FAQ’s

Insurance

Category: Insurance

Dr. Swinton is happy to bill your insurance for your counseling services. Insurance panels he currently accepts include:

  • AETNA
  • Alaska Medicaid (aka Denali Care & Kids Care)
  • Beacon Health Options
  • First Choice Health
  • Premera Blue Cross Blue Shield of Alaska (also all other BCBS & Federal BCBS plans)
  • Optum
  • United Healthcare

Other insurance information:

  • If Dr. Swinton does not accept your insurance, we are happy to provide you with a superbill so you can seek out-of-network reimbursement directly from the insurance company.
  • All patients wishing to bill a third party for treatment will be required to keep a credit or debit card on file that will be billed as soon as insurance is processed.
Category: Insurance

The following will influence if and how much you may have to pay when using your insurance:

  • Negotiated rates: Insurance companies have a negotiated rates with Dr. Swinton (as they do with all providers). These rates vary depending on the insurer and the type of service provided (e.g. intake session, individual follow-up session, couple or family session follow-up, session evaluations). These rates may be more or less than his self-pay rates.
  • Insurance with a deductible: If you have an annual deductible that deductible will need to be met before insurance will contribute to the cost of your treatment. For example, if you have a $2,000 deductible you will need to have paid $2,000 in covered healthcare expenses during your current deductible year before your insurance will contribute. You are responsible for the cost until then. All payments made for counseling services will be applied to your annual deductible. The deductible resets each year. You will always get the negotiated insurance rates for services regardless of if you have met your annual deductible or not. Once your deductible has been met you will be responsible for coinsurance payment. Coinsurance is the percentage you will pay of the services rendered. A common coinsurance breakdown is 80/20, meaning insurance will pay 80% of the costs after the deductible is met and you will be responsible for 20% of the cost. The percentage you are responsible for typically ranges from 0% – 30%. You can reach out to your insurance provider to identify your coinsurance rate.
  • Insurance with a defined copay: Some insurance plans have a set copay. This rate will be the same regardless of what kind of treatment is provided. Typical copays range from $15 – $60 per session. Insurance will pay all other costs beyond your copay regardless of what kind of service was provided (e.g. intake, individual follow-up, couple or family follow-up). This rate is typically listed on your insurance card if you have a defined copay. You can also reach out to your insurance provider to identify your copay.
  • Out-of-Network: If Dr. Swinton does not accept your insurance, you will be required to pay the self-pay rates at the time of service. We can then provide you with a superbill so you can submit it to your insurance provider to seek out-of-network reimbursement.
  • How you pay: We take care billing the insurance company for you if we accept your insurance. Once we hear back from the insurance company, we will bill a credit or debit card on file in your chart. All patients wishing to bill a third party for treatment will be required to keep a credit or debit card on file that will be billed as soon as insurance is processed. We will do everything we can to increase the chance your insurance will cover your treatment. However there are uncommon situations where claims are rejected. In these cases you will be required to pay the self-pay rates for your treatment.
Category: Insurance

When doing any type of couples or family counseling one person in the couple or family is the “identified patient”. Sessions will be billed under this person. However, all participants will be asked to complete a brief set of evaluations at each visit which help Dr. Swinton track progress. Insurance companies encourage progress tracking and as a result they reimburse for doing this. Hence, if more than one person participates, tracking will be done for each participant and each participant’s insurance will be billed for these evaluations. If any participants do not have insurance, Dr. Swinton will waive that participant’s requirement to bill insurance.

Self-Pay

Category: Self-Pay

The No Surprises Act requires notification of the potential total cost of counseling. Cost can vary significantly depending on the number of sessions needed, session frequency, presenting challenges, diagnosis, implementation of counseling recommendations, and other varying factors. However, most people attend between 5 and 20 counseling sessions*. Hence, the potential total cost of therapy for those who are paying out of pocket, uninsured, or whose treatment is not covered by their insurance is as follows:

Total cost of 5 sessionsTotal cost of 12 sessionsTotal cost of 20 sessions
$1,045$2,438$4,030
Category: Self-Pay

For those who are paying out of pocket, uninsured, or whose treatment is not covered by insurance, Dr. Swinton’s self-pay rate for services is $249 for intake assessments and $199 for follow-up sessions regardless of service code or diagnosis. Payment is due at the time of service.

Other Payment FAQ's

  • Credit card
  • Debit card
  • Health savings card (HSA)
  • Flex spending card
  • Check
  • Cash

When an appointment is booked, we hold that time for you. Dr. Swinton’s services are in demand, and he typically operates with a substantial waitlist of people who want to receive assistance. When appointments are missed or canceled late that leaves an hour empty that could be used by someone else. Hence, appointments not canceled by 9:00 am the business day prior to your appointment will be subject to a $55 fee. Same-day cancelations and no-shows will be subject to a $95 fee. 

Session Questions

Category: Session Questions

Counseling sessions are approximately 50-minutes in length.

Category: Session Questions

Each session you and any other participants in counseling (in the case of family or couples counseling) will be asked to complete four brief evaluations that track mental health symptoms, stress levels, and overall outcome progress. It is best practice to track indicators of progress. As a result, insurance companies will reimburse Dr. Swinton for the administration, scoring, recording, and tracking of the results of these evaluations. Hence, if you have insurance pay for counseling, we will submit claims for these evaluations. The reimbursement rates are small and typically don’t add much in terms of cost to patients. If you are self-pay the evaluations will still need to be completed, but there is no additional cost for the administration, scoring, recording, and tracking because we don’t have to take the time to bill the insurance company.

Category: Session Questions

The number of sessions needed significantly depending on the number of sessions needed, session frequency, presenting challenges, diagnosis, implementation of counseling recommendations, and other varying factors. However, most people attend between 5 and 20 counseling sessions.

Category: Session Questions

Yes! In addition to family relationship challenges Dr. Swinton is thoroughly trained and experienced in diagnosing and treating mental health issues and addictions. He often encourages those with individual challenges to bring a partner, spouse, or parent if applicable to work together toward the individual counseling goals. However, he encourages patients to make this decision.