InPowered Therapy Policies

Effective Jan 2025

At InPowered Therapy, we offer transparent, evidence-based mental health care with rates that reflect our clinicians' advanced training and expertise in Internal Family Systems (IFS) therapy and trauma-informed care.

STANDARD SESSION RATES

Our rates are based on each clinician's credentials, specialized training, and years of experience:

Individual & Couples Therapy Sessions (50-55 minutes)

• Licensed Psychologist: $200 - $250 per session

• LCPC, LCSW, LMFT: $165 - $210 per session

• LPC, LSW, ALMFT: $160 - $195 per session

• License-eligible: $155 - $190 per session

Rate factors include:

• Years of experience post-full licensure (rates increase $10 for each of the first 5 years)

• Additional certifications and specialized training ($10 increase per certification)

• Advanced training in modalities such as IFS, EMDR, or other specialized approaches

INSURANCE & PAYMENT OPTIONS

In-Network Insurance

We are in-network with BCBS PPO and Aetna PPO plans. When using insurance:

• Your session cost will be your plan's co-payment amount

• Deductibles and coinsurance apply as outlined in your policy

• We file all claims directly with your insurance company

• You are responsible for any amounts deemed patient responsibility by your insurer

Out-of-Network Benefits

Many clients choose to use out-of-network benefits, which may provide:

• Reimbursement for 50-80% of session costs (varies by plan)

• Greater flexibility in treatment approach and frequency

• No requirement for diagnosis disclosure to insurance

We can provide detailed superbills for you to submit to your insurance company for out-of-network reimbursement.

Self-Pay

For clients paying out-of-pocket, payment is due at the time of service. We accept:

• Credit and debit cards

• Health Savings Accounts (HSA)

• Flexible Spending Accounts (FSA)

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INTENSIVE THERAPY SERVICES

For clients seeking deeper, more concentrated therapeutic work, we offer intensive therapy formats:

• Half-Day Intensive (3-4 hours): Custom rate based on clinician

• Full-Day Intensive (6-7 hours): Custom rate based on clinician

• Multi-Day Retreats: Please contact us for retreat pricing and availability

Intensive services are particularly beneficial for:

• Complex trauma processing

• Major life transitions

• Accelerated IFS parts work

• Clients traveling from out of town

Contact us for more information about intensive therapy options and rates.

ADDITIONAL SERVICES

Extended Phone/Video Consultations

• Brief check-ins (under 5 minutes) are complimentary. Consultations exceeding 5 minutes are billed at $200 per hour, prorated.

Collaborative Care Consultations

• When clinically appropriate and with your consent, consultations with other providers (psychiatrists, medical doctors, school personnel) may be billed at the clinician's standard hourly rate.

Letters & Documentation

• Standard treatment verification letters: No charge

• Detailed letters for court, disability, or other purposes: $150-300 depending on complexity

GOOD FAITH ESTIMATES

Your Right to Know Costs

If you are uninsured or paying out-of-pocket, you have the right to receive a Good Faith Estimate of your treatment costs before beginning therapy.

Your estimate will include:

• Expected number of sessions

• Cost per session

• Total estimated cost

• Any additional anticipated fees

Your Rights: Under federal law (No Surprises Act), if your actual bill exceeds your Good Faith Estimate by $400 or more, you have the right to dispute the charges.

For more information: www.cms.gov/nosurprises or call 1-800-985-3059

RATE UPDATES

Our fee schedule is reviewed annually. Rate adjustments, when necessary, are implemented every January in odd-numbered years (2025, 2027, 2029, etc.) to reflect:

• Increases in operational costs

• Continuing education and advanced training investments

• Cost of living adjustments

Existing clients receive 60 days notice of any rate changes.

FINANCIAL ACCESSABILITY

We believe therapy should be accessible. If you are experiencing financial hardship:

• Speak with your therapist about your situation

• Contact our administrative team to discuss options

• Ask about our reduced-fee slots (limited availability)

Early communication helps us work together to find solutions that support your continued care.

QUESTIONS ABOUT FEES?

We're happy to discuss:

• Your specific insurance benefits and coverage

• Payment options that work for your situation

• Good Faith Estimates for your anticipated treatment

• Intensive therapy pricing

Contact us:
Phone: (312) 636-6109
Email: billing@inpoweredtherapy.com
Office: 2224 W Lawrence Ave, Chicago, IL 60625

This fee schedule is effective as of January 2025 and is subject to change. Current clients will receive advance notice of any rate adjustments

Effective January 2026

Thank you for choosing InPowered Therapy. This policy outlines our billing practices and your financial responsibilities as a client. We believe in transparency and want you to understand our policies before beginning treatment.

PAYMENT & BILLING

Payment Is Due at Time of Service

To streamline the administrative side of therapy and keep our focus on your healing, we collect payment at each session for:

• Insurance co-payments

• Self-pay session fees

• Any deductible or coinsurance amounts

Accepted Payment Methods: We accept:

• Credit and debit cards (Visa, Mastercard, Discover, American Express)

• Health Savings Accounts (HSA)

• Flexible Spending Accounts (FSA)

• Health Reimbursement Arrangements (HRA)

• ACH/bank draft (by arrangement)

We do not accept: Venmo, PayPal, Zelle, CashApp, Apple Pay, or similar peer-to-peer payment apps, as these don't allow for the required automatic billing of outstanding balances.

CREDIT CARE ON FILE

All clients are required to keep a current, valid credit card on file. This policy helps us:

• Reduce administrative burden so therapists can focus on clinical care

• Process payments efficiently

• Address any outstanding balances promptly

How We Protect Your Information

Your payment information is stored securely through our PCI-certified payment processor and is used only for authorized charges related to your treatment.

How It Works

• Your card is charged at the time of service for the session fee

• Outstanding balances (if any) are automatically charged to avoid accumulation

• You receive a receipt for every transaction

• If your card information changes, please notify us immediately

Important: We reserve the right to pause services if a valid payment method is not maintained. If you don't have a valid card on file within 2 sessions of being notified, we'll block scheduling of future appointments until payment information is updated.

INSURANCE

We File Claims for You

If you have insurance, we handle the claim filing process.

Before Your First Session, it is your responsibility to:

• Verify your mental health benefits

• Understand your deductible, co-pay, and coinsurance

• Obtain any required prior authorizations

• Provide current insurance card and photo ID

Important to Know:

• Insurance benefit quotes are estimates, not guarantees

• Not all mental health concerns are covered by insurance

• You remain responsible for any amounts not covered by your plan

• If prior authorization is required but not obtained, you will be billed at self-pay rates

• Copays, coinsurance, and deductibles cannot be waived or reduced—these amounts are set by your insurance contract

• Insurance will only reimburse for one session per day and limits session times to 30-53 minutes per session

• To bill insurance for therapy, we must submit a mental health diagnosis code. This becomes part of your permanent medical record.

• For Couples & Family Therapy: Insurance requires at least one partner or family member to have a diagnosis. Many insurance plans don't cover couples therapy, or only cover it when there's a diagnosable mental health condition (not just relationship concerns).

Your Choice: You can use insurance and accept having a diagnosis in your medical record, or pay out-of-pocket to avoid having a diagnosis documented. If you choose to pay out of pocket but have insurance, you will need to sign an “Insurance Opt Out” form

DENIED OR REJECTED CLAIMS

If your insurance denies a claim due to your responsibility (such as outdated information or missing coordination of benefits), you have one week to resolve the issue. After that, the balance becomes your responsibility.

Coordination of Benefits & Multiple Insurance Plans

If you have more than one insurance plan (such as coverage through both your employer and your spouse's employer), it's critical that you:

• Inform us of ALL insurance coverage at intake and whenever it changes

• Tell us which insurance is primary and which is secondary

• Understand that we cannot bill secondary insurance until primary insurance has processed the claim

Important: Providing incorrect insurance information in the wrong order (like giving us your secondary insurance as primary) can result in claim denials and clawbacks. You are responsible for any claims that must be rebilled due to incorrect insurance information you provided.

Administrative Fee: If we must rebill claims due to incorrect, incomplete, or improperly sequenced insurance information, a $50 administrative fee per claim will apply to cover the staff time required to research and resubmit.

When We Need Your Help with Insurance

While we handle claim filing, there are limits to how much time we can spend resolving complex insurance issues. After about 2 hours of staff time working on a difficult claim, we may ask you to contact your insurance company directly to help resolve the issue. You remain responsible for payment regardless of insurance outcomes.

UNDERSTANDING INSURANCE CLAWBACKS

Sometimes insurance companies request repayment of claims they previously paid—this is called a "clawback" or "recoupment." Under Illinois law, fully-insured plans can seek repayment up to 12 months after they initially paid a claim. However, self-funded ERISA plans (often offered by large employers) are exempt from this Illinois time limit and may seek repayment for longer periods under federal law.

What You Need to Know:

• You remain financially responsible for services rendered, even if insurance initially pays then later claws back the payment

• Common clawback reasons include: eligibility issues, coordination of benefits errors, retroactive coverage termination, or services later deemed not medically necessary

• If you're no longer in active treatment when a clawback occurs, we'll notify you and you'll have 30 days to respond before the balance is charged to your card on file

Our Commitment: We will make reasonable efforts to dispute clawbacks we believe are incorrect, but you remain responsible for payment during any dispute process.

SPECIAL INSURANCE TYPES

Labor Union Network Plans: Some union insurance plans (like Telegen) require approval before each therapy session. If you have this type of plan, you must obtain authorization before every appointment. Without authorization, you'll be responsible for the full self-pay rate.

Union Health Funds: If you have insurance through a union health and welfare fund, coverage can change based on hours worked. You'll need to verify eligibility before sessions, and these plans often take 60-90 days to process claims.

Employer Supplemental Benefits: Some employers provide special accounts that automatically pay your medical copays and deductibles. These are different from HSA/FSA accounts. Important: You must tell us if you have these benefits at intake to prevent billing confusion and duplicate payments.

OUT-OF-NETWORK INSURANCE

If we're out-of-network with your insurance:

• Payment: You pay the full session fee at time of service

• Superbills: We provide detailed receipts (superbills) you can submit to your insurance for potential reimbursement. Superbills are provided within 5-7 business days of your request.

Your Responsibility:

• Verify your out-of-network benefits before starting therapy

• Submit claims to your insurance yourself

• Understand we make no guarantees about reimbursement

• You remain responsible for full payment even if insurance doesn't reimburse you

Helpful Tool: We partner with Mentaya (www.mentaya.com), a service that helps out-of-network clients file claims and manage reimbursement for a small fee. Ask your clinician for details.

Note: Out-of-network clients are not eligible for sliding scale rates, as sliding scale is reserved for uninsured clients.

NON-REFUNDABLE SERVICES

All therapy services are non-refundable once provided. This includes:

• Individual, couples, and family therapy sessions

• Intensive therapy sessions

• Phone or video consultations

• Any professional services rendered by our clinicians

We provide high-quality, professional mental health services. Once a session has occurred, payment is final. This policy ensures fair compensation for our clinicians' time and expertise.

CANCELATION POLICY

**24-Hour Notice Required

Life happens, and we understand that. However, last-minute cancellations affect both your treatment progress and our ability to serve others waiting for appointments.

Please provide at least 24 business hours notice if you need to cancel or reschedule.

Late Cancellation & No-Show Fee: $100

This fee applies when:

• You cancel with less than 24 hours notice

• You do not attend your scheduled session

Forgiveness Policy: We understand emergencies happen. Adults receive one fee forgiveness per year, and children under 12 receive two forgiveness per year, at therapist discretion.

Important Details:

• Insurance does not cover cancellation fees

• HSA/FSA accounts cannot be used for these fees

• The fee will be charged to your credit card on file

Why This Policy Exists: Your appointment time is reserved exclusively for you. When cancelled last-minute, we cannot fill that time with another client in need, which impacts both our practice sustainability and community access to care.

COUPLES & FAMILY THERAPY

When working with couples or families:

• All participating adults must complete intake paperwork

• One person is designated as the primary billing contact

• That person is responsible for the full session fee

• If you wish to split costs with your partner/family member, please arrange this privately—we bill only one person per session

Important for Insurance: If using insurance for couples or family therapy, at least one person must have a mental health diagnosis that will become part of their permanent medical record. Many insurance plans don't cover couples therapy or only cover it when there's a diagnosable mental health condition, not just relationship concerns. You may choose to pay out-of-pocket to avoid having a diagnosis documented.

EXISTING CLIENT PHONE & EMAIL CONSULTATIONS

Phone or video consultations exceeding 5 minutes are billed at $200 per hour, prorated ($3.33 per minute). Your therapist will let you know if a conversation is approaching the 5-minute mark.

• Brief Contact: No Charge

• Quick check-ins, scheduling changes, or brief questions (under 5 minutes) are complimentary.

• Extended Consultations: Billed Time

OUTSTANDING BALANCES

We want to work with you if you're experiencing financial difficulty. Please communicate with us early so we can explore options.

Interest on Unpaid Balances

Balances that remain unpaid for more than 30 days and are not being actively addressed will accrue interest at 9% per year (0.75% per month), as permitted under Illinois law.

You won't be charged interest if:

• You have a signed payment plan agreement and are making your payments

• Your balance is under dispute or appeal with your insurance company

• You're in regular communication with us about payment

Interest applies when:

• A balance is over 30 days old with no response from you

• A payment plan has been missed or defaulted

• You're non-responsive to billing inquiries

ADDITIONAL FEES

• Late Payment Fee ($25): If you have a payment plan and miss a payment, there's a $25 late payment fee. This helps cover the administrative work of tracking down missed payments and keeping your account current.

• Returned Payment Fee ($35): If a credit card is declined, a check bounces, or a payment is returned for any reason, there's a $35 fee to cover the administrative costs. You'll need to provide a valid payment method within 5 business days.

OUR APPROACH TO COLLECTIONS

We'd much rather work with you than pursue collections. However, if a balance remains unaddressed, here's what happens:

For Current Clients:

• Balances unpaid for 4 months with no response to at least 3 billing notices may go to collections

• This only happens if no payment arrangement has been made and the card on file doesn't work

For Former Clients:

• Outstanding balances that arise after treatment ends (like insurance clawbacks) will go to collections if you don't respond within 30 days

What Collections Means:

• Current and future appointments will be cancelled

• You'll be responsible for collection costs including attorney fees

• The account may be reported to credit bureaus

Payment Plans

We offer payment plans to help manage balances. Our payment plan requirement is simple: your balance must always be going down.

This means:

• You must pay for current sessions at the time of service

• PLUS make additional payment toward the past-due balance

• The old balance must decrease every month

For example: If you owe $500 from past sessions and your weekly therapy is $175, you might pay $225 per week ($175 for today's session + $50 toward the old balance).

Payment plans require a separate agreement. If payments are missed, the full balance becomes due immediately and may proceed to collections.

Good Faith Estimates

Federal Law Requires Transparency

If you are uninsured or paying out-of-pocket, you have the right to receive a Good Faith Estimate of your treatment costs before beginning therapy.

What's Included:

• Expected number of sessions

• Cost per session

• Total estimated costs

• Your rights if actual costs exceed the estimate

Your Protection: If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute it through a federal process.

More Information: www.cms.gov/nosurprises or 1-800-985-3059

Financial Accessibility

We believe healing should be accessible. If cost is a barrier to your care:

Sliding Scale Appointments

We offer a limited number of reduced-fee slots for uninsured clients experiencing financial hardship.

How It Works:

• Rates vary by clinician and license level

• Priority goes to existing clients already in treatment

• Arrangements are time-limited and reviewed periodically

• Application and proof of financial need required

To Apply: Contact our administrative team to request a sliding scale application.

Note: Out-of-network insurance clients are not eligible for sliding scale, but may reduce costs through insurance reimbursement (consider using Mentaya to simplify the process).

Payment Plans

If you're facing difficulty paying your balance, we offer payment plans with one requirement: your balance must always decrease. This means you pay for current sessions plus make additional payments toward past-due amounts.

Payment plans require a separate agreement. Contact us early—the sooner we know about financial difficulty, the more options we can offer.

Out-of-Network Assistance

If we're out-of-network with your insurance, Mentaya can help you get reimbursed more easily, which may reduce your out-of-pocket costs significantly.

Questions?

Our goal is to make the financial side of therapy as clear and stress-free as possible. If you have questions about:

• Your insurance benefits

• Payment options

• Your Good Faith Estimate

• Financial hardship accommodations

Please don't hesitate to reach out:

InPowered Therapy
2224 W Lawrence Ave
Chicago, IL 60625
Phone: (312) 636-6109

Legal & Regulatory Information

This financial policy complies with:

• The No Surprises Act (federal patient protection law)

• HIPAA privacy and security regulations

• Illinois insurance and consumer protection laws

For specific questions about your rights under these laws, please contact the appropriate regulatory agency or consult with a legal professional.

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This policy is effective January 2026. Clients who begin services will sign a detailed Financial Agreement that expands on these policies. If you have questions before starting therapy, please contact our office.

Last Updated: December 2025