OUT OF NETWORK REIMBURSEMENT

 

If I do not work directly with your insurance, you may still be eligible for some reimbursement from your insurance if your benefits cover “Out of Network” providers. Please note: some policies do not offer any reimbursement for Out of Network providers, but many do offer this. For policies that do have Out Of Network reimbursement, in many case the reimbursement rates can be pretty good and result in a difference of only a few dollars  more than what an in network co-pay would be. Please check with your insurance regarding your specific policy for “Out of Network” provider information so you will know if your policy will reimburse you, and approximately how much reimbursement you can expect.

 

If you do have this benefit, I will have you pay my full fee, and then I will give you a pre filled out bill (officially this is called a "superbill") that YOU send to your insurance- it will have the information on it that your insurance company needs.  Your insurance will then reimburse you for the appointments based on your policy's provisions. 

 

With any insurance reimbursement-either in network or out of network, a diagnosis must be made.  In a few lucky cases, insurance companies will pay out for what are called “V Code” diagnoses, which are “areas of clinical focus” and not “disorders”. If your insurance company will pay out for V Codes, in general it is better for me to list that (if applicable). But most companies do not pay out for V Codes. 

 

Again, since I do not contract with your insurance company, it will be up to you to find out what you can expect regarding reimbursement and covered items. Please contact your insurance company for this information. 

 

Also, please know that “diagnoses” is not what matters to me in our work together. What matters is you figuring out good ways to deal with whatever is bringing you to counseling at this time.

 

 

Additional information