My practice is an out-of-network provider for some insurance carriers. I understand that if you have insurance benefits you might want to use it for therapy sessions. I believe its important for me to inform you of the following:
- When using insurance, treatment needs to be “medically necessary”, therefore a mental disorder diagnosis must be reported to the insurance carrier.
- When using insurance, all of your reported medical data is kept for your lifetime. A diagnosis remains on your permanent record and could possibly lead to a long-standing impact on future healthcare.
- When using insurance, you must be “sick enough” for coverage to be provided. In other words, to continue therapy each session must be clinically justified. Many normal life struggles and transitions do not meet criteria for a justifiable and reimbursable diagnosis. As an out-of-network provider, I could be contacted by your insurance carrier to provide a justifiable reason for continued treatment needs.
- When using insurance, the amount of sessions is left in the hands of the insurance company.
- When using insurance, your confidentiality and privacy are not maintained. Third-party members become involved in the process and have access to you and your family’s sensitive mental health record.
On a monthly basis I can provide a statement, known as a, SuperBill, which you may submit to your insurance carrier for reimbursement. Although each insurance carrier is different, some clients have reported a 70-80% reimbursement rate. This SuperBill will be presented to you and you will need to complete all paperwork. While I am not an expert in insurance paperwork I would be willing to help.
I recommend that you contact your insurance provider prior to our initial meeting to better understand your insurance benefits and the reimbursement policy for an “out-of-network” provider.