Questions to ask your insurance provider regarding Out-of-Network Benefits

I have chosen to not work with insurance companies. I do not like their practices. They have the right to dictate the type of treatment and frequency of that treatment. In my office, you get to decide this important aspect of your recovery. Learn more about my thoughts here. 

1.Does my plan cover mental health outpatient visits?  
2.Does my plan cover out-of-network providers?
3.How many sessions can I be seen for in one year?
4.How much will my reimbursement be if the therapy session (CPT 90837) is $235 or (CPT 98034) $90?
5.Do I have a deductible I have to satisfy? 
6.Do I have to fill out any paperwork or have pre-certification prior to seeing a provider?

 
Glossary
1.Deductible:  Money you pay out-of-pocket before you insurance covers your expenses.
2.Out-of Network:  A provider who has no contract agreement with your insurance company.
3.Pre-Certification:  A process of pre-approval from your insurance company to activate your mental health benefits.  This can be done online at your insurance company’s website or by calling them; this is a yearly process. Your insurance company will send you a letter confirming pre-approval or you may be able to print it from the website immediately.  Often times if your company requires pre-certification for mental health services but you do not request pre-certification before your first appointment, you could be responsible for appointment fees.  When you make your first appointment to see a provider, the person scheduling the appointment may ask you for your pre-certification number before you meet with the provider.    

As a reminder: I do not work with insurance companies. I do not have phone contact, email or fax exchanges regarding paperwork. You are responsible for all insurance related questions. Please be mindful before scheduling with me.