Insurance and Cost

River of Hope desires to minimize financial limitations to treatment by being in network with multiple commercial insurance companies, Medicaid, Medicare, and state funded services to provide everyone the mental health and substance use treatment they need. Each Provider is in network with different insurance companies.

Marisa Isbell is in Network with the following insurance companies:

Blue Cross Blue Shield of NC/Anthem

Vaya Medicaid

HealthyBlue Medicaid

Amerihealth Caritas Medicaid

Medicare

United Healthcare and Optum

United Medicare Advantage Plans

Medicare/Medicaid Combination

Cigna

Aetna

Carolina Complete Health (medicaid)

Ambetter

Carolina Behavioral Health Alliance (CBHA)

Wellcare Medicaid

State funded services for patient's without insurance

Rachel Chu is in network with the following Insurance Companies:

Blue Cross Blue Shield of NC/Anthem

Aetna

Cigna

Vaya Medicaid

Healthyblue Medicaid

Amerihealth Caritas Medicaid

Wellcare Medicaid

Medcost

State funded services for patient's without insurance

Rachel Chu is pending credentialing with the following insurance companies:

Medicare

Tricare

Merinda Cutshaw is in Network with the Following Insurance Companies:

Blue Cross Blue Shield of NC/Anthem

Aetna

United Healthcare

Cigna

Medcost

Vaya Medicaid

HealthyBlue Medicaid

Amerihealth Cartias Medicaid

United Community Plan (United Medicaid)

Wellcare Medicaid

State funded individual therapy and group therapy (excluding SAIOP) for patient's without insurance.

Merinda is pending with the Following Insurance Companies:

Medicare

Tricare

Substance Abuse Intensive Outpatient Program (SAIOP) is in network with the following insurances:

United Health Care/Optum

Vaya Medicaid

Substance Abuse Intensive Outpatient Program (SAIOP) is pending credentialing with the following insurance companies:

Aetna

Cash Pay Rates:

Psychiatric Medication Management Fees:

Initial psychiatric evaluation (~60 minutes) : $300

Follow up (~30 minutes): $200

Therapy Fees:

Initial Individual Session: $ 175

Individual Therapy: $150 for 60 minute session

Couples Counseling: $225 for 90 minute session

** Please note Couples Counseling is not covered by insurance, as there is no billing code for couple’s therapy and there is no use of diagnosis.

Good Faith Estimate

Beginning 01/01/2022, health care providers are required by law to give uninsured and self-pay clients a Good Faith Estimate (GFE) of costs for services that they offer, when scheduling care or when the patient requests an estimate.

A good faith estimate (GFE) is a document that outlines the estimated costs and terms of receiving services from a healthcare provider. This enables clients the opportunity to compare pricing among different providers by giving detailed information regarding services and costs of services received at each provider’s location. The costs noted on the Good Faith Estimate are estimates based on service pricing at the time the estimate is given. The final costs for services may be higher based on when the services are provided and the duration of the services. If this happens, federal law allows you to dispute (appeal) the bill.

The Good Faith Estimate is not a contract. Which means you are not required to obtain the items or services provided by Your River of Hope listed in the Good Faith Estimate.

You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, 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 the Good Faith Estimate. 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 more about disputes and get a form to start the process, go to www.cms.gov/nosurprises or call 1-800-985-3059.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 1-800-985-3059.

Alexa Young, CA