Although the choice to use your insurance for reimbursement of therapy is yours, please consider the following before making this decision:
- Insurance companies are designed to reimburse for the treatment of illness. Therefore, a psychiatric diagnosis is required before any reimbursement is allowed.
- Managed care companies control many facets of your therapy, including the medical necessity of care, the type of therapy they will cover, and the duration and pace of therapy.
- All insurance companies require some personal information in order to facilitate processing your claim.
Because I value confidentiality and believe that your therapy should be guided by you and not your insurance company, I am not, “In Network” with any managed care plans. To find out what your insurance plan will reimburse you for, call them and ask the following questions:
- Do I have mental health benefits?
- Does my plan have out of network benefits?
- What does the company allow (“reasonable and customary”) for the following codes: 90791, and 90837?
- How much does my plan cover for an out of network mental health provider?
- Is approval required from my primary care physician?
- Are there standardized forms I will need to submit for reimbursement? Where do I find them?
- What is my annual deductible and has it been met for this year?
- When does my calendar year start?
- How many sessions per calendar year does my plan cover?
