​​​​​​PAYMENT
​Insurance
​Currently, Dr. Shital is in network with the following insurance provider:
 ***** Blue Cross Blue Shield *****
Please note that Dr. Shital does not accept Medicaid or any of the Medicaid 
CMOs (e.g. Amerigroup, Peachstate, Wellcare, Caresource, etc)

It should be noted that payment for services is the responsibility of the client. Hence, it is recommended that families contact their insurance company regarding reimbursement for both, “out of network providers” as well as "in-network providers."

Here are some of the questions that you may ask your insurance company if you wish to get reimbursed:

1. What is the amount of your deductible for out-of-network providers? Have you already met your deductible? Do both in-network and out-of-network services count towards the same deductible?
2. Do you need any kind of special referral (from your primary care physician/pediatrician) before you can be reimbursed?
3. How much of each therapy session will your insurance provider reimburse (this is typically a percentage)?
4. How many mental/behavioral health sessions per calendar year will your insurance plan cover?
5. How much of the assessment cost will the insurance provider reimburse? ​
6. Are there any rules related to seeking services (e.g., only a certain amount of money allowed for behavioral health reimbursements, reimbursement only for certain types of diagnoses, etc.)?
​
Out-of-pocket Rates: 

For evaluations (all sessions and reports included), the rates range from $1800-$3500. For therapy, her hourly rate is $185 per 50-55 minute sessions. If you would like a one-time consultation, the rate is $300/60 minutes. 
 1. Comprehensive Pyscho-educational evaluations --- $2800-$3500
 (includes ADHD, Learning disability, ASD and Emotional disorders) 
 2. Developmental Evaluations
  4 Years and Younger -- $1800-$2000 
  5 Years and Older --- $1900-$2800 
As an out-of-network provider, Dr. Shital will be happy to provide documentation required by your insurance company for reimbursement. 
​
 ***** Good Faith Estimate *****
​
Under the No Surprises Act (which went into effect on January 1, 2022), we, as healthcare providers need to give our patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

​​--- You have the right to receive a “Good Faith Estimate” explaining how much your service will cost Under the law, 
--- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency services.
--- We will give you a Good Faith Estimate in writing at least 1 business day before your srvice. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service. 
--- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

​For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call
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