Insurance
My practice focuses on providing genuine care and individualized treatment. I do not participate in health insurance networks and do not bill insurance directly. However, if your insurance has a PPO plan, I will be glad to to provide superbills for you to seek your Out-of-Network (OON) reimbursement which can typically cover 30%-70% of the cost depending on your plan.
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I am considered an Out-of-Network (OON) provider. Being an OON provider allows me to use my time directly to help clients and to maintain greater client privacy. Keep in mind that for you to submit your OON claim for your psychotherapy sessions, I must give you a mental health diagnosis that will stay on your permanent health record. In some cases, your insurance company may also ask for more details of your treatment. For those who want to ensure complete privacy and/or do not have diagnosable mental health disorders, they often choose not to file OON claims. Coaching/comprehensive consultation sessions are not covered by OON benefits.
If your insurance has a PPO plan and you intent to file OON claims, I will provide superbills at the end of each month. Please contact your insurance company directly about your OON benefits. Here are some key questions you may want to consult your insurance company:
1. Do I have Out-of-Network mental health benefits?
2. Are telehealth sessions covered?
3. Is individual psychotherapy (CPT codes 90834, 90837) covered?
4. What is my deductible amount and has it been met?
5. What is the reimbursement rate for my OON mental health services once my deductible has been met?
6. Is there a maximum allowed amount per session?
7. How many therapy sessions per calendar year does my plan cover?
8. How do I submit an OON claim?
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Good Faith Estimate (Per the No Surprises Act of Jan. 2022)
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” explaining how much your medical care will cost.
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