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SEEKING REIMBURSEMENT FROM INSURANCE COMPANIES

As a counselor I have chosen to only provide services as an out of network provider. This means that if you see me, and you feel I might be the right counselor for you, you will need to pay me at the time of our session, and then claim a refund from your insurance company. If your insurance plan does cover providers who are out-of-network, then I can complete the required documentation so that some or all of your payments are reimbursed.

PROTECT YOURSELF AND DO THE RESEARCH

  • If you are considering using out-of-network benefits, it is wise to first contact your insurance company and ask the following questions:

  • Does my plan cover counseling sessions?

  • Does my plan cover only individual counseling or will it also cover family or couples counseling?

  • How many sessions does my plan cover in a year? How many sessions do I have left?

  • Does my plan cover services to out-of-network mental health providers?

  • What is the deductible I have to meet before coverage to an out-of-network provider kicks in?

  • What is my copay or what percentage of treatment do I pay when seeing an out-of-network mental health provider?

  • Is there a maximum amount per session the insurance will cover for an out-of-network provider?

  • How much time do I have to file a claim for out-of-network services?

  • Do I need pre-authorization or a referral from my PCP to see a counselor?

  • If I need pre-authorization, do I need to call or does my counselor?

  • What is the process to get reimbursed for out-of-network services?

Please be very clear about the last question. Each insurance company will have a slightly different process and it is vital to know what information your company will need and what form your company uses so that you can be given the proper documentation for your claim.

GETTING REIMBURSED

Upon request, I can provide you with a detailed invoice. It contains all the information that most insurance companies require. Please know specifically what your insurance company will need from you so that the practice can provide you with the adequate documentation that you need. Once you have your documentation, you can provide it to the insurance company so that it will reimburse you for your payments.