Cartaya Psychology Clinic, Insurance Information

Insurance Information for The Cartaya Psychology Clinic

The Humanistic and Behavioral Psychology Clinic does not participate with insurance panels or Medicaid, and full payment is due at the time of service at the rates listed on her fee schedule.  Effective January 1, 2017, Dr. Romero Cartaya has opted out of Medicare, meaning that she may accept patients with Medicare only if she and her Medicare-eligible patients volitionally enter into a yearly private pay contract stipulating that neither party will submit medical charges to Medicare.  Medicare-eligible patients must review and sign this contract prior to initial scheduling: Medicare Patient Agreement

The Professional Coaching Clinic does not use medical diagnosis to shape the care plan, but rather a conversation and collaboration to support and inspire personal and professional growth.  Because a medical diagnosis is required for submitting services to health insurance, coaching is not eligible for insurance reimbursement.  As a wellness service, its eligibility for Health Savings Accounts is subject to compliance with IRS guidelines and restrictions, which is the full responsibility of our clients.

Both credit/debit cards and cash are accepted for payments at the time of service, and checks will be accepted from established patients or clients. When appropriate, we happily provide a receipt of medical service for those who wish to apply for reimbursement from their insurance companies or Health Care Spending Accounts.  Our patients are encouraged to speak with their insurance companies in advance of scheduling their first appointment, so that they are aware of their policy requirements and limitations..  Your insurance provider may have restrictions for mental health services, psychotherapy and/or out-of-network psychologists, or may want a referral letter from your physician before you begin psychotherapy as part of your treatment plan.  We strongly recommend that you contact your insurer if you have any questions about the specific terms of your policy as pertains to NON-PARTICIPATING psychologists, which is the status that is applicable to Dr. Romero Cartaya’s private practice.

In calling your health insurance policy, the following questions may be helpful:

Do I have mental health benefits?
Do I have out-of-network benefits to see a psychologist whom is not on your panel for psychotherapy?
Do I need a referral to see an out-of-network psychologist in order to be eligible for reimbursement?  
Do I have a deductible that I have to meet before being eligible for reimbursement?
How much will I be reimbursed for each appointment?
Are there limits to the number of sessions I can submit for reimbursement in a calendar year?
What steps do I need to follow to apply for reimbursement?

While we understand that the billing practices of this office will not fit every person’s needs, this model of care ensures that we are able to provide the highly personalized level of integrative care and attention in which we specialize. In this practice, a completely transparent fee schedule means that clinician time is given to individualized patient services rather than negotiating treatment plans or collecting on contracts with insurance companies. Additional benefits of the direct-pay model include the option of complete privacy for our patients’ medical information.

Our office is committed to choosing an approach that supports a safe, therapeutic environment for focused healing, while we continue to passionately participate in conversations about health care reform and strategies for mental health advocacy.