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Insurance FAQs​​​

Do you accept my insurance?

• We accept a limited number of plans. Accepted plans vary by provider type and credentialing. Please upload the front and back of your insurance card during intake to verify eligibility.

 

Accepted Insurance Plans

• CBH/Medicaid (Philadelphia County residents only)

• Quest Behavioral Health

• United/Optum (not all United plans)

• LEHB (Law Enforcement Health Benefits)

• Aetna

• If your plan isn’t listed, we cannot accept it at this time.  This means, we do not accept Medicare Advantage Plans, Cigna/Oscar, Highmark, Anthem, Independence/BCBS, and other plans. 

 

Why don’t you accept my insurance?

• Some insurance plans are not open to new providers, or reimbursement rates do not meet our requirements.

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What is a deductible?

• A deductible is the amount you must pay out of pocket before your insurance begins to cover services. Deductibles can range from $300 to $8,000, and may vary for in-network and out-of-network services or between physical and behavioral health coverage.

 

Can I use out-of-network benefits?

• If your plan has out-of-network benefits, you may be reimbursed for services provided by our therapists. Please check with your insurance to confirm details, as out-of-network benefits often require specific provider licensure.

 

What is the difference between Medicaid and Medicare?

• Medicaid is a public assistance program based on income, providing coverage for low-income individuals and families.​​

• Medicare is a federal insurance program primarily for individuals aged 65+ or with qualifying disabilities.

  • Perez Therapy does not accept Medicare.

  • Perez Therapy does not accept Medicare Advantage Plans.

 

What if I have Medicaid and a secondary insurance?

• Medicaid is the “payor of last resort”.  So if you have a secondary insurance, Medicaid will not pay. 

• If we are not credentialed with your secondary insurance, then neither your commercial/secondary plan nor Medicaid will pay us for your services.  Therefore, we cannot offer you admission for services, due to lack of payment.

 

Do you verify insurance coverage?

• Yes. For Medicaid, we can verify eligibility during referral and on a daily basis.

• If we cannot verify your insurance with your legal name and date of birth, we will request your social security number.

• For commercial insurance, we’ll verify and follow up within 1 to 2 business days. Please email your insurance card to info@pereztherapyllc.com.

 

Medicaid-Specific Policies

• You must have Philadelphia County Medicaid (CBH) to receive services.  You cannot have Medicaid coverage in another county or state.

• Clients cannot have secondary insurance if using Medicaid benefits.

• CBH client eligibility is verified daily through the Pennsylvania Promise system. Proof of eligibility is uploaded to your client record.

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Service Availability FAQs

We understand the importance of timely access to mental health services, but our capacity to accept new clients is occasionally limited based on provider availability and other factors. For this reason, we recommend that potential clients complete our Prescreening Form to help our intake team assess whether we have the ability to meet their needs.​​​

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Prescreening

All clients complete a Prescreening Form with essential demographic, insurance, and referral information, for the intake team to review and assess.  Completing a prescreening form, ensures that your application for services is reviewed by the Intake Team. 

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After completing the Contact Us form, or request for more information, we will email you a Prescreening Form to complete.  If you are unable to complete the prescreening form, please call us and a member of the Intake Team will 

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Services We Currently Offer

• Adult Individual Therapy: some of our providers are closed, but we do have providers who are open.

• Teen 14+ Individual Therapy: some providers work with teens, but 4pm or later appointments can go quickly.

• Couples & Family Therapy: We are limited in our additional capacity, so it depends on our providers.​

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Limited Services/Waitlisting

• Children under 14 years old (we are trying to hire more child therapists!)

• Family therapy

• Spanish-speaking therapy​

• Please Note: Providers can reach full capacity with clients, and we may not be able to update their status on the website quickly enough.  

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If we are unable to provide the services you need, or if we are out-of-network for your insurance, we recommend you try the following: 

• Your health insurance patient portal

• PsychologyToday.com

• Philadelphia Medicaid clients can also contact CBH directly at (888) 545-2600 for further assistance

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Please Note: Availability is subject to change as we continue to hire and adjust our capacity. Be sure to check back for updates.

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We're sorry... but we do not offer these services

• Medication, psychiatric evaluations

• Psychological evaluations and diagnosis

• High-risk treatment

• Group therapy services (but we hope to offer this soon)

• Autism services

• In-home therapy

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Insured Clients FAQs

Please read the following important information if you are intending to use insurance for your services.

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Commercial Insurance Plans

• We do not accept all insurance plans. See below for our accepted plans.

• Our system may automatically generate an invoice, statement and superbill, but receipt of such documentation does not mean that you are covered by insurance, or that you may use out-of-network benefits.

• If requested, the company can provide you with written proof of your coverage to assure you that services are covered. 

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Medicaid Recipients 

• You must have Philadelphia County Medicaid insurance to receive services from us. Unfortunately, if you have Pennsylvania Medicaid from another county, the State will not permit you to receive covered services from our company.

• Philadelphia Medicaid Physical Health Coverage is managed by a variety of plans.  Due to the annual cycle of health insurance enrollment, the available insurers can change.  Medicaid receipients are likely to have one of the following physical health insurances.

  • Geisinger

  • Health Partners Plans

  • Highmark Wholecare

  • Keystone First

  • UPMC for You

• ​However, Philadelphia Behavioral Health Coverage is managed by a smaller group of behavioral health insurance providers in the state, but it depends on the county.  For Philadelphia residents, you must have Community Behavioral Health (CBH). ​

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Medicare Recipients

• We cannot accept ANY clients who with full or partial Medicare coverage.​

• Even if you have Medicaid or a commercial plan with Medicare, we are unable to work with Medicare clients.

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Scheduling FAQs

When is my appointment?

• For security, we do not provide appointment information over the phone. Please confirm your appointment details via email or text. Ensure your contact information on file is up-to-date.

 

Do you have a waitlist?

• Currently, we do not have a waitlist. Most new clients can schedule an intake appointment within a few days.

• However, if you want to see a specific therapist, they may not be open for new clients, or they may have a waitlist.  We cannot determine the length of time that a therapist will have a waitlist, so if you need to speak with someone quickly, we will get you assigned to a qualified provider as soon as possible.

 

\What are your self-pay rates?

• Rates vary by therapist and service type:

  • Individual Therapy: $120-$180 per session (50 to 53 minutes)

  • Couples Therapy: $120-$200 per session (60 minutes)

  • Family Therapy: $120-$200 per session (60 minutes)

• We can confirm specific rates during your initial consultation.

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Policies and Procedures FAQs

How do I contact you?

• Phone: 215-278-9444

• Email: info@pereztherapyllc.com

• Fax: 484-930-0829

 

What should I do if I miss a call from you?

• If you missed a call, check your text messages, voicemail or email. We respond to inquiries promptly and will follow up as needed.

 

What information is needed for a prescreening?

• Completing a Prescreening Form

• Reason for referral

• Type of therapy (individual, couples, or family)

• Insurance details (if applicable)

• Basic demographics (name, date of birth, contact information)

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Jobs & Hiring FAQs

Do you have open positions?

• Yes, all open positions are listed on our website: Perez Therapy Jobs. Submit your cover letter and resume to jobs@pereztherapyllc.com.

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Do you accept interns?

• Not yet! We do hope to create intern positions at Perez Therapy.  More information to come in the next few months.

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Complaint FAQs

How do I make a complaint?

• Anyone may make a complaint, clients, staff, or the public.

• To make a complaint, you can email Complaints@PerezTherapyLLC.com. All complaints will be reviewed by the practice owner and the management team, as appropriate.

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How do you handle complaints?

• We will handle all complaints seriously, conduct an appropriate investigation, and document our findings.

• Perez Therapy will have 30 days to provide a written response to the complainant after electronic receipt of their grievance.

• Any individuals who cannot email their complaint may call the main phone number 215-278-9444, and request an audio recording of their complaint to be received for review by management.

• Response to the complaint will be given in writing via email to the person making the complaint.

• We ask complainants to provide as much information as possible for investigation.

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What if I do not receive an appropriate response to my complaint?

• Philadelphia Medicaid recipients may call Community Behavioral Health (CBH) Member Services at 888-545-2600 for further assistance if you cannot attain resolution to your issue.

• An anonymous or confidential report can be made to our Compliance Hotline by calling 855-252-7606 or filling an online report at www.hotline-services.com, 24 hours a day, 7 days a week.

• Grievances are documented and made available to Perez Therapy insurance networks, Philadelphia County and the State of Pennsylvania regulatory boards.

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