I am an out-of-network provider. Payment for your services with me is made directly by you.   If you have out-of-network benefits, I will provide you with a bill for your psychotherapy visits, and you submit it to your insurance company to be reimbursed.  Most insurance companies have digital submissions now. 

I am not contracted with any insurance companies, which means that I am not in-network with any insurance companies.

You can either contact your insurance company by phone at the phone number for patients on the back of your insurance card, or you can check it digitally on your insurance company’s patient portal.

 Here is what you need to know, and if you are speaking to a customer service agent at your insurance company, I recommend asking these questions as they are stated below:

1.    Do I have out-of-network benefits for outpatient mental health for individual psychotherapy?

2.    What is the individual out-of-network deductible that needs to be met before insurance will begin to pay for out-of-network psychotherapy sessions?

3.    What percentage of the fee does my insurance company pay once my deductible is met? (usually, this will be a number like insurance pays 70% of the fee, and the patient pays 30% of the fee)

4.    Is there an allowed amount per session?  (Some insurance companies will reimburse up to a certain amount.  For example, if my fee is $200 and they reimburse 70% with an allowed amount of $225 per session, you will be reimbursed 70% of $200.  If their allowed amount is $175, then they will reimburse you 70% of $175, and you will be responsible for 30% of $175 plus the additional $25 leftover.)

5.    What is my out-of-pocket max for out-of-network mental health benefits? (This is the maximum amount of out-of-pocket money per calendar year that you will be required to spend before your insurance begins to pay 100% of your fees for out-of-network services.  For example, if your insurance company reimburses 70% of each session with an out-of-pocket max of $1000, after you have spent $1000 out-of-pocket, your insurance company will begin to reimburse 100% of each session up to the allowed dollar amount.)

6.    Is there a calendar year visit limit for out-of-network reimbursement on outpatient psychotherapy visits?

7.    How and where do I submit for reimbursement? (Please ask your insurance provider directly about how long it takes for reimbursement to come through. I am unable to provide this information.)

When a provider contracts in-network with an insurance company, the insurance company maintains a level of clinical, administrative, and financial oversight that is restrictive.  As an out-of-network provider, I can focus on providing a high-quality service that is grounded in my professional judgment and based solely on the needs of my clients.

Postpartum support groups are not reimbursable through insurance out-of-network benefits because they are not psychotherapy groups; they are support groups. To be reimbursed by insurance as a psychotherapy service, a mental health diagnosis is required, and mental health diagnoses are not provided in the post-partum support groups.

Yes, if you have out-of-network benefits, you can submit for reimbursement for birth experience processing sessions.

Yes, if you have out-of-network benefits, you can submit for reimbursement for perinatal/postpartum psychotherapy sessions.