Services

Kentucky owned and based Tele-Mental Health Service

 

 

 

 

 

 

 

 

NO INSURANCE REQUIRED (Affordable per visit rates)

Insurances accepted

Kentucky-wide clients accepted

After hours and Weekend appointments available (Don’t miss work)

• Medication Management/ Prescriptions (non-control) for: (Depression, Anxiety, OCD, Mood Disorders, ADD/ADHD, Psychosis/Schizophrenia, and Substance Use Disorders, Sleep Disturbances)

• Genetic testing for Medications

• Addictions- MAT (non-control) Naltrexone/Vivitrol, Acamprosate Calcium, and Antabuse)

(For higher level need clients post Psychiatric Intake / Cosultation access to a collaborating Third-Party Kentucky-based Tele-health Suboxone provider is available- Note : Suboxone Prescriber Intake and fees are separate and paid directly to the Third-party)

• Therapy

• Life Coaching

• Court-ordered (Parenting, Anger Management, and Life Skills  classes/certificates)referral available

• Addictions Individualized Intensive Outpatient Therapy (IIOP)

• Support Animal Assessment/ Letters (Housing & TSA)

• Diagnosis Assessment and assignment

Health Insurance Information

Do you accept insurance?

YES. Aetna, Anthem, Cigna, Humana (pending), and United

Shore Side Behavioral Health Service, LLC operates in a private-pay setting. We are considered an “out-of-network” provider and have no contract with any insurance companies, Medicare, or Medicaid. This allows our organization to spend more time with our patients and ensures treatment decisions are made by patient and the providers, not insurance companies. If you are eligible for out-of-network reimbursements from your insurance company this may cover up to 80% of the cost of your visits with our providers.

Please contact your insurance company directly to determine your specific coverage and complete any necessary paperwork.

We do provide a “superbill” upon request which will allow you to get reimbursed from your insurance company if eligible.

Why is Shore Side Behavioral Health Service, LLC an "out-of-network" organization for health insurance?

Our providers believe that behavioral health and addictions practice involves careful diligence, direct thorough input from the patient, and a focus on the patient’s long-term wellness, treatment goals and success. Sometimes achieving these focuses requires time and flexibility, which is more compatible with a private-pay model for your care, and not the typical 15 minute “get you in and get you out “appointments with your mental health provider that did not address your needs. For example, we block off 166% of time in comparison to the norm appointments for medication management visits and strive to have a minimum of five emergency appointment slots left open daily when our facility is open to our established clients. We further strive to follow up with our established clients within 72 hours of contact with a provider if needed. All the options are not available within most behavioral health / addiction’s treatment organizations.

If I do not have an accepted insurance-How do I claim "out-of-network" benefits from my health insurance?

A. Consult your health insurance Plan Booklet, and/or

B. Call your health insurance company, either before or after your first visit

C. Tell the insurance company representative with whom you are speaking that you are seeing an “out-of-network” mental health provider.

D. Ask how much you will be reimbursed for :

1. CPT 99205 (new patient outpatient visit)

2. CPT 99214 (prescriber follow up visit)

3. CPT 90832 (Therapy-30 minutes)

4. CPT 90834 (Therapy-45 minutes)

5. CPT 90837 (Therapy- 60 minutes)

E. Ask your insurance company representative with whom you are speaking how much your annual deductible is with your insurance plan.

F. Ask your insurance company representative with whom you are speaking how many certified visits you have per calendar year.

G. Submit your “Superbill,” see how much reimbursement you will receive, and read your insurance plan’s E.O.B (Explanation of Benefits).

FYI: Most health insurance companies are required by law to pay the claim or tell you why they are not going to pay within 30 days.

You should at this point have most of the information you need to estimate the amount you can expect to be reimbursed for your treatment per each type of encounter/visit.

You may obtain an estimated national reimbursement amount by visiting fairhealthconsumer.org.

Please be aware Shore Side Behavioral Health Service, LLC CAN NOT guarantee that you will be reimbursed by your insurance company.

Health Reimbursement Accounts (HRA), Flexible Spending Accounts (FSA) or Healthcare Savings Accounts (HSA)

Patients who have Health Reimbursement Accounts (HRA), Flexible Spending Accounts (FSA) or Healthcare Savings Accounts (HSA) MAY be eligible to utilize these funds to pay for appointment fees and medications. Please contact your insurance company for more information.

Please be aware Shore Side Behavioral Health Service, LLC CAN NOT guarantee that you will be reimbursed by your insurance company.

Fees are based on the type, time and length of appointments and are subject to change.

Shore Side Behavioral Health Service, LLC current rates are as follows:

60 Minute Initial Psychiatric Intake/ Consultation: $200 ( Intake 45-60 minutes)

CPT 99214 (prescriber follow up visit) $119 (Medication management visit 15-30 minutes)

CPT 90832 (Therapy 16-30 minutes) 

$$$$$$ Savings $$$$$$

Basic Monthly Therapy Subscription- $125 (cash only) per month includes:

- Two 30 minute (Brief Therapy Session) if desired or needed per client therapy subscriber

Base line labs are required prior to prescribing medications (lab order will be provided or labs obtained from your Primary Care Provider will be accepted if they are not more than 90 days old. an additional urine drug screen is required and if you are within child bearing years a pregnancy test will be required less than 30 days old from of time of intake. Lab Monitoring may be required for certain medications these requirements are mandatory and if not completed as ordered no refills will occur-No exceptions (this is for your safety!!!)

- Coordination with your Primary Care Provider, Clinic, or Pharmacy for administration of the Long Acting Injectable (Invega Sustenna, Invega Trinza, Invega Halfyera, Abilify Maintena, Aristada, Vivitrol and other injectables)is the responsibility of the patient.(Note this does not include the administration cost of the injection-the cost of the injection administration is the responsibility of the patient and may or may not be covered by your insurance - please contact your insurance company)

 

"Assistance Animal" / Emotional Support  Prescription (If client qualifies under the DSM V) (Initial Intake $200 with diagnosis assignment/confirmation, treatment plan development, and a minimum of a follow up appointment every 6 weeks to maintain an legal actual "Therapeutic relationship" with Behavioral Health Provider(s). "Assistance Animal" / Emotional Support Prescription letter  will be provided if the prescription is deemed as needed and must be reevaluated yearly to continue based upon Behavioral Health Professional (s)'s evaluation. If a Housing or  TSA letter is needed a fee of $50 is required for each type of letter and will require renewal yearly. Shore Side Behavioral Health Service LLC representatives will provided attestment in writing to any landlord or housing authority within 7 buisness days excluding holidays assuring that qualified patients have met the requirements of KRS 383.085 as it pertains to an acceptable mental health provider and an active "Therapeutic Relationship" (a consent to provide said information to a third party upon each request must be authorized by the patient via a signed release of information form) at no charge one time annually, additional attestments will require a fee of $50 for either Housing or TSA letters.

referral for

Life Coaching (Initial Consultation- 30 minutes $75, $35 per 30 minute follow up Sessions)




Individualized Intense Outpatient Therapy

Intensive outpatient programs typically meet on weekdays in the morning or evening but our program is flexible to your needs (Work Schedule, Childcare, etc.) Programs primarily consist of individual counseling and life skills, and psycho-education modules. Most programs last about 60-90 days and includes drug testing (Orders provided by our Providers if you are not being managed by a MAT provider for your local area testing and/ or work / court requirements).

We focus on individuals and their success in recovery with our Addictions Resolution Therapy sessions, and our self-guided psycho-education/ life skills modules. Many times the IOP group setting is not individual focused even disruptive for participants causing impairments in their recovery process. Our program is designed for your schedule via telehealth and emailed modules for completion.  Certificates Available:

Anger Management Certificate

Parenting Certificate

Individualized Intense Oupatient completion Diploma

Relapse Prevention Stratgies Certificate

Addictions Resolution Therapy Certificate

Time Management Certificate

Acheiving Personal Sucess Certificate

Personal Finance (Budgeting/Management) Certificate

Job Offer/Employment Formula Certificate

Modern Job Searching Skills Certificate

Technical Writing for Job Acquisition-Resume & Cover letter completion Certificate

Conflict Resolution (Dealing with Difficult People in Life & Work) Certificate

Our program is a Telehealth based Accelerated 8 week Individualized Intense SAMHSA content Outpatient program that does not require you to quit your job, leave your family, or relocate to complete. Schedules are available to accomadate all shift work needs.

$Cost dependent upon court or work ordered needs detailed description can be provided for court or work review (payment prior to start no refunds for non-completion of program content-one warning for (non-excused) non-compliance with program schedule, if warning is not taken to resolve program compliance, expulsion will take place with no refund)