Do You Take Insurance?
One of the most common questions potential clients ask us is if we take insurance. The answer is no, but that doesn’t mean your insurance won’t pay for your therapy. Even if they don’t pay for your therapy, it may still be beneficial to you to notify them that you’re paying out of pocket, as it may count towards your deductible.
Navigating insurance can be tricky, so we’ve put together these guidelines so you can better understand the process and know what questions to ask your insurance company for the best chance of being reimbursed for your therapy costs.
Questions to Ask your Insurance Company
Do You Cover Out of Network Mental Health Services?
We are outside of your insurance company’s network. This simply means that we have not signed a contract with them. Many PPO insurance companies cover out of network services, but HMOs do not. If they say yes, you should be able to pay for our services out of pocket and be reimbursed by your insurance company.
If your insurance only covers in-network mental health services, they can give you a list of the therapists whose services they will cover. You may find the perfect therapist on this list! Or you may find that the list is short, the wait times are long, or none of them are a good fit for your needs. In that case, you may choose to see a therapist out of network anyway, and you’ll want to ask them….. .
Does This Count Towards My Deductible?
You may have a different deductible for in network and out of network services, so make sure to ask them about your out of network deductible. If your insurance company allows payments made out of pocket to count towards your deductible, it could save you hundreds of thousands of dollars in the long run. For example, if your deductible is met by paying for your weekly therapy appointments and then you need to see a doctor, it should be covered! Make sure to ask how much of your deductible you have already met this year.
What Exactly Do You Cover?
If your insurance company does cover out of network therapy services, you’ll want to find out the details. Ask:
Is Virtual Therapy covered?
How many sessions are covered?
Do you cover couples or family therapy?
Do you cover associate therapists or only licensed therapists?
What is My Coinsurance Percentage?
If your insurance company does reimburse for out of network services, they may not reimburse the whole amount. For example, if your coinsurance percentage is 25%, you are responsible for paying for 25% of your therapy costs and your insurance company will reimburse you for the other 75%.
What is the Allowed Amount?
Some insurance companies put a limit on the amount that they will pay for each session. This is called the “allowed amount.” You will pay our fee out of pocket and your insurance will reimburse you the allowed amount, minus your coinsurance percentage.
How Do I Submit a Claim?
Find out your insurance company’s process for submitting claims for reimbursement. In addition to any paperwork they have you fill out, they will tell you to submit a Superbill. This is simply an invoice that shows how much you paid for services so they know how much to reimburse you. Our superbills contain all of the information the insurance company needs to process your claim, and we will send it to you through our secure portal, usually within the same day you request it.
How Often Should I Submit a Claim?
Some insurance companies have a time limit on claims. If you wait too long before trying to get reimbursed, they may deny your claim even if they otherwise would have paid out. Ask your insurance company about their rules, and make it a habit to submit a claim on a regular basis, such as every month or every quarter.
We hope this answered your questions and helped ease some of your fears surrounding insurance and how to pay for your therapy. If you have any other questions, please contact us!
Insurance is inherently connected to money and that can be a scary topic for many people. If it brings up feelings of anxiety or dread for you, that is something you can explore with one of our therapists in sessions and discover ways to help you feel confident.
Wishing you all the best on your journey!
Emily,
Client Care Coordinator
