Fees and Policies
I offer several different services, based upon your needs,
goals, and current situation. To be absolutely sure you get the correct
information about cost, please contact Dr. Chester to
discuss your needs.
Fees are payable at the time of service. If you choose to
utilize your insurance coverage, my office manager Beth, will be happy to assist
you in the filing process.
In general I would be considered an "out of network" provider.
You may be reimbursed for some amount of your fee although each insurance
company contracts differently with its client organizations. Please read my
thoughts about why I choose not to be on Managed Care plans as a general rule.
Why I chose not to accept Managed Care Reimbursement for Mental Health
Lack of Confidentiality:
All managed care plans (MCP's) involve direct clinical management by the plan's
case managers. If you access therapy through your MCP, it can make it necessary
for your therapist to disclose information related to your case to gain
additional sessions. For some plans, you may have an "assessment session" and
the therapist gives a comprehensive review of your problem(s), medications you
may be on, current family and work situation/history, along with the likelihood
that you may become aggressive toward others or harm yourself.
This information is used by the MCP to determine benefits, which they allocate
at their discretion. This impacts your confidentiality; your information is
stored in ways that allow access by other case managers that are employed by the MCP.
Difficulty in Getting Treatment Authorized
Due to the direct care management by MCP's and their desire to keep costs to a
minimum, getting therapy sessions approved often becomes quite cumbersome and
time consuming. Every plan has different requirements and standards for
authorizations. Phone calls to and paperwork required by the MCP in order to get
initial authorizations and receive additional sessions can be frustrating for
both the therapist and client.
Additionally, MCP's allow a certain number of sessions per year for each plan.
Many plans allow 20 sessions per calander year and you may have to "share" those
sessions with another mental health professional - a psychiatrist for example.
Unless the client is in severe distress, and this can be proven in some
way, then coming to therapy once a week is the acceptable standard. If you
as the client felt that it would be beneficial to come twice a week to work
through an issue more quickly, the MCP would still pay for only one visit
per week. You and your therapist are not in control of your case - your MCP
MCP's Decide Who Gets To Go To Therapy
The vast majority of MCP's do not pay for marital therapy or for
family therapy. With marriages and families experiencing unprecedented stressors
and challenges, this policy seems out of touch with today's needs. However,
under a typical MCP, only individual therapy is recognized and authorized.
Under this policy, members of the family or couple are then seen individually
with only a few minutes of mutual consultation or discussion at the beginning or
end of the session. The person with "the problem" is the one given the diagnosis
and therapy; insurance is then filed on them. This policy by MCP's is
unfortunate, since much of the crushing stress in the lives of healthy
individuals is the result of poor interactions in their relationships, and are
most effectively dealt with within that framework.
Misdiagnosing and/or overdiagnosing in order to get treatment authorized
Many MCP's will not cover treatment unless it is a "medical necessity." For
example, most MCP's will not allow a diagnosis of Parent-Child Relational
Problem. The therapist then may diagnosis that person with some type of anxiety
or depressive disorder so that the sessions can be covered. Work related
problems which may be boss or co-worker related fall into this category as well.
I don't believe that the client should be given a mental illness diagnosis that
is not correct or that is more serious than what is true simply to get treatment
paid by the MCP.
Dr. Chester | Counseling
Services | Professional
Services | Fees
5949 Sherry Lane, Suite 825
Dallas, Texas 75225