Insurance Matters

To offer the highest quality mental health care possible, we are Out-of-Network Providers, for all insurance companies.

Payment is due at the time of Service of each Individual or Family Therapy session. Groups are paid as monthly “tuition”.

You may call your insurance company to inquire about your Out-of-Network Outpatient Mental Health Benefits. This information will help you determine how much you will be reimbursed for your care at the Resilience Therapy Collaborative.

When you call your insurance company to get information about your Out-of-Network Benefits, be sure to ask what your Annual Deductible is, and if it has been met for this calendar year. Ask about the percentage your plan will reimburse you for each mental health visit, such as 80% or 70%, etc, after your Deductible has been met.

The CPT codes of treatment services that we most typically
provide are:

Initial Consultation, CPT #90791;
Individual Psychotherapy, CPT# 90834/90837;
Group Psychotherapy CPT #90853;
Multi-Family Group Psychotherapy, CPT#90849;
Family Therapy CPT# 90847/90846

You are not responsible for your Reserved Individual or Family Therapy session when:

• You give us 48 hours notice
• You have a serious individual or family medical emergency
• There are hazardous road conditions

Resilience DBT Skills & Eating Recovery Skills Groups are paid as monthly “Tuition”. Cancellation does not apply.

Fee Schedule

Our Consultation and Treatment Fees for this Calendar Year,
are furnished upon request.

Effective January 1, 2022, a ruling went into effect called the “No Surprises Act” which requires practitioners to provider a “Good Faith Estimate” about Out-of-Network care. The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your health care needs for an item or service, a diagnosis, and a reason for therapy. The estimate is based on information known at the time the estimate was created.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur and will be provided a new “Good Faith Estimate” should this occur. You’re getting this notice because this provider or facility, Resilience Therapy Collaborative, LLC,  is  not  in your health plan’s network and is considered out-of-network services.  This means the provider or facility does not have an agreement with your plan to provide mental health services. You have right to the access your In-Network benefits if you are concerned that receiving mental health care from this provider or facility, could cost you more than utilizing your In-Network insurance benefits.

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” (GFE) of expected charges. The GFE shows the costs of items and services that are reasonably expected for services provided by facility. The estimate is based on information known at the time the estimate was created. The GFE does not take into account any reimbursement that you may receive as a result of submitting your insurance claims to your Out of Network Benefits. The GFE does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. An updated Good Faith Estimate will be provided.

Surprise Billing Protection Form

This document describes your protections against unexpected medical bills. It also asks if you’d like to give up those protections and pay more for out-of-network care. IMPORTANT: You aren’t required to sign this form and shouldn’t sign it if you would prefer to use services with an In-Network provider for your care. You can choose to get care from a provider or facility in your health plan’s network, which may cost you less.

Prior to the onset of service, contact your health insurance plan to discuss your potential out-of-network mental health benefits, including your deductible and co-insurance. If you have charges you did not expect,  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 not have to pay the price on this 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 and get a form to start the process, go to www.cms.gov/nosurprises or call 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 800-985-3059.

Resilience DBT & Eating Recovery
Resilience Therapy Collaborative, LLC
33 Plymouth Street, Suite 105
Montclair, NJ 07042
( PHONE) 973-783-2292 (FAX) 973-216-8003
EIN # 852-710-726
NPI # 1548854326