I currently accept Premera insurance, which includes many out-of-state Blue Cross/Blue Shield insurance plans, such as Blue Cross of California. If you believe you have a plan covered through Premera, I can have my biller verify your coverage and what your co-pay or deductible will be.
For most clients, I am out of network and work in a private pay capacity. This means that I am paid directly for sessions at the time of service by a client.
I am always glad to provide receipts for services so you can apply to get reimbursement from your flexible spending account (FSA) or health savings account (HSA), if your employer offers one. For these, you typically have to designate an amount of money to set aside each paycheck during an open enrollment period, so if you don’t currently participate in your employer’s offering, ask your HR department when you could enroll. Many programs offer a card that can be used for HSA transactions. This card can often be used to pay for counseling fees in pre-tax dollars as a health expense.
I am considered an out of network provider by many insurance companies. You may contact your insurance company by calling the number on the back of your insurance card to see if your insurance will reimburse you directly for services you receive from out of network providers. Some plans often have some coverage for out-of-network services. Often, there is a deductible you must meet, and then you can receive reimbursement after services for some percentage of the allowed cost as determined by your insurance. This is a way to make therapy more affordable, but it typically does not cover the full cost.
I am able to provide a periodic (monthly or quarterly) superbill for you to submit to your insurance provider listing our previous sessions during that period. They will then determine any reimbursement to you from them for a portion of the session fees. I do not know the details for specific insurance plans and have no direct contact with providers.
I recommend asking your insurance company the following questions to check on out-of-network coverage:
Do I have out-of-network benefits? And if I do:
Does my plan cover reimbursement for services from Licensed Mental Health Counselor Associates (LMHCA’s) for CPT code 90837?
Does my plan limit how many sessions per calendar year I can have?
What is the percentage of reimbursement for out-of-network services?
Do I have to meet my deductible before reimbursement occurs? If so, how far away am I from that?
Clients are financially responsible for the full cost of therapy sessions, regardless of whether their insurance offers reimbursement.
A superbill does require a billable diagnosis, assigned to an individual insured person. This means that for the purpose of therapy, one person must be designated as the "patient" and be given a formal diagnosis. I am glad to talk with you about the pros and cons of receiving a mental health diagnosis.