Aetna, Oscar Health, United Healthcare, UMR, Optum, Oxford, West Virginia (PEIA)
For clients in Texas & West Virgnia who have Aetna, Oscar Health, United Healthcare, UMR, Optum, Oxford, Macy Gardipee uses a third-party billing company called Alma to manage insurance claims, eligibility checks, billing and admin work related to your appointments. Macy Gardipee is an LPC provider who provides a diagnosis, counseling treatment and case management related to working with clients in therapy. If you have Aetna, UMR, Oscar, United Health, Optum or Oxford insurance and would like to see if your insurance will help cover the cost of counseling, please click on the link "Schedule Free Consultation" below or email Macy Gardipee about scheduling a free phone consultation to talk about starting counseling and verifying your eligibility and benefits.
Once we speak, you or I may submit your insurance information through the Alma client portal. You should receive a response within 1-3 business days about whether you are eligible for counseling sessions and how much counseling sessions will cost through your insurance.
You may also call Macy Gardipee, LPC at (210) 816-1524 or email her at firstname.lastname@example.org to schedule a free 15-20 minute phone consultation to see if she would be a good fit to help you with your treatment goals in therapy and then verify your benefits. Please note, your benefits and eligibility must be verified first before scheduling an appointment in order for your appointment to be covered through your insurance.
Macy Gardipee, LPC is available Monday-Thursday.
You may or may not choose to file claims through your health insurance. Please note, that if you choose to file a claim for an out-of-network provider or in-network provider that most insurance company providers require a mental health diagnosis that will become a part of your medical record. If you have insurance that I accept, but choose not to use it to pay for counseling sessions you will be asked to sign a “Self-Pay Agreement” by your counselor.
For clients who have health insurance that Macy Pawelek does not accept, you have the option of contacting your health insurance provider and asking them if they will cover mental health counseling for out-of-network providers. If your health insurance provider covers out-of-network mental health counseling services, then you may ask if you can submit claims to your health insurance provider on your behalf and be reimbursed for mental health counseling services. Macy Pawelek, LPC can provide clients who want to use their insurance with a super bill, invoice for sessions or mental health diagnosis so that clients who qualify for out-of-network coverage can use their health insurance and be reimbursed for sessions or apply those fees to their deductible. Again, clients who wish to use their health insurance for out-of-network services will be responsible for following up with their insurance provider and submitting claims to their insurance. Some health insurance companies will do this and some will not, but clients interested in counseling and using their insurance will need to ask their insurance company directly.
For questions about out-of-network provider services, feel free to contact your health insurance provider or Macy Pawelek, LPC today!