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Treatment Fees and Insurance
 

Fees

 

Individual sessions are typically 50 minutes in length. This may vary depending on your needs and goals. Please contact us for industry standard rates and applicable fees. We accept credit cards*. Clients will be billed and can pay online through our TherapyNotes.com client portal.

Premarital Enrichment Packets, group work, couples counseling, parenting coaching, and other special events are not covered by insurance. Rates for all events, treatments, and support work can be found on our Events page.

Pono Roots session rates range from $120 - $200 for a standard 50 minute session. Longer sessions may be booked as needed for an additional fee. Group sessions typically cost $25-$50 per person/per session.

We never deny mental health services based on a person’s race, color, sex, age, national origin, disability, religion, gender identity, sexual orientation, or inability to pay.

Health Insurance.

We plan to accept most major commercial and government insurance plans, including Employee Assistance Program (EAP) plans. Please check with your Pono Roots team member for an up to date list of acceptable insurance. Most mental health counseling services (both in-person and through telehealth) are covered by insurance, and the only cost to you may be an annual deductible, copayment, or coinsurance, which is payable by Visa/Mastercard. 

Sliding Scale Fees.

We offer a sliding fee scale for clients who are able to pay the costs of mental health care, based on financial circumstances. We work with clients and agree to an amount they can afford. Note that therapists are limited to the number of sliding scale patients they are able to take. If you wish to request a sliding scale rate, please email us at Help@ponoroots.org and note Request sliding scale in subject line. If you are working with a therapist, please indicate that, along with your reason for requesting the fee reduction, and the amount you can afford.

Client Assistance Fund (supported by donations and grants). 

We offer subsidized mental health counseling for uninsured, under-insured, low-income, or elderly individuals and families. Subsidies are also available if their health plan will not cover counseling services or if they cannot afford sliding scale fees, high deductibles, or high copays. To be an active participant in their care, we encourage people to pay a minimum fee of $25 per session, or an amount they can afford, to help replenish the Client Assistance Fund.

 

To make a donation to the Client Assistance, visit www.afamilytree.org

Insurance 

Please check with your insurance plan before making an appointment to verify that your benefits cover psychotherapy/mental health. We recommend using the insurance language when calling, “I am calling to check on my mental and behavioral health treatment coverage”. Take note of insurance details above and below.

Things Of Which to be Aware

Often health insurance can be used to cover all or part of your counseling services. It is important to know that in order to use your insurance for counseling and psychotherapy there must be what the insurance companies call "medical necessity". In other words, to bill insurance you must qualify for a mental health diagnosis and this must be placed on your medical record. The insurance company views paying for counseling and therapy services in a similar way to paying for any other medical service, like visiting the doctor. This means that you must meet the criteria for a mental health diagnosis as established in the DSM or ICD manuals.

When you use your insurance, it is important to understand that as a payer in the United States, they maintain the right to access any intake data, session case notes, treatment outcomes or other information, established medical necessity and any other records involved in your counseling and therapy treatment. They may also have specific rules, limits, and required treatment procedures that may or may not inhibit your therapy experience. This is particularly an issue for in-network providers.

Due to the medical model used by insurance companies, it is not typical for your insurance plan to cover things like parent coaching or couples counseling. There are cases where this may be covered, but only when one "identified patient" qualifies for a mental health diagnosis. Please be wary of counseling, psychotherapy, and psychological services that do not disclose this information to you. If you are using your health insurance, a diagnosis has been made. It is our goal to make this as transparent and clear as possible. Again, it is very common for clients to use their insurance to reap the benefits of counseling and therapy services at a reduced personal cost.

When you use your insurance, it is important to review the US federal HIPPA privacy law to recognize how insurance companies may access and use your private health information as well as a list of your rights and the ways your records will be protected and maintained. Please check-out our FAQ for more information on using your insurance to help pay for therapy and counseling services.

Out-Of-Network Insurance And The Super Bill

Many insurance companies and plans provide out-of-network coverage for mental health services. This may cover all or part of your visits. For out of network insurance plans, Pono Roots accepts the "Super bill".  A super bill is a form that is prepared for you at the time of service that you mail into your insurance company for reimbursement at the "out of network" provider rate. Sometimes we can send this directly and electronically your insurance company on your behalf, making it easy to collect reimbursement. Simply pay the fee at the time of service and a check will be mailed to you from your insurance company covering whatever out-of-network percentage your insurance plan covers.

This means that you pay the full fee on the day of your service, and then either we electronically send it on your behalf or provide you with a paper Superbill that you simply mail into your insurance for reimbursement. In order to get reimbursement, insurance companies require the form to include at least the following details:

  • Your name

  • Your address and phone

  • Any additional identifying information

  • Your therapist's name

  • Your therapist's address

  • Your therapist's license number, NPI number, tax ID number

  • Your diagnosis

  • The treatment(s) rendered to you

  • The cost of the treatment

This is standard information that is shared whenever insurance is used to help pay for a service. Before using your insurance, it is best to check your "out-of-network" reimbursement rates so that you are able to accurately calculate your costs.