Insurance
Jessie is in-network with United HealthCare, and Diana is private pay only at this time.
If you have out-of-network benefits, you may be eligible for reimbursement for part (or all) of the session cost. We don’t directly submit any paperwork on your behalf, but we’re happy to work with you to get any reimbursement available from your insurance.
If you’d like to use your insurance, you’ll pay us directly for services and submit a superbill to your insurance company. We will provide the necessary paperwork to do this, and your insurance will reimburse you directly if mental health services are covered. We’re also registered with Reimbursify to help simplify the process for submitting claims. You download the free app, register, and then you can submit claims electronically. It only takes about a minute to do and costs $1.99 per claim.
A few things to note: most PPO and POS plans have out-of network benefits, while HMOs typically do not. You usually need to meet your out-of-network deductible first (which is different than your regular deductible), before you’re eligible for reimbursement. You also may not be reimbursed for the full session fee; most clients receive a percentage back, but this varies between plans. Creating a superbill does require a diagnosis and a few details about treatment, such as dates of service and type of session. If you have concerns about having a diagnosis on your health record, you might want to choose the private pay option rather than using insurance.
It is important that you get answers to the following questions from your insurance provider prior to our first session in order to fully understand what your costs will be.
Prior to our first session, please call the number on the back of your insurance card and ask the following questions:
Does your plan cover mental health services? If you’re interested in online sessions, be sure to ask about telehealth coverage as well. Some plans will reimburse for in-office sessions but not for online counseling.
What is the rate of reimbursement for an out-of-network provider (will you be reimbursed for the full fee or just a percentage)?
What is the amount of your out-of-network deductible? This might differ from your regular deductible.
How much remains to meet your deductible for the year? When does it reset?
Is pre-authorization needed for mental health services?
Is there a yearly session limit?
If your insurance does provide coverage for mental health services:
Because we do not accept your insurance benefits directly, you will pay the full fee for each session at the time of service.
We will provide you with a statement covering the required information that you can submit to your insurance company (a "superbill"). You can submit this on your own or using the Reimbursify app. Your insurance company will then reimburse you directly, usually within 2-4 weeks.
You will receive an “Explanation of Benefits” (EOB) from your insurance company each time you submit a superbill.
If you remain in treatment until the time that your deductible resets (usually January 1 of each year), you will again need to satisfy your deductible in order to use your insurance benefits.
If you are billed for a missed session (session missed or cancelled within 24 hours of appointment), you will be personally responsible for the full fee as insurance does not pay for missed sessions.
Using an FSA/HSA card:
We can accept any type of debit or credit card, but it is your responsibility to determine whether online mental health services are an eligible expense under your plan. You might need to obtain a referral from a medical provider (such as an OB-GYN, midwife, general practitioner, or psychiatrist) in order to qualify as an eligible expense.
Hopefully this gives you a better idea about using out-of-network benefits for counseling services. Please contact us if you have any further questions!