Dragonfly Peak Counseling
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Pricing and Service Information

Counseling Services without Insurance for Fully Licensed Counselor (LPC)

  • Individual Service 50 - 60 minute counseling session: $125
    • Includes: Play Therapy, Filial Therapy, Parent Consult, Sandtray Therapy, EMDR Session, and Activity Therapy 
  • Group Therapy 50-60 minute session : $45
  • Crisis Session or Intensive EMDR Session 90 minute or longer: $150
  • Phone consultation lasting longer than 30 minutes will be billed for $50 per half hour. This also includes any time spent answering text messages or e-mails sent by clients outside of regular appointment times.
  • Late fees will be charged for no shows, and cancellations made less than 24 hours notice. 
  • We can provide a super bill for insurance purposes if we do not accept your insurance at this time so that you may receive some reimbursement from your current insurance.

Counseling Services for Counseling Associates (LPC Associates)

  • ​Individual Service 50 - 60 minute counseling session: $90
  • Sliding scale services are available based on income and are available upon request. Please let your counselor know if you are interested.
  • Couples/ Family Counseling 60-90 minute sessions : $100
  • Phone consultation lasting longer than 30 minutes will be billed for $25 per half hour. This also includes any time spent answering text messages or e-mails sent by clients outside of regular appointment times.
  • Late fees will be charged for no shows, and cancellations made less than 24 hours notice. ​

Insurance Accepted

  • Tricare East
  • Blue Cross Blue Shield
  • Cigna  
  • United Healthcare
  • Oxford
  • Oscar Health 
  • Aetna     

Notice Of Privacy Practices

privacy_practices_2017.pdf
File Size: 112 kb
File Type: pdf
Download File

Good Faith Estimate

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
​
(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)? 
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs,     such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
 
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
 
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:
Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable  condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
 
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections  not to be balance billed.
 
If you get other services at these in-network facilities, out-of-network providers can’t balance  bill you unless you give written consent and give up your protections.
 
You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
 
When balance billing isn’t allowed, you also have the following  protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
 
If you believe you’ve been wrongly billed, you may contact:
Texas Behavioral Health Executive  Council (800) 821- 3205 for Texas Clients 
Colorado Consumer Health Initiative (800) 222-4444 for Colorado Clients
The Indiana Department of Insurance (800) 622- 4461 for Indiana Clients
 
Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.


Jacqueline Jayde Young                                                                Sydney Bowen
 [email protected]                                            [email protected]
  682-231-3857                                                                                             817-235-0335
© COPYRIGHT 2015. ALL RIGHTS RESERVED.
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