I am a private pay or “out of pocket” practice. I do not accept insurance.
You may have an “out-of-network” benefit which allows you to see any therapist, pay directly, and then be partially reimbursed by your insurance provider. I can provide you with a Super Bill, which includes a diagnosis, dates and payments for each session so you have documentation to submit to your insurance company for reimbursement. The best way to determine what portion of your fee may or may not be reimbursed by your insurance company is to contact them directly by calling the customer service phone number on the back of your insurance card. There is often a separate phone number for mental health or “behavioral health” services information. When speaking with your insurance company, you will want to ask them the following questions:
What are my “out-of-network” outpatient mental health benefits? How much of each therapy session will you, the insurance provider, reimburse (this is typically a percentage)?
Must I meet a deductible (the amount of money you have to pay before your insurance company will start to reimburse you) before my benefits will begin paying for out of network providers? Have I already paid any of this deductible?
Are there any limitations to services (e.g., only a certain amount of money allowed for mental health reimbursements, a limited number of sessions, reimbursement only for certain types of diagnoses, etc.)?
Do you need any kind of special referral (i.e., from a primary care doctor) before I can be reimbursed?
How long will it take to get reimbursed after I mail my Super Bill?
Where do I need to mail or email my Super Bill?
Many individuals who have health insurance elect not to use it for coverage of mental health services, and instead pay for therapy as an “out of pocket” expense, or use their flexible or health savings account. Most often, this is due to concerns about the privacy of their health information, and the potential release of this information to health insurance companies and their affiliated entities.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. 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 expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a 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. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.