Insurance & Out Of Network Benefits

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You can find out information regarding your specific plan and benefits by reaching out to your insurance provider directly. Here are a few questions that we encourage asking when communicating with your provider:

• Does my plan have out of network coverage for mental health services?
• How many sessions are included?
• What is the process to submit superbills for reimbursement? 
• What amount will I be reimbursed for an initial evaluation/ intake and individual therapy?
• Does my plan include telemedicine for online sessions?

Once you have confirmed your out-of-network benefits it is important that you notify us if you plan to use your out-of-network benefits. We will then get you set up to received a superbill through your client portal each month. The superbill is a document used for insurance reimbursement. 

Keep in mind that insurance only pays for medically necessary treatment therefore, services are only typically covered if there is a mental health diagnosis. If you need a mental health diagnosis for your treatment we can schedule you for a diagnostic assessment. However, we are unable to assign a diagnosis for the purposes of insurance reimbursement if you do not meet the diagnostic criteria. 

 Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.