Payment and Insurance

Everyone should have access to mental healthcare

 

Part of Seleni’s mission is to provide accessible, specialized psychotherapy that is covered by insurance. We understand that insurance can be complicated, and we’re here to help you navigate that process.

 

In-Network

A select number of our clinicians are in-network with the following insurance plans:

  • Anthem Blue Cross Blue Shield

  • Empire Blue Cross Blue Shield (all states)

 

Out-of-Network

If you do not have Blue Cross Blue Shield, our providers are considered out-of-network. The fee for out-of-network sessions starts at $300. If you see your insurance company on the following list, we can submit an out-of-network claim on your behalf.

  • Aetna

  • Cigna

  • Emblem Health/GHI

  • United Healthcare

  • Oxford

Since every plan is unique, we are unable to check reimbursement rates and plan benefits. We encourage you to call the member services phone number on the back of your insurance card. If you are unsure of the questions to ask, don’t worry! We explain the entire process and define useful terms in our Frequently Asked Questions below.

 

No Insurance?

We strive to make psychotherapy accessible and affordable and recognize that insurance is not always an option. Therefore, we offer a sliding scale to qualifying individuals. Sliding scale rates are re-evaluated every six months. Please contact reception@seleni.org for more information.

Cancellation & No-show Policy

Our goal is to provide quality, individualized, consistent care in a timely manner. No-shows, late shows, and cancellations inconvenience both patients and clinicians.

If you are unable to show up for a scheduled appointment, we require that you cancel at least 24 hours in advance. Please call the Seleni Institute office promptly if it is necessary to cancel your appointment.

  • Late Cancellations: A cancellation is considered late when the appointment is cancelled without notice 24 hours in advance.

  • No Show Policy: A “no-show” is a patient who misses an appointment without cancelling it. A failure to be present at the time of a scheduled appointment will be recorded as a “no-show”. When a Late Cancellation or “No Show” occurs, patients will be charged a cancellation fee, up the full fee of the visit. Charges will be determined based on the patient’s insurance and payment plan.

 

Frequently Asked Questions

  • Unfortunately, since we are out-of-network, we are unable to retrieve any benefit information from your plan. You will need to contact the Member Services number located on the back of your insurance card.

  • We suggest explaining that you would like to speak with someone involved in out-of-network mental health benefits, and that you’re interested in learning the reimbursement rate for therapy services. The procedural, or “CPT” codes we use are 90791 (the first appointment), 90834 (all other appointments thereafter) and 90847 (couples therapy). Our facility Tax ID is 462331896.

  • This means that your deductible must be met before you can be reimbursed for any sessions. For example, if your deductible is $1,000, and your insurance applies $200 towards your deductible after each session (the “allowable amount”), you will not be reimbursed until you’ve had 5 sessions.

  • Submitting an out-of-network claim works in a few simple steps:

    We collect the session fee at your appointment time.

    After your session, we automatically submit the claim for you.

    Your insurance company reviews the claim and determines whether you qualify for reimbursement.

    Your insurance company sends the reimbursement directly to you.

  • The “allowable amount” is what your insurance plan determines as customary for the cost of the session. Let’s say your clinician has a rate of $300 per session, and you submit the claim to your insurance. Let’s also assume your plan reimburses at 70% (30% coinsurance). Upon review of the claim, your insurance plan can determine that the allowable amount for sessions is actually less than you paid for the session (for example, $200). So, in that case, you would be reimbursed 70% of $200 (not $300).

  • Coinsurance is the amount you are responsible for. In other words, your plan will reimburse you 70% of the allowable amount. If you have 40% coinsurance, your plan will reimburse you 60% of the allowable amount, and so on.

  • By using our insurance worksheet, which you can download at any time. If you still have questions, we’re happy to review everything with you. We know that understanding benefits can be an intricate maze!