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Frequently Asked Questions

Q: Who pays for services?
A: South Shore Mental Health Counseling bills Optum, the administrator of your mental health benefits. The SOA pays for your first 10 session copayments and then you pay the $25 copayment thereafter.

Q: Why are you billing Optum? Don't we have Anthem Blue Cross Blue Shield (or Aetna) insurance?
A: Optum is the administrator of your mental health benefits. Medical and mental health benefits are considered different services and some plans contract with different companies for these services. 

Q: Who is providing services?
A: You will receive services from New York State Licensed Mental Health Counselor Ken Roche, a pre-licensed professional counselor under the direct supervision of Ken Roche, LMHC, or another licensed clinician affiliated with South Shore Mental Health Counseling Services.

Q: I don't want anyone to know that I'm in counseling, will anyone find out?
A: Other than verifying with the SOA that you or your dependent are active members so that the SOA will pay for your copayments, seeing a counselor is your private information and subject to HIPAA privacy rules.

Q: Will I run into anyone I know at your center?
A: We think it's unlikely that you'll cross paths with anyone you may know or work with at our center. You are always welcome to wait in your vehicle and notify your counselor once you've arrived. Alternatively, Telehealth is a great option! You can have a Telehealth session from anywhere you choose within the state of New York. 

Q: I do not want an "Explanation of Benefits" mailed to my house. How do I stop them?
A: You can call Optum at 1-800-765-6709 (or the number on the back of your insurance card) and speak with a representative. Alternatively, you can log in to Optum here. After you log in click "browse on my own", scroll down to the bottom of the page and under "Member info" click "Account settings". On the next page you can manage your communication preferences.

Q: Why am I being asked to leave a credit card on file?
A: We will bill the SOA for your first 10 copayments and thereafter you will be responsible for the $25 copayment which will be billed automatically by our system after each session. Also, the card is on file for our $60 no show fee or for cancellations with less than 12 hours notice. Your first no show/late cancel is waived and you will be charged for appointment no shows or late cancellations thereafter.

Q: Will I receive a bill from South Shore Mental Health Counseling?
A:  After your first 10 sessions you will be billed your $25 copayment automatically after each session. Applicable late cancel/no-show fees will also be billed to your credit card. As long as you remain a member (or retiree) in good standing, and you do not opt for primary benefits through another employer or plan, there should be no surprise bills. If your insurance or employment situation changes, please notify South Shore Mental Health Counseling immediately to avoid billing issues. If the person receiving services is a dependent under age 26, please notify us prior to your 26th birthday so we can make arrangements for ongoing services or provide you with an appropriate referral.

Q: What is the cancellation policy?
A: You will not be charged cancellation fee if you cancel your appointment directly with your counselor at least 12 hours before your appointment. If you cancel your appointment with less than 12 hrs notice or do not show for your appointment you will be charged a $60 fee. The first $60 late cancel/no show fee will be waived as a courtesy to you, and you will be charged thereafter. We have this policy in place because therapy is a commitment on your part and on the part of your counselor. Please respect their time as much as we respect yours. Remember, we are happy to be flexible with proper notice and Telehealth is always an option!

Q: If I'm going to be late or need to reschedule my appointment what number should I call?
A: After your first appointment, please call your counselor directly with scheduling and other concerns. We may not see your message on the main SOA line fast enough.

Q: I think I might need medication, can your counselors assist with that?
A: Your primary care provider is an excellent starting point! Our counselors do not prescribe, but can direct you to resources to assist with psychiatric medication evaluation and management if needed. Our practice also works in collaboration with a psychiatric-mental health nurse practitioner serving adults 18+.
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