Virtually all health insurance plans contain benefits covering a portion of the cost for psychological services based on medical necessity. Plans vary including those described as traditional indemnity types to HMO's, PPO's, and point-of-service plans. Many have a managed care component which are necessary to utilize if you want your insurance to underwrite your treatment. Often, such plans require pre-authorization for services before claims may be processed. Sometimes, the company name on your insurance card may not be the name of the managed care plan that handles your mental health or psychological coverage. Plans vary as to whether or not they will authorize care for subscribers to choose whom they wish to see. Most plans allow you to see the psychologist of your choice.

Your out-of-pocket expense will depend on answers to the following questions:

• What percentage of the fee is covered by insurance?
• What is your deductible, if any?
• Do you have an out of network option on your managed care plan and is the rate you pay different depending on the option you exercise?
• Approximately how many treatment sessions will be needed?
• Will your treatment require more sessions than will be covered by managed care?
• How frequently will you need to come for treatment?
• What is the cost of not receiving treatment? What effect is the problem having on your personal health, your work, and your family?

Research suggests that 50 per cent of psychotherapy clients had make improvement within eight sessions of therapy and 75 per cent show improvement after six months. Of course, showing improvement is not the same as successfully completing treatment. The length of treatment depends upon the nature and severity of the problem and the treatment goals selected. A serious depression requires more treatment than a mild stress response, or counseling to make a life decision. Chronic, long term depression requires longer and more intense treatment than a reactive depression. Finally, the treatment goals selected affect the length of treatment too. The treatment goal can be "to feel well enough to manage on my own," or it can be "to completely change the way I handle my life, including how I make decisions, set goals and relate to people," or anything in between. The first goal would indicate a desire for short term treatment to resolve a life crisis without necessarily examining how the crisis developed or how to avoid similar problems in the future. The second goal would require long term psychological treatment, most likely in excess of one year, with sessions scheduled at least weekly.

Typically, treatment sessions are scheduled once per week. If the symptoms are especially severe, then sessions may be scheduled more than once per week. Also, if you are unable to work because of your problem, sessions may be scheduled more frequently to assist you in returning to work as quickly as possible. Once treatment is under way, and you are experiencing some relief, you may be able to schedule appointments every other week, if weekly sessions pose a difficulty. This should be discussed with your psychologist to assess whether it is appropriate. Near the end of treatment, some psychologists will taper the sessions gradually, instead of abruptly ending treatment. That will depend on your individual circumstances.

Chesapeake Psychological Services participates with many insurance plans. Clients are required to make their copayments at the time of their visits. Insurance companies are billed monthly. If treatment plans are required by a managed care company, we fill those out in session with the subscriber/client so that he or she knows everything that is written about him or her. Cash, personal checks and credit cards are accepted.