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Below you will find answers to the questions we hear most often from patients related to billing. If your question is not covered here, please send us a secure message and we will be happy to help.

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Billing

The cost of your sessions depends on your insurance plan and benefits. Guzman & Baker accepts Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare. Your out-of-pocket cost is typically your copay or coinsurance amount as defined by your plan.We recommend calling the member services number on the back of your insurance card before your first appointment to confirm your mental health benefits. Ask specifically about:
  • Your copay or coinsurance for outpatient Telehealth mental health visits
  • Whether you have a deductible that applies
  • Any requirements for prior authorization
If you do not have insurance or your plan is not accepted, ask our office about self-pay rates. Under the No Surprises Act, you have the right to request a Good Faith Estimate of expected costs before beginning services.Please review our Financial Responsibility & Payment Policy for for details.
To streamline billing and reserve your appointment time, we require a valid credit card to be placed on file prior to your first appointment. This card will be used to process copayments, deductibles, and any outstanding balances. This is automatically collected in the patient portal prior to your session.Please review our Financial Responsibility & Payment Policy for for details.
Payments and copays are processed securely via Stripe through our practice management system Jane.
We accept all major credit cards and HSA/FSA cards.
No. Patients may elect to pay privately for their care. Under HIPAA regulations, if you pay for your services in full out-of-pocket, you can restrict the disclosure of your protected health information (PHI). This means your insurance provider will not be granted access to your clinical records, treatment plans, or psychiatric diagnoses.
Please review our Cancelation and No Show Policy for more information.
Please send us a secure message and we will be happy to help find additional options.

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Insurance

To review our full list of contracted insurance networks, see Insurance Information.Prior to your first appointment, we will verify your insurance is active and in good standing.
Important Note: While we verify that your coverage is in an active status, it is ultimately your responsibility to determine if a specific provider is “in network” with your plan and you are aware of your insurance policy benefits.
Please review The Lifecycle of an Insurance Claim for more information.
Guzman & Baker only bills insurance plans when the provider is contracted and credentialed with your specific insurance company. If they are not currently contracted, we can match you with a provider who is contracted with your network.Please review Out of Network Insurance for more information.
Additional self pay options may be available, please send us a secure message and we will be happy to help.
Services are billed using standard healthcare CPT codes based on the length, complexity, and type of the visit. These codes are paired with ICD-10 diagnosis codes that communicate to insurance companies the type of treatment provided and the diagnosis being treated.Below is a list of frequently billed codes in our practice:
  • Psychiatric Evaluations (first appointment)
    • 90791 (diagnostic evaluation, no medical services)
  • Individual Therapy
    • 90832 (16–37 minutes)
    • 90834 (38–52 minutes)
    • 90837 (53+ minutes)
  • Family or Group Therapy
    • 90853 for group psychotherapy
    • 90846 for family therapy without the patient
    • 90847 for conjoint family therapy
  • Crisis Therapy
    • 90839 (first 60 minutes)
    • 90840 (each additional 30 minutes beyond the first 60 minutes)
Guzman & Baker only bills insurance plans when the provider is contracted and credentialed with your specific insurance company. If they are not currently contracted, we can match you with a provider who is contracted with your network.Please review Out of Network Insurance for more information.
Additional self pay options may be available, please send us a secure message and we will be happy to help.
To prevent unexpected bills for our patients, we implement a 3-session provisional period for all new clients using insurance. We will schedule your initial intake and up to two follow-up sessions while we wait for your insurance claim to process. If we have not received a processed claim (Explanation of Benefits) by the end of the third session, we may pause scheduling future appointments until your coverage is confirmed. This ensures you are not accruing a large balance that insurance might later deny.Please review our Financial Responsibility & Payment Policy for for details.
Yes, but strict insurance requirements apply. If you plan to use EAP benefits, you must provide us with your EAP Authorization Number before your first session. We cannot schedule your initial appointment until we have verified this authorization to ensure your sessions are covered.
To ensure smooth billing, you must provide your current insurance card. Additionally, our practice requires a valid credit card to be placed on file before you can complete your intake paperwork. This card is used to process copayments, deductibles, and any non-covered balances.If you will be using EAP (Employee Assistance Program) benefits, you are required to contact your insurance company for pre-certification prior to your first appointment.
Yes, we can process claims for secondary insurance if we are in-network with the carrier. However, please note that our “Provisional Period” policy applies to all new insurance clients. We will schedule your first three sessions while we await claim processing. If we have not received payment or a processed claim (Explanation of Benefits) from your primary or secondary insurance by the end of the third session, we may pause scheduling further appointments until the coverage is confirmed and paid.
We allow insurance companies 60 days to process and pay your claim. If your insurance carrier has not paid a claim within 60 days of the appointment date (due to administrative delays, information requests, or denials), the full balance of the session will automatically revert to your responsibility and will be charged to the credit card on file. If insurance pays us at a later date, we will promptly refund you.Please review our Financial Responsibility & Payment Policy for for details.
Guzman & Baker Behavioral Health enforces a “No Pay, No Service” policy. If your account carries an outstanding balance from previous sessions that has not been paid or set up on an approved payment plan, you will be unable to schedule or attend future appointments until the balance is resolved.Please review our Financial Responsibility & Payment Policy for for details.
Looking to learn more about using your insurance benefits and what to expect? Review the Lifecycle of an Insurance Claim for more information.