Private Pay

Hearth Consulting and Consulting PLLC is pleased to accept private pay for clients who wish to pay for their health services out-of-pocket. We are both a private pay and insurance practice, and most of our clients use their insurance for therapy services or utilize out-of-network benefits. Our out-of-pocket fees vary by service. Please see your preferred provider’s summary page for specifics on insurance and out-of-network.

Here are some of the benefits that come with utilizing private pay:

•You choose the clinician best suited to your needs rather than the insurance company telling you who to see.

•No insurance equals less documentation. This results in more quality time to focus on care.

•Mental health diagnosis is not mandatory and not submitted to your private health records.

•No limit on number of sessions or time of your session.

•You are guaranteed privacy and confidentiality.

•Private pay clients can choose the focus, duration, and frequency of care. You are even allowed to choose the length of sessions.

•Insurance premiums and life insurance policies will not increase based on mental health diagnoses and treatments.

•You will be able to stay with your provider even if your insurance plan coverage changes.

In-Network Insurance

Most providers are in-network with some insurance, while other clinicians only accept private pay and out-of-network benefits. Accepted insurances include BCBS, Aetna, and United Healthcare. If we do not accept your insurance, you may be eligible for out-of-network (OON) benefits; we can provide you with a "Super Bill" to submit to your insurance plan for reimbursement purposes. It is not that using insurance for services is only for North Carolina residents, and all over the states are OON.

We are not in the network with the following plans:

Blue Home w/ UNC Health Alliance

Healthy Blue

Blue Home

Blue Local

Blue Local (Atrium)

Using Out-Of-Network Insurance

Suppose you want the same control and privacy that come with using private pay but would like to utilize your insurance provider. In that case, you can pursue care using your out-of-network insurance benefits. We provide you with a receipt or superbill and documentation to submit to your insurance carrier for reimbursement. Your health insurance or employee benefit plan may cover services in full or in part. If you intend to request reimbursement from your insurance company, please notify us so we can ensure proper documentation.

Each insurance plan offers different benefits, so please check your specific coverage for details. You can inquire about your insurance by asking these questions:

• Do I have mental health insurance benefits?

• What is my deductible, and has it been met?

• How many sessions per year does my health insurance cover?

• What is the coverage amount per session?

• Is approval required from my primary care physician?

Fees For Therapy

Individual initial assessment/intake (psychiatric diagnostic evaluation); required for all initial (new) clients and returning clients after six months: $190 (60 minutes)

Individual psychotherapy follow-up session: $175 (53 minutes)

Individual psychotherapy follow-up session $160 (45-minute)

Couples initial assessment/intake; required for all new couples and returning couples after six months: $215 (60 minutes)

Couples psychotherapy follow-up session: $200 (60 minutes)

Couples psychotherapy follow-up session: $265 (90 minutes)

Fees For Medication Management

Psychiatric care new patient evaluation: Adult $250 / Child $300

Psychiatric care follow-up session: (30 mins) $200

Psychiatric care follow-up session: (15 mins) $150

No-show/late cancellation (within 48 hours of the scheduled appointment day/time) has a flat-rate fee of $120

Notice

As of January 2022, you have the right to receive a “Good Faith Estimate” (GFE) explaining how much your medical care will cost. Under a new law, healthcare providers are required to provide patients who either do not have or who are not using health insurance an estimate of the bill for medical items and services. You have the right to receive a GFE for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. This estimate should be received in writing before your medical service or appointment. You can also ask your healthcare provider for a Good Faith Estimate before you schedule an appointment or service.

See link: https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/no-surprises-act

Payment Method

We accept all major credit cards, and HSA can be used via Simple Practice, a secure health and medical record system. The credit card on file via Simple Practice will be charged for co-pays, out-of-pocket expenses such as no-shows or late cancellations (within 48 hours of appointment time), and full session fees for private pay clients. Payment is due at the time of service. 

Late Cancellations & Missed Sessions

If you are unable to keep your appointment, don't hesitate to contact your provider as soon as possible to cancel or reschedule your session. We kindly ask that you provide a minimum of 48 hours' notice if you want to cancel your appointment. If you do not attend your scheduled session and have not notified your clinician within 48 hours of the appointment time, you will be charged the flat rate fee.

Please note that insurance does not cover no-show or late cancellation fees.