Some Basics

Blackbird Psychological Services is a mostly private pay-based practice; however, Dr. Jodi Nixon and Dr. Erin Sadler accept Anthem BCBS, IU Health Plans, Medicare, and Lyra.

Our licenses, training, and education will allow you to be qualified for out-of-network reimbursement with your insurance plan if this is part of your policy. If you would like to seek reimbursement from your insurance company for your therapy sessions using out-of-network benefits, we will be happy to provide you with the necessary documentation. All our therapists have self-pay options.

For associate-level therapists or trainees, we are unable to accept insurance for therapy. For those using insurance, you will be provided a discounted rate for services based on the contracted rates we have established with your insurance provider. These rates are not negotiable. Your provider cannot legally waive any patient responsibilities, including your copay, co-insurance, or deductibles, as this is considered insurance fraud.

Why or Why Not?

The Risks and Benefits of Using Insurance

The benefits of using your health insurance is mostly financial.

Submitting a mental health or physical health claim to insurance carries a certain amount of risk to confidentiality, privacy, or to future capacity to obtain employment, military affiliation, health insurance, disability insurance, or life insurance. In some cases, insurance companies may share information with a national medical information database. A diagnosis must be provided for insurance claims.

​This information is meant to be transparent, not to discourage seeking out mental health treatment.

Insurance Vocabulary

Deductible: The amount of money someone must pay out-of-pocket before coverage kicks in. Deductibles are usually set at rounded amounts (such as $1000, $2000). Typically, the lower the premium someone pays, the higher the deductible they have. Deductibles will reset annually. Many plans reset on January 1st, but depending on the employer, they may reset at a different point in the year. When someone's deductible resets, they are generally responsible to pay the contracted rate toward their services until their deductible is met again.

Co-Insurance: This is usually a set percentage of the total bill and is the amount of money someone owes after they hit their deductible. If a policy has a 10% co-insurance, the patient will pay 10% of the total allowable charges and the insurance company will pay 90%.

Co-Pay: The amount a patient must pay each date of service. This amount is usually standard across a plan (i.e. the patient pays a $20 copay each visit, regardless of what service was performed). Oftentimes, someone who has a copay will have that amount regardless of whether there is a deductible. However, sometimes someone must meet their deductible in full before their copay amount applies. It varies from plan to plan.

Out-of-Pocket Maximum: The maximum amount of money someone will pay toward deductibles, co-insurance, and co-pays for a plan year. After the out-of-pocket max is reached, the insurance company will pay 100% of allowable charges for the remainder of the plan year.

In-Network: A provider is considered in-network when they have contracted with a particular insurance company and agreed to the insurance company's rates.

Out-of-Network: A provider is considered out-of-network (OON) when they have not contracted with an insurance company. OON providers are not bound to an insurance rate and can collect the full fee for service. Sometimes people will have OON benefits and can be reimbursed for their healthcare costs, but other times they cannot.

Superbill: This is a detailed invoice containing all necessary information for an out-of-network claim to be submitted by a patient to their insurance company in order to receive a reimbursement from their insurance plan.

Benefits of Private Pay

When it comes to paying for health-related expenses, like going to the doctor or seeing a psychologist, most people just assume that using health insurance is their best option.

Here are 3 main issues that happen when using health insurance:

Privacy concerns. When you go through insurance, your records are accessible to the insurance agency. This can be particularly concerning when seeking mental health care because there are certain fields—such as aviation, the army, politics, and so on—where having that kind of sensitive information on your record could come back to harm your career.

Insurance companies dictate your care. When using insurance, your care isn’t dictated by your doctor—it’s dictated by the insurance company. This applies to the doctors you can see, the procedures you qualify for (only diagnosable conditions are covered), and even your length of care and how many sessions you’re able to have. All of which means you aren’t always necessarily getting the most appropriate care.

Overworked clinicians. Don’t get us wrong: we believe all doctors, clinicians, and therapists are doing the best they can. That said, clinicians who take insurance see 2.5x more patients than private pay clinicians—which means they have a tendency to be overworked. Anyone in the healthcare field can tell you that working with insurance companies is extremely time-consuming and tedious. This tends to lead to burnout in clinics that accept insurance, which means they often have less mental bandwidth to deal with your care (compared to private pay clinicians).

By choosing private pay you get as many sessions as you need, maintain your privacy, and get fully focused care. Plus, you can still take advantage of your HSA account and/or out-of-network benefits to help cover costs.

Good Faith Estimate

Under the No Surprises Act (H.R. 133 - effective January 1, 2022), health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services. A Good Faith Estimate is for your awareness only. It is not a contract for services.

To learn more about Good Faith Estimates, visit www.cms.gov/nosurprises or call 800-985-3059.

This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes costs related to therapy or psychological assessment. We will provide you a Good Faith Estimate at the beginning of your time with us, and with any updates at the beginning of the calendar year (January 1). Further, the Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur.

The timeline for receiving a Good Faith Estimate (GFE) is as follows:

• If your first appointment is scheduled within three business days, you’ll receive the GFE within one business day.

• If your first appointment is scheduled within ten business days, you’ll receive the GFE within three business days.

• If you request a good faith estimate (without scheduling the service), you’ll receive the GFE no later than three business days after the date of the request.