Q: What does Out-of-Network mean?

A: People that have Out-of-Network coverage will still be reimbursed a portion of the cost.  The invoice I provide has the information the insurance company will need to process the claim and submit payment back to you.  As an example: If your Out-of-Network benefits are covered at 80%, the insurance company will reimburse you 80% of the session cost.  If you pay $125.00 for your appointment, the insurance company would pay you back $100.00.  Please know these are hypothetical numbers, each insurance company and plan is different.  You will need to contact your insurance company directly to find out your information.

Q: How can I find out what kind of coverage I have?

A: Contact the number on the back of your insurance card (either Member Services or Behavioral Health Services) and ask what your Out-of-Network Coverage is.  They will likely give you a percentage of how much they will cover, which will help us determine what your out of pocket costs for the services would ultimately be.

Q: What if I don’t have Out-of-Network Coverage?

A: All that would mean is we would not go through your insurance company at all during the process. I offer a sliding scale fee for individuals that do not have the Out of Network benefits.  Please contact me directly at the link or phone number above for more information regarding my sliding scale fee option.

Q: If I go through my insurance, how much of my information do they get?

A: The invoice that you submit to your insurance company will contain your name, date of birth, the date of the service, a procedure code, and a diagnosis code.  The procedure code identifies what type of session it is (intake, individual, etc). The diagnosis code is your mental health diagnosis which is taken from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).  Please know that your insurance company will not process or pay out a claim without a diagnosis, it is required in order for them to reimburse you.  I believe in full disclosure with my clients, so your diagnosis is something that we would explore together prior to any code being put on your invoice.  This is all the information that is included on your invoice, and I have no communication with your insurance company directly as the invoices are provided to you. However; an insurance company may contact me after a certain number of sessions if they feel the problem should have “resolved” by a certain point, and they are considering stopping payment.  Please know that if that happens, I will advise you immediately before taking any further steps.  At that point, you and I will determine together what the appropriate next step would be.