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Courage • Compassion • Connection

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Consultation & Training

Donna Marie Gold, LCSW | LCS 28494 | Phone (858) 227-9182 | Fax (858) 227-9477

11835 Carmel Mountain Road | Suite 1304, PMB 153 | San Diego, CA 92128

Psychotherapist Specializing in Trauma Survivors

San Diego Access & Crisis Line: 1-888-724-7240

For a life-threatening emergency, dial 911.

LCS

28494

858.227.9182

• I am an approved provider for several insurance companies including MediCAL and MediCare. (*See HMO “in network” section below.)

• I also accept almost any PPO insurance as an "out of network" specialist. (*See PPO “out of network” section below.)

HMO “In Network” (Including MediCal and MediCare)

If utilizing your insurance, please contact me to confirm that I do take your insurance. I will need a copy of your ID and insurance card, and you will be

responsible for the copay if applicable.

Please check your coverage carefully by asking your insurance company the following questions:

Is Donna Gold, LCSW covered by my behavioral health insurance plan?

What is the amount of my yearly deductible and has it been met for the current calendar year?

How many sessions per year does my health insurance cover?

What portion of each therapy session does my insurance cover?

What is the amount of my co-payment for each therapy session?

Is approval required prior to my first therapy session?

PPO “Out of Network”

I also accept almost any PPO insurance as an "out of network" specialist. If I am not a provider for your insurance company and you would like to utilize your benefits, your insurance company will most likely reimburse you based on services rendered from an "out of network" specialist. I encourage you to contact your insurance company and ask the questions listed below so that you have a clear understanding of your coverage for services rendered by “out of network” specialists.

If utilizing “out of network” benefits, you will need to pay out of pocket at the beginning of each session, and you will receive a superbill that you can submit to your insurance for reimbursement through your “out of network” coverage. You will be responsible for seeking reimbursement from your insurance company, and because I am not contracted with your insurance, all communication regarding coverage and reimbursement will be between you and your insurance company. If for some reason your insurance company does not provide reimbursement for services rendered through “out of network” coverage, you will remain responsible for payment. Reimbursement should be received by you, directly from your insurance company, so your insurance company should be instructed by you to send all reimbursement payments directly to you, rather than to me (the provider), as you will have already paid out of pocket at the beginning of session when services were rendered.

Please check your “out of network” benefits carefully by asking your insurance company the following questions:

Is Donna Gold, LCSW covered by my behavioral health insurance plan as an “out of network” specialist?

What is the amount of my yearly deductible AND has it been met for the current calendar year?

How many sessions per year does my “out of network” benefit cover?

What portion/percentage of each therapy session does my “out of network” insurance cover?

How long after I submit a superbill will it take for me to receive a reimbursement check from the insurance company for sessions I pay out of pocket?

*Instruct the insurance company to send the reimbursement for services rendered directly to you. Any reimbursement checks for “out of network”

services that are received by this provider will be returned to the insurance company with directions to send all reimbursement payments directly to you.

Is approval required prior to my first therapy session?

Private Pay “Out of Pocket”

Others may choose to do private pay “out of pocket “ so their therapy is not impacted by the limitations and guidelines of managed care, such as a limited number of allowable sessions, being labeled with a diagnosis, etc. Whether you choose to do private pay or utilize approved insurance coverage is up to you.

*All Private Pay clients must have an active credit card on file. See the Cancellation Policy & Credit Card Payment Agreement document on the

“Getting Started” page for more information.

Insurance

Rates & Insurances

Payment

Intake Session (60 minutes) - $200 (Telehealth)

Individual Therapy (45 minutes) - $135 (Telehealth)

Individual, Couples, or Family Therapy (60 minutes) - $180 (Telehealth)

Crisis Add-on / Extended Session - $90 per 30-minute unit (Telehealth)

Case Management - $40 per 15 minute unit

Documentation - Base rate $75 + $25 per 15 minutes needed (if exceeds an hour)

Provision of documentation, including writing of reports, letters, etc., is left to the discretion of the therapist.(Please be aware that insurance does not generally cover or reimburse for documentation.) This DOES NOT include documentation related to legal or court-related matters. Please see the Legal Correspondence & Court Policies document regarding fees for legal documentation or court-related matters, as they are billed at a different rate.

Treatment Team Conference - $90 per 30-minute unit (Telehealth/Virtual)

Sliding scale available in certain circumstances.

Venmo, Zelle, and all major credit cards are acceptable forms of payment for sessions.

Please provide at least 24 hours notice for cancellations in order to avoid being charged for your missed session. (See Cancellation Policy here.) Thank you.

*Please be aware that there will be a $35 fee for any returned checks.

Rates

Currently Serving California Residents with Telehealth Services