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Insurance

Full Spectrum Psychiatry is generally a direct-care, fee for service practice. For special populations (patients with ASD, ADHD, OCD) we accept UPMC, Aetna and CCBH (Allegheny County Medicaid) Insurance*. Dr. Borue is not able to see any patients with primary or secondary Medicare plans.


The Benefits of Fee for Service:

Time and Quality

Over the last century, health-care administration has grown into a complex bureaucracy that frequently poses roadblocks to instead of facilitating effective psychiatric treatment. Physicians are frequently pressured into seeing 4 patients per hour, which amounts to less than 10 minutes of face to face time with patients. These types of time pressures are especially detrimental to psychiatric treatment, where sensitive topics are discussed and difficult problems solved. Direct-care allows Dr. Borue to focus on providing exemplary mental health care instead of cumbersome insurance-related paperwork. Because she sees a smaller number of patients, Dr. Borue is to spend additional time on evaluation, education, and treatment. She is also able to schedule new or follow-up appointments with less waiting time than is typical for insurance-based clinics.

Cost

Many health insurance plans are high deductible plans, and you may be responsible for all costs incurred until your deductible is met. Therefore you would be paying out-of-pocket for any psychiatrist, even if they were a provider under your insurance plan. Any payments made to Full Spectrum Psychiatry will count towards medical expenses on your taxes if you choose to claim them. Your insurance will still cover any laboratory work, medical procedures, or medications that Dr. Borue orders, just as they would cover any other physician that ordered those same tasks. Dr. Borue will still work with your insurance company regarding medication or procedure preauthorizations and coverage.

Confidentiality

Direct-care keeps insurance companies from having access to your psychiatric information and maintains your privacy at the highest level. It also indirectly maintains your privacy from your employer, since your employer negotiates with the insurance company for costs based on the pooled health of the employees. Your insurance company won’t be routinely reviewing all your medical records without your knowledge, except for what you specifically choose to share with them. You will likely still want insurance as the intermediary to pay for things such as lab work, imaging studies, or inpatient care.


 Payment

Payment of all accrued charges is due in full upon arrival, before each session, so that we can keep your account current. We accept checks, cash, credit cards, or Health Savings Account (HSA) Debit Cards. There is a $25 charge for any checks that are returned unpaid by your bank. Regardless of your preferred method of payment, we require a valid credit card to be kept on file for all patients.

Patients who plan to use insurance benefits to cover a portion of the cost of treatment should ensure they have met the specific requirements of their insurance plans. These requirements may be waived or modified by the insurance company if the patient insists that the network physician is not appropriate, based on requirements such as location or practice specialty.

For patients using insurance, we will file an insurance claim as a courtesy. If there are any problems with this submission, you will be notified immediately and your prompt assistance is required with any conditions under your control that are causing a delay in processing. Full Spectrum Psychiatry cannot guarantee that your services will be covered in full by your insurance company and you, as the patient or patient’s guardian are responsible for all charges not covered by your insurance.


Fees for our services are as follows: 

New Evaluation:

  • Standard: 60 minutes -  $310
  • Comprehensive (most Autistic patients, complex cases): 90 minutes-  $460

Follow-Up (for medication management and/or psychotherapy):

  • Comprehensive: 60 minutes -  $270
  • Standard: 30 minutes -  $160

We strive to complete most routine paperwork during our scheduled sessions. It may occasionally be necessary for us to charge on a prorated basis ($50.00 per fifteen-minute interval) for professional services that require extensive time commitment; such as specialized report writing, phone conversations lasting longer than 20 minutes, prior authorization appeals, and consultations with other professionals that you have requested. Full Spectrum Psychiatry cannot guarantee that your services will be covered in full by your insurance company and you, as the patient or patient’s guardian are responsible for all charges not covered by your insurance.