Out of Network Care: I also treat many patients as an Out of Network provider. You can check with your health insurance to see if you have out of network benefits and if so, you can see what your copays and deductibles are as well as any Prior Authorizations that are required for Out of Network care.
WILL MY INSURANCE COVER MY VISIT?
Services are provided with the understanding that you (not an insurance company) are ultimately responsible for the cost of your treatment. Insurance plans vary and not all services may be covered. Even if that provider is "In-Network" with your insurance company this does not guarantee that your specific plan provides benefits for our services. It is also important to verify with your specific plan that we are in-network as they sometimes outsource to a third party for mental health services. Coverages can change at any time even with in-network plans.
You are responsible for knowing what services are covered by your particular plan as well as if our services will be in network, please check with your plan by calling the number on the back of your card before your appointment (please see the answer to the following question for what to ask when you call). If your need prior authorization for services, this must be completed before you are scheduled.
We are not in network and are unable to bill Medicaid (OHP) or Medicare. Please note that they will not cover any services provided by out-of-network providers.
WHAT QUESTIONS SHOULD I ASK MY INSURANCE WHEN I CALL?
1. Is Lesley Arle, PMHNP considered an in network provider? If so, ask them about your "In-Network Benefits."
2. What is the co-pay amount or co-insurance percentage specifically for 'outpatient mental health office visits'? (Copays are sometimes a fixed amount or they may also be a co-insurance which is a percentage of what is billed. Please be sure to verify your patient responsibility with your insurance to avoid any surprises. It is your responsibility to know and to pay your co-pay, co-insurance, or deductible at the time of your visit. Your insurance company will still be billed to validate your copay or deductible. Any amount not covered by your insurance will be billed to you. )
3. What is the annual deductible and how much has been met?
4. Are there limitations on the number of outpatient mental health visits covered?
MY INSURANCE IS OUT OF NETWORK, CAN I STILL START THE INTAKE PAPERWORK?
Yes, but if you would like to find a preferred provider in network with your plan, please contact the customer service number on the back of your insurance card. They can provide you a list of in-network providers in your area so that you can use your full benefits.
If you do not have an insurance plan or are not currently working, you may sign for OHP / Medicaid or contact the Salem Free Mental Health Clinic at (503) 990-8772.
DO YOU TAKE PRIVATE PAY / CASH?
Unfortunately at this time we are not accepting private pay / cash patients, but we will in the future on a limited basis. Oregon Health Plan and Salem Free Mental Health Clinic are able to see patients on a very low cost basis.
DO YOU OFFER FINANCING OPTIONS?
Unfortunately at this time our office does not offer payment plans. Your patient responsibility is always due at the time of service.
Other Important Information:
Prior approval (if required) from your insurance company must be completed before your visit. Please call your insurance company to help determine your coverage as well as your deductible.