Insurance Questions

“Do you accept insurance?”

We are an out-of-network provider. This means that your insurance may cover a portion of the therapy cost if you have out-of-network benefits. You will pay the full cost upfront and receive receipts to submit to your insurance company for reimbursement. If your insurance covers this service, they will send you a reimbursement check directly. We find that clients often receive 50-80% back from their insurance companies after meeting their deductible.

“What should I ask my insurance company?”

Three simple questions:
· Do I have out-of-network benefits for behavioral health?
· Do I have to meet a deductible before getting reimbursed?
· What is the percentage of reimbursement that I will receive for individual or family therapy?

“Why do you not accept insurance?”

Insurance companies often limit what therapists you can see, how long you can see them for, and the reasons that you can see them. We also have clients who would prefer to keep their information completely confidential and not submit diagnostic codes to insurance companies. If we contracted with insurance companies, we would be bound by their rules and required to submit documentation. We want you to be able to make your own mental health choices. If you choose to see us, we want you to be able to decide when you want to see us and for how long. Our out-of-network status puts you in the driver’s seat, not your insurance company.

“Does health insurance cover marriage/couples counseling?”

Health insurance does not cover marriage/couples counseling, however, many times, one or both partners may have a diagnosis that insurance would cover. We can determine this after your initial appointment and/or after your four-session assessment.

“What is a Good Faith Estimate?”

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, when feasible, before your medical service or item. You can also ask your healthcare 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.

If you have a question that we have not answered, please call to speak to our Client Care Specialists at 856.208.6443.