The amount that your insurance company may reimburse you for services is determined on a case by case basis by the insurance company when you submit a Superbill. See Billing Insurance below for more information.

How Insurance Works

In-Network Providers: Some licensed advanced alcohol and drug counselors (LAADC) sign contracts with insurance companies to provide services and are reimbursed by insurance companies at a fixed rate. These contracted counselors are called "In-Network Providers". Insurance companies prefer that you use In-Network Providers. The contracted reimbursement rates are typically much lower than the rates most counselors charge for services. For example, most LAADCs charge somewhere between $100 and $175 for a 50-60 minute session. Insurance companies will reimburse In-Network Providers typically in the range of $105 to $130 for a session. The advantage for In-Network Providers is that they receive referrals from the health plan (more patients).

Out-of Network Providers: Many insurance companies will also reimburse if you receive services from an Out-of-Network or Non-Contracted Provider. This reimbursement works differently as there is no contracted reimbursement rate. Insurance companies will typically reimburse either a set amount (for example, $90-135/session, no matter the cost of the session) or a percentage of the session cost (for example, 70% of the amount billed). You are then responsible for paying the difference between what the counselor charges ($30/session, for example), and what the insurance company reimburses (for example, 70%, or $70). ACIS submits the insurance claim for you, and you are responsible for your portion of the payment at the time of service.

Some insurance companies will not reimburse Out-of-Network Providers at all in an effort to control their costs. In this case you are responsible for the full session cost.

Scott Henrywestwood is an Out-of-Network or Non-Contracted Provider for some insurance companies (Aetna, BC/BS, HealthNet, UHC, and UBH), and In-Network Provider for Cigna/Evernorth, Carelon Behavioral Health, Military One Source, and other contracts are in process.

Billing Insurance
If you receive services from us as an Out-of Network Provider (e.g., Anthem BC, BC/BS) we can provide you with what is called a Superbill. A Superbill is simply a bill for the services you have received and paid for that has all of the information that an insurance company will need to consider reimbursing you for those services. You will need to contact your insurance company to find out how to submit a Superbill for reimbursement. Procedures may differ by insurance company.

Please notify your counselor at your first session if you would like us to prepare Superbills for you. Typically we complete Superbills on a monthly basis, but at your advanced request, we can give them to you more frequently.

What You Should Know
You are responsible for understanding your insurance benefits and what will and will not be covered. Some questions you should ask your insurance provider before starting counseling are as follows:

• What type of plan do I have (e.g., HMO, PPO, EPO, Restricted to an Independent Provider Association (IPA), etc.)?
• Do I have mental health benefits? Is my mental health carved out, i.e., Carelon, ComPsych, etc.?
• What is my coverage for substance use disorder counseling/therapy?
• How many sessions per calendar year does my plan cover?
• What is my co-pay amount per counseling/therapy session?
• What is my deductible for an Out-of-Network Provider and has it been met?
• Does my insurance cover services for an ACIS provider?
• Does my insurance require a licensed counselor?
• Is a referral required from my primary care physician?
• Is a “prior authorization code” or other approval required before I start counseling/therapy?

Other Important Information
Insurance will not pay for missed or late-cancel sessions. In these cases, you will be responsible for the full session fee. A minimum of 24 hours notice of cancellation is required.

If your insurance company requests a report in order to process your claim, you are responsible for payment for the report writing service. We will notify you of this requirement in advance of writing and billing for the report.

Questions?
If you have any questions about insurance or how our billing works, please make sure to ask us at your first appointment!

 

Individual/Couples/Family Counseling
Initial 15-minute phone consultation is complimentary. Counseling services are $90.00 per 50-60 minute session.

In an effort to make services available to all, a sliding scale for fees is available to those who qualify. Fees are based upon 50-60 minute session.

Number of People in Your Household
Annual Household Income	1	2	3	4+
<$50,000	$75	$70	$65	$60
$50,001-$70,000	$80	$75	$70	$65
$70,001-$90,000	$85	$80	$75	$70
$90,001-$110,000	$90	$85	$80	$75
$110,001-$130,000	$90	$90	$90	$90
$130,001-$150,000	$95	$95	$95	$95
$150,001+	$100	$100	$100	$100

In order to qualify for this fee adjustment, clients need to provide copies of the first page of their 1040 for the last two years. If a client cannot afford this fee, we will make every effort to accommodate or refer that client to a nearby community counseling center.

Group Counseling
$40 per 60 minute session

Cancellation Policy
If you schedule a session, we reserve that time for you. We are not able to schedule anyone else for that session. If you cancel 24 hours in advance you may reschedule your private session at no charge. Cancelling a session within 24 hours requires $80 payment for that session. NO EXCEPTIONS.

If we are required to go beyond the standard cancellation policy i.e., letters, respond to outside parties, agencies, we also reserve the right to assess those fees directly to you, the client.

Refund Policy
Once payment is made, there are NO REFUNDS.

Other Costs
Clients are responsible for costs of required materials and/or resources, i.e., books, workbooks, journals, etc.. Relapse Prevention and Addiction-Free Pain Management, Sex Addiction therapy require a workbook. If a need arises for incidentals relative to treatment needs, the client is responsible to cover fees incurred.

 

An Intervention has Three Phases:

1. The first phase begins after the Initial Call and includes the preparatory work for the intervention, the ACIS Interventionist network session(s), and the necessary follow-up sessions to facilitate the loved-one's  acceptance of treatment and program recommendations. Together, we determine which type of treatment is best for the addict. This will include screening and recommendations for Detox, Inpatient/Residential, Outpatient, Recovery Coaching, and Continuing Care Treatment.
2. The second phase begins with entry into any form of treatment, and covers the treatment coordination and aftercare services for 6 months. Treatment is defined as any level of care, including detox, inpatient/residential, day treatment, outpatient, recovery coaching, and/or self-help support meetings. The second phase does not cover the cost of treatment. If any form of treatment is to be provided, a referral to the agency is made. We discuss the options available and the fees associated with each option. The second phase services involve: consulting, screening, provision of referrals and recommendations for inpatient and/or outpatient treatment; interface between the Intervention team and the various treatment providers, coordination of aftercare; integration planning if the individual is returning home or to the community; and, our on-going support.
1. ACIS provides information and referrals to self-help meetings, to develop a self-help support network; information and support regarding any questions related to ongoing treatment and other necessary issues, i.e., relapse prevention; 12-step and non-12-step groups, and/or faith groups that can assist if a relapse occurs.
2. These functions are a critical aspect of the work for the first 6-months of recovery. Usually these services go beyond the 6-month period following the beginning of treatment. Monitoring and accountability are essential to ensure lasting recovery.
3. The third phase is continuing Recovery Management Services for a period of 6 or more months immediately following the second phase. These services can be paid for based on a hourly fee or on an agreed upon flat monthly fee.

Intervention Payment Options:

There are two ways to pay for ACIS' Intervention Services. The first is the flat rate option of $2,000.00 (cover up to 10 hours; additional hours $100/hour); the second is by paying for each session individually. We bill an hourly fee basis of $250 per hour with a 2 hour minimum for each session. For the flat rate option, a non-refundable fee of $500.00 is required to begin services. Pay fee by credit card at time of scheduling 1st session. For the hourly rate option, a minimum of $500 due at time of scheduling first session, and full payment is due at the time of each additional session (minimum 2 hour).

With each method of payment, the ACIS process is the same and will continue for a minimum period of 6 months after the individual has entered treatment.

To continue with ACIS' third phase after the addict completes residential, day-treatment, and/or intensive outpatient treatment you can pay for services on an hourly rate of $100 or chose a flat rate of $320/month for 4 sessions.

We do not bill your insurance for Intervention Services because insurance does not cover these services (except in the State of Pennsylvania, where you may file a claim for reimbursement). For individual sessions, we are in-network with Beacon Health Options, Cigna, Military One Source; and, can bill out-of-network for Aetna, United Healthcare, and HealthNet. There is usually an deductible to be met before insurance will make payment for claims.

A sliding fee scale will be considered based upon income. A financial assessment is required to qualify for a reduced fee request.

Location:
Much of the ACIS Intervention and treatment process can be provided in person, on the telephone, via email, secure video conferencing, and/or in the Interventionist's office. When we provide services "on-site" and outside 30 miles from our corporate office location (San Jose, CA), an on-site consultant fee is assessed beyond the agreed service fee.

The out-of-the-area travel costs may include airline flights, ground transportation, and lodging charges. Anticipated travel costs require a specific deposit be made prior to travel. We assess the State of California rate of 67¢ per mile for driving our own vehicle beyond 30 miles. We assess a travel fee of $80.00 per hour after traveling first 30 miles. We bill for travel costs by separate invoice and that fee is due upon receipt.

Terms and Conditions:
Terms of our Flat Rate or Hourly Rate fees contract for First Phase are due at the time our sessions begin. The first phone consultation of up to 15 minutes is complimentary. Our intake assessment and preparation sessions are usually done over the phone and prior to the initial intervention team meeting, requires payment of the non-refundable fee before we begin.

1. For clients choosing the Flat Rate fee option, a $500.00 non-refundable payment is required.
2. For clients choosing the Hourly Rate fees, non-refundable payment of $500 is required at time of scheduling each session.
3. The Interventionist will transport the loved one to treatment. This service is included in the $2,000.00 fee up to the first 10 hours of services; additional travel time is $80.00 per hour.

Non-Sufficient Funds and Outstanding Balance
Should a check be returned with insufficient funds, the client will be responsible for paying any ‘return check fee’ incurred by ACIS (in addition to the amount of the bad check), and will be asked to pay by Cashier's Check, Money Order, Bank Wire Transfer, Credit Card, or in cash for all future transactions. If fees are not paid at the time of services rendered, an interest rate of 10% will be charged on fees which are 30 days overdue. This 10% interest rate will apply each month that your fees are overdue. If your account has not been paid for more than 30 days and arrangements for payment have not been agreed upon, ACIS has the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. If such legal action is necessary, its costs will be included in the claim. In most collection situations, the only information ACIS releases regarding a client’s case is his/her name, the nature of services provided, and the amount due.

Cancellation Policy
Once an appointment is scheduled, we reserve the time for you, and we expect a minimum payment of one hour $100.00; unless you provide 24 hours advance notice of cancellation (by phone call), or unless we both agree that you were unable to attend due to circumstances beyond your control. When cancellations occur, we will either find another time to reschedule the appointment or resume with the next regularly scheduled appointment time.

 

The fee structure for recovery coaching is identical to individual counseling. See the counseling tab for more detail.

 

The fee structure for addiction-free pain management is identical to individual counseling. See the counseling tab for more detail.

 

The fixed fee for U.S. Department of Transportation Substance Abuse Professionals face-to-face assessment & evaluation, treatment plan, periodic check-ins, updated evaluation face-to-face, Follow-Up Drug Testing Plan (to employer/TPA), and, Initial Evaluation and Final Evaluation reports --- entire process in my practice is $600.00, payable at the time of the initial appointment, in cash, debit, credit card, or a money order made out to ACIS.

 

Credit card payments can be made using this link.