Using an "Out of Network" provider

We currently do not accept direct payments from insurance companies. In order to assist you in determining your own reimbursement from your insurance provider, we have outlined the steps you may take in order to find out the actual benefits that may be available to you.

Make sure you keep careful records of your conversation in the event you need to appeal a future decision by the insurance company.

Call the number on the back of your insurance card for the Benefits Department and ask the following questions: 

1. What is the representative's name and extension number? 

2. Does my policy cover an Out-of-network, Licensed Clinical Social Worker?

3. My therapist is willing to provide a statement of Session Dates Attended, the CPT code, and the diagnosis. Is this acceptable to the insurance company?

4. Does my policy cover Individual Psychotherapy? (Refer to CPT code 90837)

5. What mental health diagnoses are NOT reimbursable?

6. How many sessions are covered per year?

7. What is the lifetime maximum for mental health benefits? 

8. What is my Out-of-network deductible?

9. What is the allowed amount of the fee?

10. What percent of the allowed amount will be reimbursed? 

11. How do I file a claim?