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Integrating modern hypnosis, clinical psychology, and eastern philosophy to foster real and lasting change.

Dr. Sera Lavelle, Ph.D, CHt is New York's expert in using hypnosis and integrative therapy for weight loss, compulsive behaviors, anxiety, and a variety of issues related to confidence and motivation. She has been written about in Elle Magazine and Allure and helped hundreds of people overcome their difficulties.

Integrating modern hypnosis, clinical psychology, and eastern philosophy to foster real and lasting change.

Dr. Sera Lavelle, Ph.D, CHt is New York's expert in using hypnosis and integrative therapy for weight loss, compulsive behaviors, anxiety, and a variety of issues related to confidence and motivation. She has been written about in Elle Magazine and Allure and helped hundreds of people overcome their difficulties.

At Soho Integrative Psychological Services, PLLC, we are considered an out-of-network provider for all insurance carriers. This means we don’t have contracts with any insurance companies. Therefore, you are responsible for paying the full fee for services at the time of your appointment. After your session, we will provide you with a superbill (an itemized receipt) to submit to your insurance company for possible reimbursement. Please note that if you have an HMO plan, our services are likely not covered. Additionally, our practice has opted out of Medicare.
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But My Insurance Said They Might Cover It?

Sometimes, your insurance company may tell you that you can receive services from an out-of-network provider, like us, and that they might cover it. They may mention the possibility of an exception or a Single Case Agreement (SCA) that could allow out-of-network coverage. However, it’s important to understand that even if they suggest coverage, it is often not guaranteed. Here’s what you should know:
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• Verbal Assurances Do Not Mean Approval
  Even if an insurance representative tells you that coverage is likely, it does not mean they will definitely approve reimbursement or an SCA. Many times, insurance companies initially seem open to covering services but later deny claims.
• Approval Can Take Time and May Not Happen
  In some cases, your insurance company may recommend applying for an SCA or another out-of-network exception. This process can be lengthy and complicated, and approvals are often denied, even after appearing likely.
• You Are Responsible for Full Payment
  Regardless of any statements from your insurance company, our policy is that full payment is due at the time of service. We cannot bill your insurance directly or wait for approval.

If your insurance company suggests that coverage might be possible, we recommend getting their assurance in writing. Remember that any reimbursement decisions are between you and your insurance provider, and we are unable to change our payment policy based on their initial statements.

Single Case Agreements and Specific Insurance Plans

Some insurance plans, such as Health Maintenance Organizations (HMOs), Medicaid, or other managed care programs, may sometimes offer Single Case Agreements (SCA) for out-of-network care. An SCA allows you to see an out-of-network provider (like us) when there are no suitable in-network options. However, these arrangements are typically restricted and not guaranteed. Here’s how common plans handle SCAs:
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• ‍HMO
  Usually require using in-network providers and may rarely approve SCAs on a case-by-case basis. SCAs are not guaranteed
• ‍Medicaid or State Programs
  May allow out-of-network coverage in rare situations, but the approval process is usually long and uncertain
• Exclusive Provider Organizations (EPOs)
  EPOs often do not cover out-of-network providers without an SCA, and approval is limited

If you wish to pursue an SCA, you will need to work directly with your insurance provider to arrange this. We are unable to assist with obtaining, negotiating, or managing SCAs on your behalf. Even if your insurance company indicates that an SCA might be approved, it’s important to understand that many of these requests are ultimately denied, and the responsibility for payment remains with you.

Full Payment at the Time of Service

As an out-of-network provider, we require full payment at the time of each appointment. We cannot accept direct payments from insurance companies. After your session, you may submit the superbill we provide to your insurance company to request reimbursement. However:

• 1. Each insurance company has its own policies regarding out-of-network reimbursement
• 2. Your specific plan’s terms will determine if and how much you might be reimbursed

Risks of Reimbursement

Some insurance plans, especially HMOs, Medicaid, or EPOs, may imply that reimbursement is possible, but it is common for these claims to be denied or significantly reduced after submission. By choosing to receive services at Soho Integrative Psychological Services, you understand that your insurance company may not reimburse you, or may reimburse less than expected. Any reimbursement issues are strictly between you and your insurance provider.

Important Points to Remember

By receiving services from Soho Integrative Psychological Services, PLLC, you agree that:

1. You are fully responsible for payment at the time of each session, regardless of any promises made by your insurance company about reimbursement
2. Any reimbursement from your insurance will go directly to you, not to us
3. You will not attempt to negotiate lower fees based on your insurance company’s willingness to cover out-of-network services.
4. You accept responsibility for full payment, even if your insurance company denies your claim or reduces the reimbursement.

Acknowledgment

By choosing our services, you confirm that you understand and agree to these policies. You will not request reimbursement directly from Soho Integrative Psychological Services, PLLC, nor attempt to negotiate fees based on your insurance company’s statements or policies.