We are In-Network with the following Insurance companies:
Key: 1-Marie E. Holland, 2-Michelle, 3-Crystal, 4-Jenna, 5-Marie Shelton, 6-Karen, 7-Sarah, 8-Sherri
- Aetna 1,2,3,5,6,7
- Blue Cross Blue Shield 1,2,3,4,5,6,7, 8
- Carelon (formerly Beacon Health Options) 1,2,6
- Cigna and Cigna EAP (also known as Evernorth) 1,2,3,5,6,7, 8
- MedCost 1,2,3,4,5,6,7
- Military OneSource 6
- Optima 1,2,6,7
- TriCare East 1,2,7
- United Healthcare (also known as Optum) 1,2,3,6,7, 8
- VA Community Care Network 6
NC State Health Plan: Holland and Associates Counseling, PLLC. is an in-network “CPP” provider.
EAP: We are contracted with several Employee Assistance Programs (EAP). Please contact them or your employer prior to contacting us and ask them for the EAP group name, company name, authorization number, and forms for reimbursement.
Medicare: We are unable to submit out-of-network claims.
Medicaid: We are unable to submit out-of-network claims.
We will file in-network and out-of-network claims as a courtesy to our patients.
Please note, that the filing of your claim does not guarantee payment by your insurance company. When we file your claim you are agreeing to pay the predetermined amount based on your individual insurance policy’s benefits. This could be a co-pay, co-insurance or deductible. Please contact your insurance company to determine your policy’s benefit coverage for Mental Health/Behavioral Health/Substance Use Disorder in an office or Telehealth outpatient setting.
For Out of Network, Self Pay or Uninsured Clients
“Good Faith Estimate for Health Care Items and Services” Under the No Surprises Act
January 1, 2022
Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care items and services.
This form may be used by the health care providers to inform individuals who are not enrolled in a plan or coverage or a Federal health care program (uninsured individuals), or individuals who are enrolled but not seeking to file a claim with their plan or coverage (self-pay individuals) of the expected charges they may be billed for receiving certain health care items and services. A good faith estimate must be provided within 3 business days upon request. Information regarding scheduled items and services must be furnished within 1 business day of scheduling an item or service to be provided in 3 business days; and within 3 business days of scheduling an item or service to be provided in at least 10 business days.
The Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
The Good Faith Estimate is not a contract and does not require you to obtain the items or services from our office in the Good Faith Estimate.
If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay a higher amount.
Keep a copy of the Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.