Samantha S. Maierle, Ph.D.
Licensed Clinical Psychologist
Most of the services I provide are covered by health insurance programs that include mental health coverage.
Fee-for-service terms are available if you do not wish to use your health insurance or if your insurance does not cover mental health.
I am a contracted provider with most major health insurance companies, including BCBS, Cigna, Aetna, Medicare, Tricare and numerous others
Most health insurance plans require you to pay a copay or co-insurance for the services they cover. For my services,this is typically the amount indicated on your insurance card for "specialists"
1. Call to make an appointment (843-452-0669) and provide me with your name, date of birth, street address, insurance company name, insurance id number.
2. With your permission, I will contact your insurance company to determine the exact benefits your insurance will provide for my services.
3. I will inform you of these benefits prior to your first appointment so that you know exactly what your payments will be and what your insurance will cover.
4. Bring your insurance card, driver's license and the initial forms downloaded from this site to your first appointment. I will make a copy of your card and identifying information for your chart and we will contact your insurance company together if either of us has questions about what they require or what they will pay for my services.
5. I will send claims to your insurance company on a monthly basis. Within a week or two of each claim, we will each receive an explanation of benefits (EOB) documenting the services I billed, the amount insurance paid or applied to your deductible, and the amount you are expected to pay for each service.
6. If you have questions, we will review your EOBs at your convenience. I will make any adjustments in compensation necessary.
*The following information is provided to assist you with a basic understanding of the terms we may discuss when you wish to use your health insurance to help pay for my services. These are not complete, legal definitions. Please see your insurance contract or contact your insurance carrier for more in-depth explanations.
Contracted Provider: provider who has entered a contract with an insurance company in which they agree to accept the payment rates set by the insurance company and to follow procedures approved by the insurance company
Pre-authorization or pre-certification: some insurance companies require the provider to obtain a pre-authorization or pre-certification before the patient is seen. The pre-authorization or pre-certification means that the provider is approved to provide the requested service and that the insurance company will consider payment for the service at the contracted rate. It is important to note that while a pre-auth or pre-cert may be required for insurance payment, it is not a guarantee that the insurance company will pay for the services.
Deductible: the amount of money a patient pays for health services before their insurance begins to pay the contracted rate
Copay: amount of money a patient pays to the provider at each health service visit after the deductible is met. The copay is a relatively small portion of the contracted fee that is paid while the insurance company pays the remainder of the contracted fee. For example, if the contracted fee for a particular service is $80.00, the copay made by the patient to the provider may be approximately $25.00 while the insurance company may pay the provider the remaining $65.00.
Co-insurance: co-insurance is similar to the copay. However while a copay is a set amount, a co-insurance is a percentage of the contracted fee. For example, if the contracted fee is $80 dollars, the co-insurance might be 20%, meaning that the insurance company pays 80% of the fee ($64.00) while the patient pays the provider 20% of the fee ($16.00).