FEES & INSURANCE
FEE SCHEDULE
To review Dr. Martins' current fee schedule, please complete the CONTACT Form to receive an automatic reply detailing the current fees and for other important information about the practice including cancellation policy and payment information.
Note that Dr. Martins has a separate fee for a 60-minute initial assessment, a 45-minute follow-up, and a 30-minute follow-up. Fees also differ between medication management only sessions and sessions combining medication with psychotherapy. A routine medication management follow-up session lasts 30 minutes while a combined therapy session typically lasts 45 minutes.
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INSURANCE
Dr. Martins does not accept or participate with any insurance plans including private/commercial*, Medicare** or Medicaid. Upon receipt of your direct payment, Dr. Martins will send you a Superbill that you can submit to your insurance carrier for reimbursement.
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* United Healthcare (Optum):
(With our sincerest apologies in advance) Dr. Martins does not currently accept new patients who plan to submit to United Healthcare (Optum) for out-of-network reimbursement. UHC/Optum has randomly chosen Dr. Martins' practice for pre-payment audits, which means that all claims submitted for services by Dr. Martins will be denied unless a medical record is sent to the insurance company for each and every patient session note to be reviewed. This creates denials and, at best, delays in your reimbursement and Dr. Martins feels this is an unnecessary breach of your protected health information. Most providers are not on this pre-payment audit list, which means if you receive behavioral health services by another psychiatrist, you are most likely reimbursed on time without the need to send your medical records. Dr. Martins will begin to accept new UHC/Optum patients when this audit ends.
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** Medicare Note:
Dr. Martins has opted out of Medicare - this means that if you are a Medicare recipient, Dr. Martins' bills cannot be submitted for reimbursement - you are responsible for the full session cost. Secondary insurance carriers may cover some treatment costs if you have out-of-network benefits (and it is worth a phone call to clarify this with your insurance carrier).
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SUBMITTING YOUR SUPERBILLS FOR REIMBURSEMENT?
If you have out-of-network behavioral health benefits, reimbursement kicks in once your yearly out-of-network deductible is met. Note that the reimbursement rate is usually only a percentage of what the insurance carrier deems to be "reasonable and customary" for specific procedure codes (e.g. 90792. 99213, 99214, 90833, 90836). It is worth learning about your benefits to anticipate your out-of-pocket costs before initiating your treatment.
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Dr. Martins' office does not submit reimbursement claims on your behalf - this is solely your responsibility. Often you can submit online claims and attach your Superbill as a PDF (which is how you will receive the Superbill upon invoice payment).
TIP: to maximize reimbursement and avoid headaches on your end: engage a company to help you receive the reimbursement your plan entitles you to. This can save you time and effort and achieve better results. There are several services you can find with an online search e.g. Sheer Health which Dr. Martins' patients have used successfully (especially for current patients with United Healthcare / Optum).​