Fees, Billing & Insurance
Fees for Service
50-55 min
APPOINTMENT
$160
90 min
APPOINTMENT
$240
90 min
GROUP THERAPY APPOINTMENT
$50
(Your individual therapist may offer another fee structure than the one listed above. You will receive written documentation of this alternative fee structure if available.)
Tandem Columbus provides reduced fee services for 20-30% of our clients on a weekly basis. Reduced fee services are generally reserved for those without insurance; those with Medicaid, Medicare, or Marketplace (Obamacare) coverage; or, for those who do not have access to mental health benefits through an employer or family-based insurance plan. If you receive Medicaid, you should know that therapy services are covered by Medicaid at many locations in Ohio. Your services will not be covered here at Tandem Columbus and we will not submit a claim on your behalf. If you need a referral to in-network Medicaid providers, please let us know.
We additionally will attempt to work on a “Solidarity Scale” ($30-$100) based on expressed need for anyone who identifies with one of these experiences:
Trans, Non-binary, and Gender Expansive people
Black and Indigenous people
Migrants, and/or 1st and 2nd Gen
Sex workers
Artist-Activists
Mental health workers in community settings
Recently incarcerated
Persons living with multiple disabilities, or persons with already high medical costs due to chronic illness
There are times when reduced fee services may be negotiated with clients who would experience a great financial strain by utilizing our services due to already high medical costs within the household.
Though we cannot guarantee we will be able to provide reduced fee services upon request, we will make every attempt to get you connected with a provider who is able to meet your financial needs when requested.
All reduced fee services will be documented in writing. We strongly encourage clients who feel comfortable requesting reduced fee services to step back by allowing someone else that opportunity, and for those who could greatly benefit but rarely ask to speak up.
Billing & Insurance
As an organization, we do not contract with insurance groups and are unable to bill most insurance groups on your behalf. Every therapist at Tandem Columbus should be considered an "out-of-network" provider, unless otherwise stated by your individual therapist. It is important to know that you may pay a higher cost for our services compared to services with an in-network provider outside of Tandem.
We will gladly provide referrals to an in-network provider outside of Tandem if you decide another billing agreement will better fit your needs.
There are many reasons why we do not contract with insurance groups:
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Unfortunately, most people do not have access to adequate mental health benefits–even those who are paying high insurance costs. We know that all insurance plans are not equal. To help address inequities in the current health system, Tandem charges an independent rate to avoid privileging those who can afford more comprehensive insurance plans over others, and to help accommodate folks experiencing financial strain. By charging our full service fee, we are able to provide sliding scale fee services to 20-30% of our caseload for folks experiencing financial hardship; folks without insurance; and folks who are unable to afford the cost of counseling out-of-pocket.
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Many insurance groups do not adequately cover relationship, family, or group therapy despite the research demonstrating support for each of these approaches to therapy. Additionally, most insurance groups restrict coverage for sexual health issues and often will deny treatment.
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Many individuals and families have high deductible plans that require them to pay out-of-pocket for these services as they would without insurance coverage. Some individuals/families spend the year working towards paying off a deductible and never experience the benefits of "in-network" coverage. We have also found that some insurance groups reimburse the member (you) for out-of-network services more than they would reimburse for in-network services, putting more money back in your pocket.
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Insurance groups require therapists to diagnose their client with a mental health disorder to reimburse for counseling services. While we believe diagnosis can benefit those who are experiencing a mental health disorder by ensuring resources and access to care, we also believe counseling can benefit those who do not meet the requirements of a mental health diagnosis. By providing counseling to folks who are not experiencing mental illness, we can reduce the possibility of experiencing mental illness over the life course. We believe everyone should have access to counseling, whether they are in a crisis; managing a long-term mental health condition; seeking to strengthen their relationships; or are otherwise feeling well and looking for feedback, perspective, and insight to support new goals.
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Insurance companies have access to all of your medical records, including diagnoses, medical notes, and personal history. When contracting with insurance companies, we cannot guarantee the confidentiality of your protected health information.
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Insurance companies control the number, length and frequency of therapy sessions, and restrict the therapist’s ability to negotiate fees and payment. We firmly believe you and your provider are best suited to make all of these decisions together. Additionally, we are able to provide more flexibility in regard to scheduling, rescheduling, and cancellations by refusing insurance contracts and remaining "out-of-network".
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Contracting with insurance companies costs us lots of time, money, and frustration--sometimes without any benefit to you. Rather than prioritizing our relationship with insurance groups, we would much rather spend our time getting to know you and providing you with an excellent counseling experience.
Applying your insurance benefits
If you choose to use your insurance plan to offset the cost for counseling services at Tandem, most people will need to have insurance coverage that includes "out-of-network" benefits ("out-of-network" insurance benefits are not usually available through the marketplace/"Obamacare", or most HMO policies). It is important to know: Most insurance groups require a diagnosis to reimburse for counseling services. If you plan to use your out-of-network benefits, you and your provider will need to discuss the documentation of a clinical diagnosis at the start of your work together. Please note: if you are working with a pre-licensed intern or trainee at Tandem Columbus, your services are unlikely to be covered by your insurance in- or out-of-network.
To assist clients in obtaining the most accurate information on expected costs of services when applying insurance benefits, we recommend asking the following questions when contacting your insurance company’s member services (the phone number for member services can typically be found on the back of your insurance card):
1. Is psychotherapy/outpatient mental health care covered under my plan?
2. Is telehealth covered? (If applicable)
3. Do I have a deductible that I have to meet? What is my deductible?
4. What is my coinsurance or copay for outpatient mental health therapy sessions?
5. Is there a limit to the number of sessions I can receive on an annual basis?
6. Can I petition to receive a “single-case agreement” to have my sessions at Tandem covered at an in-network rate?
Payments
Payment in-full is due at the time of your counseling appointment. Your credit/debit/HSA/FSA card on file will be charged unless you notify your therapist of another form of payment.
We will work with you to try and ensure employee benefits, or other insurance benefits can be utilized.
