Selby Psychological Services, PLLC
Caring Psychological Services for All Ages

207-299-2442
6 State Street, Suite 502

Bangor, Maine  04401

 

serving the Bangor area
since 2007

Dr. Brian Selby can take the following insurances:

  • Aetna
  • Blue Cross/Blue Shield
  • TRICARE
  • United Behavioral Health (UBH)
  • Managed Health Network
  • Harvard Pilgrim
  • Cigna
  • Teamster's BehavioralHealth

Dr. Christine Selby can take the following insurances:

  • Aetna
  • Beacon Health Strategies
  • Blue Cross/Blue Shield
  • Cigna
  • Harvard Pilgram
  • United Behavioral Health (UBH)

Please call 207-299-2442 to schedule an appointment

New Clients


You should be commended for taking a step toward seeking psychological services from a well-trained, licensed psychologist. Making the decision to seek psychotherapy services is a sound and potentially life-changing decision. 
We are invested in helping you make changes that may allow you to live a more satisfying, healthy, and well-balanced life.

Please continue your journey to wellness by contacting us to make an appointment with either Dr. Brian Selby or
Dr. Christine Selby.

Below you will find sections on 1) Fees and Insurance, 2) Printable Forms (including the Outpatient Services Contract From which includes a complete description of our policies and procedures) and 3) HIPAA and Federal Red Flag
Rules.

 

 

FEESinsurance


Payment is expected at the time services are provided.  The full fee is due at the time of your appointment. If however, you are using insurance you may only be responsible for a co-payment or coinsurance amount.  

If you are using insurance pre-authorization may be required.  Please verify with your insurance company what your behavioral health benefits are. 



 
Fees
  • Initial 45-50 minute appointment (diagnostic interview): $165.00
  • Ongoing 45-50 minute sessions: $110.00 per session.
  • Crisis Sessions: $150.00
 
Insurance

Please see the information on the far left to see if Dr. Selby accepts your insurance.  If your insurance is listed it will be important for you to verify with your insurance company details on deductibles, coinsurance, and co-payments.  You may have to pay the entire session fee if you have a deductible.

If your insurance is not listed you may still be able to use your "Out of Network" benefits.  We recommend contacting your insurance company regarding this option.

For additional questions about billing, payment, or insurance please send an email to DrChristineSelby@Hushmail.com or call 207-299-2552 to leave a message

 

 

 

 
Payment
The following forms of payment are currently accepted:
  • Cash
  • Personal Checks (in state only)
  • American Express
  • Discover
  • Master Card
  • Visa
  • Debit Cards


As an added convenience, you can authorize Dr. Selby to charge your Credit or Debit card for co-payments, deductible fees, etc.  Please print and complete the Credit Card Authorization Form for this purpose.

PRINTABLEforms


Several forms are required to initiate services with Selby Psychological Services.  To save time at your initial
appointment (or to avoid having to arrive early) please print and complete the forms below to bring with you to your first
meeting.  You will need to complete the first two forms: 1) Outpatient Services Contract and 2) Disclosure of
Health Information Consent Form
.  You will also need to complete either the Adult Intake Form (for clients 18
years old or older) or the Child Intake Form (for clients 17 years old or younger).  The Release of Information 
Form
can be printed in the event that there are family members and/or other professionals with whom you would like
Dr. Selby to communicate or coordinate services.

 
Outpatient Services Contract

 

Disclosure of Health Information Consent Form

 
Adult Intake Form

 

Child Intake Form



 

 
Release of Information Form

 

 

 

 

HIPAAfederal red flag rules


Selby Psychological Services strictly adheres to the Health Insurance Portability and Accountability Act
(HIPAA).
  As such we have developed a HIPAA Policy Statement.

We also adhere to the Federal Trade Commission's "Red Flag Rules"which require us by Federal Law to ensure 
that the individual seeking services is also the individual named in the insurance policy.  To accomplish this, we will
ask you to bring photo identification (i.e., driver's license, passport, or other government issued ID) and current
insurance card.  If the address on your photo ID is not current then we will require a utility bill, lease or other evidence
of current address.