Insurance and Copays

Daleoworks Psychological Services, Inc., is a preferred in-network provider for several insurance companies. While we try to keep our list updated, it is best for you to initially verify if Dr. David Daleo is a Participating Provider on your insurance. As you know, there are many recent changes occurring with medical insurance. Sometimes insurance companies “carve out” mental health benefits to another insurance provider. For example, you may have an Anthem Blue Cross insurance card, but your mental health benefits are covered thru Cigna. This system can be confusing as a provider may be on Anthem Blue Cross but not Cigna, so you may believe your sessions are covered, but ultimately they are not as the provider is not on the secondary insurance. Ultimately, it is your responsiblility for payment of services if they are not covered, as with all businesses, therapy is fee for service. The following are some of the most frequently asked questions:

Question: What is a deductible and why must I pay it?

Answer: A deductible is a dollar amount that is your out of pocket expense before your insurance starts to pay your claims. Some deductible are small, say $250.00, some are much higher, say $8000.00. An in-network provider will bill your claims normally but you must pay the contracted amount for the service at the time of your session. Otherwise, your doctor won’t receive payment. Once your deductible is satisfied, the insurance company will pay whatever your plan benefits are. Usually that leaves a person responsible for a copayment or copay.

Question: What if I am seeing multiple doctors and I think my deductible is satisfied, do I still need to pay you or can I wait until the billing is complete?

Answer: You are still responsible for payment at the beginning of each session or appointment. If you ever over pay, Daleoworks Psychological Services, Inc. will write you a refund check or you can choose to apply any monies to future copay credits.

Question: What is a copay?

Answer: A copay is the amount of money you pay every time you see a doctor. It is also referred to as “office visit”. Some insurance cards have that amount listed on the card. Sometimes a card will say “regular” or “specialist” and the copay amount will be higher for the specialist. Depending on your plan, mental health coverage may be subject to the higher “specialist” copay amount. Please call your insurance company to verify.

Question: When is payment due?

Answer: Payment is always due at the beginning of the session time.

Question: Do you accept credit cards?

Answer: No, Daleoworks Psychological Services, Inc. only accepts cash or check.

Question: Who do I make my check out to?

Answer: Please make your check out to Daleoworks Psychological Services, Inc.

Questions: Can I do a phone session or any Video Teleconference Sessions for insurance?

Answer: No. On April 5th, 2013 Virginia became the 12th state to require that insurers pay for services provided through telemedicine. Clinical research shows telemedicine has the same effectiveness and outcome as traditional “face-to-face” therapy. However, and unfortunately, the State of California and insurers in the State of California forbid telemedicine for mental health unless the client signs an insurance waver and pays out of pocket for the sessions.  Conducting phone sessions and billing your insurance company for such sessions is fraudulent and unethical in the State of California.

Question: How long are the therapy sessions with a clinical psychologist?

Answer: Therapy sessions are 45 minutes long.

Question: What if I start seeing a provider at Daleoworks Psychological Services, Inc., and change insurance

Answer: If you are planning or know that you will be changing insurance companies, please let us know so we can assist on verifying if Dr. David Daleo will be on that panel before you make the change. Remember all insurance must be verified by you and Daleoworks Psychological Service, Inc., prior to any appointments. This is to protect the consumer as much as to ensure payment for services.

Question: Do you offer a sliding scale if I do not have insurance or don’t wish to use my insurance?

Answer: Yes, as with any financial assistance, some factors go into determining an individual cash rate. Your rate will depend on your income and expenses, and what you can afford.

Question: Does Daleoworks offer VIP accomodations?

Answer: Yes, Dr. David Daleo sees many celebrity clients, professional athletes and government officials during the nearly 20 years of practice.

Question: What if I decide I don’t want to pay my balance ?

Answer: Usually payment is not a problem, there are many different options including making payments over time. There are those exceptions, and as with any business one can encounter a person who is simply impossible to satisfy and will push all limits. This is rare. In nearly the 20 years of private practice, Daleoworks Psychological Services, Inc., has sent a handful of people to collections. Most people are mindful that therapy and medical services are not free and value their doctor’s time.