Thank you for choosing SamaraCare as your mental health care provider. Please read our Financial Policy carefully as it explains important information about our services and your responsibilities, as a client. SamaraCare’s fees are competitive within our service territory.

All office (in-person) or virtual (teletherapy) counseling and psychiatric sessions are by appointment only. Each therapist keeps their own appointment schedule and makes appointments directly with their clients. To schedule an appointment with one of our psychiatrists or psychiatric mental health nurse practitioner, call our Clinical Intake Coordinators at 630-541-8930 or send an email to [email protected].

Please note: All fees stated below may be subject to change and a few exceptions may apply. Please check with our Business Office for exceptions or fees related to a specific counselor. Our rate for counseling sessions is $185 per counseling hour.

• Intake sessions: $235
• Subsequent therapeutic/counseling sessions: (45-53 minutes), $185 per session
• Testing, Assessment and Consulting/Observation Services:  $185 per hour

• Intake session: $400
• Subsequent sessions: $125 – $440, depending on complexity and duration range

All clients are expected to attend every scheduled session on time. Cancelled or late appointments delay treatment. Since appointments involve time reserved for a specific client, and out of respect for our therapists, doctors and psychiatric mental health nurse practitioner, and other clients, a minimum of 24 hours-notice is required for rescheduling or canceling an appointment, except in the case of a serious or contagious illness or an emergency. We appreciate more than 24 hours-notice when possible, so we can make that time available to other clients. If 24 hours advance notice is not given, the client will incur a late cancellation fee for the full amount of the appointment. Frequent cancellations (3 or more in 6 months or 2 consecutive) and/or missed appointments (no show) may result in the termination of all services.

Please note: insurance companies do not provide reimbursement for missed appointments or late cancellation charges.

Also, fee subsidy assistance will not be applied to missed or late cancellation charges. Therefore, costs associated with a missed appointment or late cancellation will be the responsibility of the client, and in accordance with our fee schedule. Lastly, sliding fee scale rates and any discounted fees do not apply and are not relevant to missed or late cancellation charges.

24-hour Notice for Appointment Cancellation:
In order to avoid paying a late cancellation fee, please do the following:

• Contact your therapist directly or your psychiatrist, or psychiatric mental health nurse practitioner as previously directed or call our Business Office at 630 357-2456 at least 24 hours in advance of the appointment to cancel an appointment and reschedule. If you reach voice mail, please leave a message.
• Cancellations left on voicemail after business hours will be considered received as of the next business day.
• Monday appointments need to be cancelled on the Friday before the scheduled appointment.

• If a check is returned to SamaraCare for insufficient funds, a $35 fee will be charged to the respective client.
• Requests for medical records will be charged at $25 per request
• There are client fees for phone calls and letters made by the psychiatrists or psychiatric nurse practitioner. Additional information about these fees is available upon request.

Payment is due at the time services are rendered unless special arrangements have been made in advance with the Business Office to carry an account balance. Payments may be made using cash, checks, credit or debit cards.

• In-network insurance or other third-party payment: Clients are responsible for co-pays, co-insurance, and contract deductibles at the time of service.
• Self-pay (not utilizing any health insurance coverage): Clients are responsible to pay any and all fees in full at the time of service unless a payment plan has been previously arranged.
• Fee assistance (Mental Health Access Program): Clients are responsible to pay the client portion of the sliding fee scale payment at the time of service.
• Medicare benefits: Clients are responsible for all treatment fees that Medicare or other secondary insurance does not pay for.

Except in the case of minors or when other arrangements are made, the person receiving the counseling services is financially liable.

Credit Card Information on File:
When scheduling a first appointment, clients will be asked to provide credit card information which may be used for payment of fees incurred for counseling/psychiatric sessions, co-pays, co-insurance, deductibles, sliding fee scale payments, late cancellations, missed appointments, returned checks, and/or past due balances.

Outstanding Balances:
If at any time, a client account balance is greater than $250, SamaraCare requires a payment plan agreement be put in place and adhered to in order to continue to receive any and all services. SamaraCare reserves the right to deny services until accounts are paid in full.

Past Due Accounts:
Accounts with no payment activity or those with previous payment arrangements that are not being adhered to will be considered past due after 30 days, after which the client will be unable to schedule appointments until all outstanding monies are received. SamaraCare reserves the right to pursue other remedies, including but not limited to collection agencies, in the event of a failure to pay fees.

Credit balances will be applied to future fees incurred for clients continuing to receive services. Account overpayments will be refunded within 6 months after termination of services.

We currently participate in several insurance plans (Blue Cross Blue Shield, Aetna, United Health Care and Medicare). If you are not insured by a plan in which we participate, payment in full is expected at the time of each visit. If you are insured by a plan we do business with, but do not have an up-to-date insurance card, payment in full is expected at the time of each visit until your coverage is verified. Clients should contact their insurance provider with any questions about their coverage. Claims not paid by an insurance provider will be the sole responsibility of the client.

Insured clients are responsible for the client portion of SamaraCare’s fees as indicated by their insurance company benefit plan and explanation of benefits (EOB). Please note that the balance of any claim is the responsibility of the client whether or not the client’s insurance company pays the claim. Insurance benefits are a contract between the insured and the insurance company, SamaraCare is not a party to that contract.

Psychotherapy/Counseling:
We are currently a contracted provider in PPO insurance plans with Blue Cross Blue Shield, Aetna, UnitedHealth Care, and Medicare. We do not accept HMO or Medicaid insurance plans. If your insurance provider is not listed, please contact our Business Office at 630 357-2456.

Psychiatry:
We are currently a contracted provider in PPO insurance plans with Blue Cross Blue Shield. Our psychiatrists do not accept any other insurance plans. Our Psychiatric Nurse Practitioner accepts Aetna PPO, Blue Cross Blue Shield PPO, UnitedHealth Care PPO, and Medicare.

Co-Pays and Deductibles:
All co-payments and deductibles must be paid at the time of service. This arrangement is part of a client’s contract with their insurance company. SamaraCare will provide an estimate of what the co-pay should be for each visit. However, clients should be aware that under many policies, the co-pay may change during the course of treatment and insurance plans change without notifying providers. The only way SamaraCare can confirm exactly what a co-pay should have been is by reviewing the materials sent to us from the insurance company after the session is billed and paid. Clients should receive a copy of an Explanation of Benefits (EOB) from their insurance company. If a co-pay was higher than what was collected, the client is responsible for paying the difference. If it should have been lower, SamaraCare will issue a credit.

Verification of Insurance Coverage:
SamaraCare will try to verify a client’s financial responsibility with their insurance provider. However, we do not guarantee insurance coverage or payment by the insurance company. Therefore, any and all charges incurred are ultimately the client’s responsibility.

In-Network/Out-of-Network:
It is the client’s responsibility to confirm whether or not SamaraCare is in network with their insurance. If a client uses out-of-network benefits, some reimbursement from their insurance provider may be available. Clients using out-of-network benefits, should contact our Business Office for additional information. If SamaraCare is out-of-network for a client who does not have out-of-network benefits, the client is responsible for our full fee and all fees incurred.

Change in Insurance Status:
If a client acquires, loses, or has a change in insurance coverage they are required to inform SamaraCare immediately.

Exhaustion of Mental Health Benefits:
Clients who have exhausted their mental health benefits may still qualify for a reduced fee based on their household income and size. However, eligibility for a reduced fee will be discontinued at the time of the renewal of their insurance plan year.

No or Limited Behavioral Health Insurance:
Clients who are uninsured, underinsured, or facing financial hardships, may apply for reduced fees through our Mental Health Access Program (MHAP). Those applying for financial assistance from the MHAP are required to provide documentation to establish eligibility for reduced cost care prior to their in-take session. Once clients have qualified for the MHAP, and the client fee has been communicated and agreed to by both the client and care provider, a client may make their first appointment. Clients are required to renew eligibility annually or whenever there’s a significant change in their financial circumstances.

1/1/24