LIFE SYNERGY WELLNESS

Insurance (Questions to ask your insurance company)

Services may be covered in full or in part by your health insurance or employee benefit plan. Please check your coverage carefully by calling your insurance company and asking the following questions immediately after our first phone consult : (Call me back after to speak with your insurance company so we can determine your fees)

  • Does my insurance cover Out of Network mental health services CPT code 90791 and 90837?

  • What is my deductible and has it been met for the year?

  • How many sessions per year does my health insurance cover?

  • What % is my coinsurance responsibility and how much % does the insurance cover after the deductible has been met?

  • Do I need any prior authorization?

  • What is your electronic payor ID and address for the claims?

Please submit Insurance Information - Form* after you obtain answers to the questions listed above from your insurance company. (*Download the forms and send them to me over email: gpatelcounseling@gmail.com). Depending on your insurance company, also "authorize" me and put me on your file to speak to them so I can call them for further information if needed to avoid any delays. Call me back after you speak with your insurance so we can determine your fees. 

 

Accepted Insurances:

I do not participate in any insurance panels but out-of-network benefits will cover my services - 

(*Insurance coverage depends on your plan and deductible, please check will your insurance prior to 1st appointment by asking the questions listed above)

Instructions prior to 1st Intake Session

Self Pay Clients - 

  1. After our initial phone consult please fill out the Adult Psychotherapy Intake Form* or or Child/Youth Psychotherapy Intake Form and submit it online. 

  2. You will be signing the HIPAA form, Informed consent form, and Financial Agreement Form at the first session. (You will receive a copy of these forms upon request otherwise they will be kept in your file for records).  

Insurance Clients -

  1. After our initial phone consult please send me an email : gpatelcouseling@gmail.com or text message : (646)379-5163 with a clear picture of the front and back of your Drivers License and your insurance card you will be using for our services. (We need this information to verify if your insurance will cover our services, and to keep this information in our files).

  2. Please fill out and submit the Insurance Information Form via email: gpatelcouseling@gmail.com

  3. Also fill out the Adult Psychotherapy Intake Form* or Child/Youth Psychotherapy Intake Form and submit it online.

  4. You will be signing the HIPAA form, Informed consent form, and Financial Agreement Form at the first session. You will receive a copy of these forms upon request otherwise they will be kept in your file for records.  

Thank you for helping us expedite the process which will leave us with more time to get to know each other during the intake session. *For Couples Counseling each adult must fill out the Adult Psychotherapy Form and submit it prior to the 1st session. 

Fees & Payment

*** I accept payment by credit or debit card, check, online transfer via (PayPal or Google Wallet) and cash***

**Even if you don't have a PayPal account and wish to pay with a credit/debit card ONLINE, click on the link below enter the "price amount" as per our discussion and follow the prompts to pay online** 

Reduced Fee 


Reduced fee services are available on a limited basis.

 

* In some cases I charge fees on a sliding scale - so we talk and then agree on a fee. 

Weekly Sessions and Cancellations

​Psychotherapy is like going to the gym:  Go on a regular basis, go at least once a week, and you're more likely to see results. Setting up a regular schedule means I hold a time for you and I charge for the time. If you tell me in advance that you're unable to come to a session, we try to find time for a make up session. If you do not show up for your scheduled therapy appointment, and you have not notified us at least 3 hours in advance, you will be required to pay cancellation fee. Please be polite to inform us ahead of time so we can help someone else who is in need of that hour. 

       6540 Lusk Blvd., Suite c277,

       San Diego, CA 92121

LPCC License #4683 and LMHC License # MH14441

Copyright © 2017. GP Counseling Services, Inc. All Rights Reserved.