Should I use my Insurance?

Access to services, equity in care, and full transparency are extremely important values to us as a company.

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Choosing to utilize insurance opposed to out of pocket could mean:​

• Your diagnosis will be part of your healthcare and your insurance provider will be made aware of the diagnosis. Insurance can sometimes push back on specific diagnosis.

• Insurance can determine when you no longer can receive services, how frequent your services are, your type of treatment, and your duration of treatment.

• Insurance will be able to request all notes and documentation from your therapist if warranted. They also require extensively detailed notes and diagnosis.

• Insurance does not tend to approve for more then one 50 minute session per week,

• Insurance does not always recognize or approve EMDR, Brainspotting, IFS, or couples therapy, which can limit the capacity of the work you may be able to engage in with your clinician.

• It could impact Life Insurance cost as your medical insurance is then aware of mental health diagnosis

• We are unable to retain/safeguard information including notes, diagnosis, etc from your insurer.​​

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This links to a great article that outlines insurance use.

Seeing an Out-Of Network Provider

Please contact your insurance provider to check coverage carefully by asking these questions: 

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•  Do I have mental health insurance benefits and are you able to pursue mental health services from an out-of-network provider? Is pre-authorization needed?

• How many appointments per year will my health insurance cover?

• Am I limited to 45 or 50 minute appointments or can I be approved for 90 or 120 minute appointments?

• Can I utilize EMDR, Brainspotting, or Couples Therapy?

•  What is the coverage amount per therapy session (percentage, max amount, ect)?

• What is the process for you to get reimbursement (partial or full)? (i.e. is there a specific form you must submit with your SuperBill)

• What procedural codes are needed in order to receive reimbursement?

• Do you recognize all diagnosis from the DSM for superbills? if not, which ones are not accepted? If they are on my superbill, will that impact my reimbursement?

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We highly recommend getting this in writing from your insurance, with an email and the employee name and employee number. Provide this information to your clinician. 

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical and

mental health care will cost.

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Under the law, health care providers need to give patients who don’t have insurance or who are

not using insurance an estimate of the bill for medical items and services, including psychotherapy services.

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You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychotherapy services.

This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service.

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You can also ask your health care provider, and any other provider you choose, for a Good Faith

Estimate before you schedule an item or service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

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For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.