I am an in-network provider for:
If you choose to utilize your insurance benefits, as an in-network provider of the above-mentioned companies, it is my contractual obligations to submit claims to them. Any costs that are not covered by your plans (e.g., co-pay, deductibles, co-insurance, certain services) are your responsibility.
Please check with your health insurance about your responsible portion of the charges. For example, you may have a co-pay for each office visit, a deductible that has to be met before your insurance pays for your services, or a co-insurance that is your responsibility even after the insurance pays for your services.
If you are unfamiliar with these terms, please call the customer service number on the back of your insurance card to find out what they are and what is your responsibility.
Please check your coverage carefully by calling the customer service of your insurer to verify whether I am an in-network provider for your specific plan. These are some of the questions that you may wish to ask:
Does my plan have out-of-network benefits? If so, what are they? (The cost is generally higher than seeing an in-network provider. You may want to utilize these benefits if you want to see a provider with certain specialties, but they are not in-network with your insurance companies.)
Do I have deductibles, co-pay, or co-insurance per an individual session for an outpatient visit? If so, what are they?
Using Your Insurance Coverage vs Private Pay Option
In order to utilize your insurance coverage, a provider needs to prove a "medical necessity." This means that a diagnosis needs to be given to the insurance company for billing purposes. Examples may include: Adjustment Disorder, Other Specified Anxiety Disorder, Persistent Depressive Disorder, etc. Because I value transparency and believe that people are entitled to make informed choices, I want this to be clear. Many clients who have received counseling prior to coming to me were never informed that a diagnosis is a term that is mandated by the insurance company.
Your insurance company may request a treatment plan or progress notes if they conduct an audit. Receiving a mental health diagnosis may impact your ability to receive health, life or disability insurance at a later date. If your physician or psychiatrist has prescribed medication such as an antidepressant, you likely have already received a diagnosis. Utilizing your health insurance for the same condition will not likely create further ramifications. This should not deter you from seeking the services you need, however. You get to decide whether you want to use the options of your health insurance coverage or private pay.