Do You Accept My Insurance?
I am currently an in-network provider with most of the plans offered by Optum Behavioral Health, including United Healthcare and UMR. As an in-network provider I have agreed to accept the maximum allowable fee set by these companies.
I am required to collect the portion of that fee identified as a “deductible”, “co-pay” or “co-insurance” amount at the time of our session. It’s your responsibility to contact your insurance carrier representative to determine the amount of this fee. For tips on this conversation, see “What Questions Do I Need to Ask My Insurance Company Representative” below.
Can I Use My Out-of-Network Benefits?
Yes. Even if your insurance plan is not listed above we can still work together using your out-of-network benefits. Most policies have a provision for reimbursing a portion of the fee paid by their insured to their therapist. Often this amount will be greater than the maximum amount paid to an in-network provider.
If you want to use your out-of-network benefits I will provide you with a statement called a “Superbill”. This statement shows the amount you paid me and other information required to initiate the insurance billing process. (A diagnosis code is required on this statement.) Your insurance company will use this information to reimburse you for the cost of your therapy at the out-of-network rate. Please call your insurance carrier representative to determine the amount of this reimbursement. For tips on this conversation, see “What Questions Do I Need to Ask My Insurance Company Representative” below.
If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you may be charged for the full rate of the session. Please be aware that insurance will not pay or reimburse for any portion of a missed appointment fee. Likewise, Health Savings, Flex Spending or Health Reimbursement cards do not accept charges for missed appointments.
What Questions Do I Need to Ask My Insurance Company Representative?
Most policies today include a mental health benefit. Depending on your current health insurance provider or employee benefit plan, it is possible for services to be covered in full or in part.
If you choose to use your insurance benefits, I highly recommend directly contacting your insurance company representative to verify how your plan compensates you for psychotherapy services. Asking these questions will provide information to help make your decision:
– Does my health insurance plan include mental health benefits?
– Do I have a deductible for “in-network” benefits? If so, what is it and have I met it yet?
– Do I have a deductible for “out-of-network” benefits? If so, what is it and have I met it yet?
– Do I have a co-pay or coinsurance fee? If so, what is it?
– Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
– Do I need written approval from my primary care physician (PCP) in order for services to be covered?
– Is my plan a HMO (Health Maintenance Organization), an EPO (Exclusive Provider Organization) or a PPO (Preferred Provider Organization)? Coverage under an HMO limits provider options to those who are “in-network”, may require PCP authorization, and may restrict the network geographic coverage area. An EPO is similar to and HMO but does not require a PCP referral. A PPO does not restrict your access to out-of-network practitioners.
An often overlooked consideration in making the choice between insurance or fee-for-service is that all insurance companies require a mental health diagnosis be given in order to pay for services. This diagnosis will become a part of your permanent health information record.
What is the Cost of Not Getting Help?
Therapy can be an expensive investment of time and money. When considering the cost of care, a seldom asked but relevant question is “What is the cost of NOT going to counseling?”.
Thinking of the natural connections between your mind, body and spirit, when one is out of balance all suffer. Studies have shown that negative life experiences do adversely effect our mental health. This often leads to physical problems. Negative self-beliefs and emotions not expressed can be held in out bodies and create physical pain, tension and posture problems. The probability of accidental injuries increases with anxiety, stress, and depression. Addictions, heart attacks, and digestive problems can also accompany the symptoms of mental health out-of-balance. Unaddressed mental health issues also negatively impact the quality of personal relationships. In some cases the ability to hold down a job declines leading to unemployment.
I Believe YOU Matter!
Through the process of therapy the symptoms that have been disrupting your life change for the better. As the mind, body and spirit come into balance you feel better emotionally and physically; relationships are more satisfying, you are more able to accept situations, others and yourself, emotions are managed more effectively, and personal joy begins to surprise you as you find your burden has begun to lift.
You matter and you are worth the time invested in the work of therapy. Only you know your personal circumstances. If you are ready to begin and your financial situation cannot bear the expense please reach out to me anyway. I may be able to direct you to and agency or other organization receiving subsidies to offer lowered fees.
Any Other Questions
Please contact me for any additional questions you may have. I look forward to hearing from you!