We understand that therapy is expensive, and we are committed to making our services accessible to as many people as possible. Although we do not accept insurance, we have a billing specialist ready to assist you with any questions you may have about receiving out-of-network benefits, as well as helping you explore other financial avenues. To begin, please see the following resources:
Determining Out of Network Benefits
Most insurance policies cover mental health services, and many offer out of network benefits, meaning they will pay for a portion of services provided. We require that services be paid for upfront, so this means you will pay out of pocket at the time of service, then we will provide you with a superbill to submit to insurance for reimbursement. 0n figuring the total cost to you, there are many things to consider, such as:
- Out of Network Deductible
- Coinsurance
- Out of Pocket Maximum
- Qualifying circumstances
- Process for filing claims
- Reimbursement timeline
It is typically best to call your insurance to get this plan-specific information from them directly. I recommend asking for your mental health benefits and asking the following questions:
- What is my out of network deductible?
- What is the coinsurance for outpatient individual counseling?
- Are telehealth services covered?
- Do you cover group therapy?
- Is there an out of pocket maximum for out of network costs?
- Is a diagnosis required for services to be covered?
- Does a clinician have to hold certain licenses or qualifications to be covered?
- Are there limits to how many sessions are covered?
- What is the process for filing claims?
Here are links to some common health insurance companies and their contact pages:
Understanding Your Benefits
Insurance typically only covers mental health services provided by a licensed clinician, so be sure to tell us if you plan to submit claims to insurance, and we will match you with one of our licensed clinicians.
Now, let's assume your insurance has the following out-of-network benefits:
Deductible: $3000
Coinsurance: 50%
Out of Pocket Maximum: $6000
Because of that deductible, your insurance would not reimburse you for any costs until you have paid $3,000 in addition to your monthly premiums. Assuming therapy was your only out of network costs, you would pay the first 16 sessions ($195/session) at full price with no reimbursement from insurance.
After reaching that amount, your insurance would begin to reimburse you at a rate of 50%. Thus, insurance would reimburse you $97.50 for each following session. After paying $6,000, insurance would begin reimbursing you for the total amount. It would take another 31 appointments paying $97.50 per appointment, to reach the total amount paid of $6,000. Thus, your 48th appointment would be reimbursed in full by insurance.
There can be additional factors that play into benefits, such as allowed amounts and authorizations, so please talk to your insurance representative to understand your plan-specific benefits.
Alternatives to Insurance
If you would rather not use insurance, or your plan does not cover mental health, there are additional options. Please consider the following resources:
- Employee Assistance Programs: Oftentimes, your employee benefits already include some kind of wellness package that will cover a limited number of sessions with a therapist. Speak with your HR specialist to find out if your company offers any such programs and how you can take advantage of those benefits.
- Reimbursify: This is an app that will file your claims for you, for a fee.
- Clergy Pay: Your church may have resources to help pay for mental health as well. It is always worth asking the clergy of your church.
- Sliding Scale: We offer sessions with a student or post-doctoral clinician at a reduced cost based on your income. Please see our Cost and Payment page for more information.
Summary
We want you to get the help you need, and we are prepared to work with you financially. Please do not hesitate to contact our billing specialist for additional questions or special circumstances. Email:
Phone: 385-446-5029
