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Insurance:

 

Please contact your insurance to determine your individual plans coverage for mental/behavioral health benefits for in/out of network.

 FOR UNINSURED OR OUT OF NETWORK, SEE "GOOD FAITH ESTIMATE" BELOW

Aetna

ASR Health Benefits

Blue Cross Blue Shield (BCBS)

Blue Care Network (BCN)

CHAMP VA

Cigna Behavioral Health

HAP/AHL/Curanet

McLaren (Commercial)

Optum - Veterans Affairs Community Network

Priority Health (Commercial)

UMR

United Health Care (Commercial)

Good Faith Estimate

In Network Therapists Blue Cross Blue Shield of Michigan Blue Care Network

Good Faith Notice


Surprise Billing Protection Form

This document describes your protections against unexpected medical bills. It also asks if you’d like to give up those protections and pay more for out-of-network care.

 

IMPORTANT: You aren’t required to sign this form and shouldn’t sign it if you didn’t have a choice of health care provider before scheduling care. You can choose to get care from a provider or facility in your health plan’s network, which may cost you less.

If you’d like assistance with this document, ask your provider or a patient advocate. Take a picture and/or keep a copy of this form for your records.

You’re getting this notice because this provider or facility isn’t in your health plan’s network and is considered out-of-network. This means the provider or facility doesn’t have an agreement with your plan to provide services. Getting care from this provider or facility will likely cost you more.

If your plan covers the item or service you’re getting, federal law protects you from higher bills when:

• You’re getting emergency care from an out-of-network provider or facility, or

• An out-of-network provider is treating you at an in-network hospital or ambulatory surgical

center without getting your consent to receive a higher bill.

Ask your health care provider or patient advocate if you’re not sure if these protections apply to you.

If you sign this form, be aware that you may pay more because:

• You’re giving up your legal protections from higher bills.

• You may owe the full costs billed for the items and services you get.

• Your health plan might not count any of the amount you pay towards your deductible and out-

of-pocket limit. Contact your health plan for more information.

Before deciding whether to sign this form, you can contact your health plan to find an in-network

provider or facility. If there isn’t one, you can also ask your health plan if they can work out an

agreement with this provider or facility (or another one) to lower your costs.


 

Good Faith Estimate


 

Estimate of what you could pay if you give up your protections


 

Total cost estimate of what you may be asked to pay:

 

►Review your detailed estimate. 

 

►Call your health plan. Your plan may have better information about how much you’ll be asked to pay.

 

You also can ask about what’s covered under your plan and your provider options.

 

►Questions about this notice and estimate? Contact 586-932-2700

 

►Questions about your rights? Contact 1-800-985-3059

 

Prior authorization or other care management limitations

 

Except in an emergency, your health plan may require prior authorization (or other limitations) for certain items and services. This means you may need your plan’s approval that it will cover the items or services before you can get them. If your plan requires prior authorization, ask them what information they need for you to get coverage.

 

Understanding your options

 

You can get the items or services described in this notice from the following providers who are in-network with your health plan:

 

More information about your rights and protections

Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.OMB Control Number: 0938-1401 Expiration Date: 05/31/2025

Take charge of your health

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Are you looking for a private practice to showcase your talents and make a lasting difference?  Are you looking to align with a company that works as hard as you do behind the scenes and strives to make YOU proud? 

 

Lakeside Professional Counseling is founded on the concept that we are here to offer exceptional services to our community.  We don't brag, we demonstrate our value.  Our reputation is earned with each transformed life we assist.  We strive to exceed standard expectations.  We look for potential problems before they arise and are not afraid to work hard.  We are proud of the collective Lakeside team talent and customer service skills that define our reputation as a well run business creating a smooth experience for clients from the first phone call through the final visit. 

 

Lakeside offers a special opportunity for Therapists with exceptional experience and education along with demonstrated leadership and excellent customer service skills.  Strong Cognitive Based therapeutic skills are essential.  Limited Licensed Social Workers and Counselors welcome to apply. 

 

Accepted Credentials:  LP, L/LPC, L/LMSW, LMFT

Hybrid virtual/In-Office schedules available.

If interested, email us your resume and a cover letter to us detailing your qualifications and why you believe Lakeside is a good fit.

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