time, not to penalize you financially. If you are wondering why you should pay for the services you have not received, please, consider the fact that when you make an appointment with the provider,you are booking the provider's time that is no longer available for scheduling. Your session time is reserved/booked for you. I am rarely able to fill a cancelled session unless I know in advance. If you late-cancel a session or no-show, I will have to charge you for the lost time unless I am able to fill it. Please, note that your insurance will not cover this charge. Please, note that I offer a financial incentive (discount) for prompt credit card (online) payments of late-cancellations and no-shows.
In particular, I provide the following discounts for prompt payment of late-cancellation and no-show charges: If paid within 24 hours: 50% If paid within 48 hours: 25% If paid within 72 hours: 10% Note that this only applies to online/credit card payments. Here’s how this works.If you know you have cancelled late or no-showed and are willing to pay the charge for the missed appointment within the 24 clock hours of your missed appointment, you can discount a total of 50% (e.g. if you missed the initial assessment appointment your late-cancellation/no-show fee is 50% of $140, which is $70; if you have missed the 45-50 minute long session your late-cancellation/no-show fee is 50% of $120 which is $60, and so and so forth).If you were unable to pay the late-cancellation/no-show fee within the 24 clock hours of your missed appointment, but are willing to pay the fee within 48 clock hours of the missed appointment, your discount is 25% (which would translate into $105 for the missed initial assessment, and $90 for the missed regular length psychotherapy appointment).If you are willing to pay the late-cancellation/no-show fee within 72 clock hours of the missed appointment, your discount is 10%.You do the math!
Administrative Costs
If a third party (whatever that might be: another provider, a lawyer, etc.) requests a copy of your treatment records, such notification, to be completed in time, would have to be made 5 work days in advance. A minimal $25 administrative fee will apply (for time, processing, and copying). Please, note that if a third party requests a copy of your treatment records, faxed releases of information signed by you will not be accepted. Dr. Somova will require the original release/consent to release information from you.
These administrative/copying fees will not apply in the situation in which, with your consent, Dr. Somov will share clinical documentation with other health related providers (such as your PCP) in order to provide continuity of care.
Court-Mandated/Employer-Mandated Documentation & Disability Documentation:
Documentation (reports/letters of evaluation and recommendations) for court-mandated, employer-mandated and disability (FMLA, etc.) will be billed at a $150 per hour. Please, note that a minimum of 1 hour will be charged (for chart/data review and documentation).On-site depositions (taken at Dr. Somov's office) will incur the fee of $300 per hour. Off-site depositions will be billed at $400 per hour with a minimum of 2.5 hours, and at $300-per-hour rate for any additional time.