Insurance for Counseling

I am a provider for several major insurance companies.  Using your insurance to help with the cost of counseling can be a bit complicated.  Health care is changing and there are still many unknowns.  It will be easier for both of us if you learn about your benefit before we meet.

Please contact them first to find out what your mental health benefit is and how it works.  You can call or contact them online.  Contact information is on the back of your card.

 

Be sure to ask the representative:

  1. What is your deductible and have you met it?
  2. How many sessions are you allowed on your plan?
  3. Are there any exclusions to your plan?
  4. What is your out-of-pocket or co-pay per session?
  5. Do you have an out-of-network benefit?  (If I am not a provider for your plan)

 

Your insurance will only pay if you have enough symptoms that fit a covered diagnosis.  They require a mental health diagnosis with documented “medical necessity” before a claim is reimbursed.  Sometimes they require a written assessment, treatment plan and follow-up summary in order to authorize additional sessions.  Once your insurance company receives that information, I can no longer guarantee confidentiality.

I will electronically bill your claim for your primary coverage for you.  You will bill your secondary if you have it.

Your insurance company will most likely manage how many sessions you are allowed depending on the severity of your symptoms.  Once you no longer fit their criteria or you run out of sessions, we can discuss the option of continuing to work with me on a private pay basis.

Your co-pay or co-insurance is due at each appointment.  If your annual deductible isn’t yet met, then you will pay my full fee per session until you reach it.   Know that it typically takes insurance 4-6 weeks to process claims.

We can discuss the ins-and-outs of using your insurance at your first appointment.  Please come prepared with information about your plan and your card so I can help you figure it out.

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