Fees & Insurance


 

Rates are competitive for the Bay Area. Please call 510.852.9772 to discuss fees for specific services (therapy, parent coaching, consultation, lectures).  Dr. Zoffness is not on any insurance panels but can provide a super bill at the end of the month to submit to your insurance company. Check with your insurance to determine what percent of CBT they will cover, and see tips below.

 

GETTING REIMBURSED FOR CBT:

 

1. If your child's doctor (neurologist, pediatrician, etc) has recommended CBT, get a written prescription. When you call your insurance, inform them that CBT has been "prescribed" by your child's medical doctor and provide a copy of the prescription.

 

2. If CBT is "medically necessary," use this language with your insurance. If CBT has been recommended or prescribed by a medical doctor, it may be considered medically necessary, especially if your child has missed a significant amount of school or his/her functioning is impaired. An insurance company is more likely to cover a service if it is medically necessary. 

 

3. If your child has had pain or health issues for 3 or more months, this is considered "chronic pain/illness." If it applies, use this term when you speak with your insurance. This is an important reimbursement designation and may affect the likelihood that your claim is reimbursed. 

 

4. Always get the name of the person with whom you are speaking and note the date.

 

5. If your insurance company denies you coverage for CBT, ask for it in writing. Ask to speak with a manager and work your way up if you believe your claim is valid.

 

6. Tell your insurance if a particular therapist: a) was specifically recommended by your medical doctor, and b) works closely with your medical team. This collaborative relationship makes your provider unique, and is a reason insurance companies may reimburse treatment with an out-of-network provider.

 

7. As a reason not to reimburse out-of-network services, insurance companies may say they have "hundreds of CBT therapists." As the service recipient, you are permitted to specify what you want in a provider: e.g.: male/female, level of training (Masters vs PhD), type of training (CBT vs psychodynamic, etc), specific expertise (child/teen, chronic pain), and availability (after school, evenings, etc). If you are told that there are many providers in your area who have all of these qualifications, get the names of these providers, call them, and call back your insurance company when you find discrepancies. Insurance companies should not send you to providers who cannot effectively or appropriately help your child.  

 

8. Type of therapist: When searching for a therapist, make sure s/he attended a CBT-based training program. While psychodynamic and psychoanalytic therapies are useful and important for many conditions, they are *not* considered evidence-based treatments for pediatric pain, illness, or anxiety/depression. A CBT therapist can be an MSW (social worker), MFT (Marriage and Family Therapist), PsyD (Doctor of Psychology) or PhD (Doctor of Philosophy).

 

9. Prevent transmission of money stress. Children have many sources of stress: peers, tests, grades, social media, fake news, real news... the last thing they need is another thing to worry about. Children with pain, illness, or injury often feel stressed about money, specifically the cost of their own medical bills. So while it's important to teach your child about money, limit "money talk" to adults. Otherwise, money stress is transmitted to children, who then worry and feel guilty about attending their appointments. Teens shouldn't have to worry about treatment costs... it's hard enough just surviving high school!