PAYMENT/UNDERSTANDING OUT-OF-NETWORK (OON) BENEFITS
I do not bill any insurance companies for our sessions. At the time of service, clients pay with a credit card that is on file that they authorize through the secured software/client portal. The credit card can be from an HSA, HRA, FSA, or personal account.
Many insurance policies include coverage for services for out-of-network providers. This means that you may be able to be reimbursed for our sessions. Typically, the sessions are reimbursed at a percentage of the total charge; however, you will have to contact Member Services (number on back of insurance card, via chat in a portal, or online via the insurance company's website). When contacting Member Services, you will be asking for the specific details of your out-of-network coverage for outpatient mental health services. Typically, the insurance company will ask you for procedural codes when they quote you your benefit. The codes you will reference are: 90791 for our initial appointment and 90837 for individual sessions, thereafter, or 90791 for our initial appointment and 90847 for sessions with two or more people, thereafter.
It is also important to find out if you have a deductible that has to be met ("satisfied") prior to your benefits being appropriated. This means that you will pay the per session rate and then, typically, the insurance company requires you to submit an invoice and a superbill to them to have the amount you have paid applied to your deductible. It is only once you have satisfied the deductible, that the out-of-network percentage will begin to be reimbursed back to you.
Please note, that at this time, Medicare will not reimburse for any out-of-network coverage.
Please let me know if you will be submitting for reimbursement, as I will provide you with an electronic 'Superbill' after each session. After each session, whether or not you are submitting to insurance, an invoice will be generated and sent electronically. These documents will have the required information for submittal to the insurance company or you may like to keep them for your personal records.
The current charge is $200.00 per session and may be subject to change.
Please contact me if you have any questions or for clarification.