Do you take insurance?
I do not "take" insurance in the sense that I am not on any insurance company's in-network panel. If I were, insurance companies would pay me about 1/3 of what I need to bill in order to sustain my practice and make a living.
Can I still use my insurance?
Yes, if you have the more expensive insurance with "out-of-network" benefits. These benefits allow people to see any doctor they wish but at a premium price. You can estimate how much therapy might cost by knowing the information below, which you can find by calling your insurance company or reviewing your benefits brochure.
Out-of-Network Variables (all of which get reset annually):
- Deductible: the amount of your co-insurance you must pay before the insurance company starts to pay their part.
- "Recognized" or "Allowed" amount: the cost of therapy that your insurance company uses to calculate your co-insurance.
- Co-insurance: the percent of the "allowed" amount that you are responsible to pay. However, it is possible that my cost per session is higher than the "allowed" amount. Then, you are responsible for paying the co-insurance plus the full cost in excess of the "allowed" amount.
- Out-of-Pocket Maximum : some insurance companies set a limit on how much you spend per year. Once you reach this limit, the insurance company will pay for 100% of the cost! However, different insurance companies include or exclude different costs towards this maximum.
- Some insurance companies limit the number of sessions you are allowed to have per year. You should know this number, too, so you are not hit with unexpected costs.
The insurance company might ask you for the procedure codes I might use. Here is the list of possible codes:
- 90791: Evaluation
- 90834: Individual Psychotherapy
- 90846: Family Therapy without Patient
- 90847: Family Therapy with Patient
How do I get my insurance to pay?
Insurance companies need to receive a claim to process the payment. You can submit the claim yourself with a copy of the receipt. In fact, most therapists do not submit claims for you and you are responsible for submitting the claim. With me, you have the option of having me submit the claim for you. I do this on a monthly basis. After a couple of months, the insurance company will send you a check for any part of the cost they cover.
How do I pay for therapy?
I usually request payment at the end of every session (cash, check, or credit card). Most of my patients allow me to keep a credit card number on file, and I charge the card at the end of every session. This allows for the most hassle-free process.