Understanding Out-of-Network Insurance Reimbursement for Psychotherapy
I want to start by sharing that I am no longer in-network with any insurance providers. This decision was not made lightly, but the complexities and challenges of working with insurance companies often made it difficult to provide the care my clients deserve. That said, I am deeply committed to making therapy affordable and not an impossible additional stressor. My goal is to support you in understanding how to make use of your insurance benefits and to work with you to ensure therapy remains accessible.
1. Deductible
Your deductible is the amount you need to pay out-of-pocket for out-of-network services before your insurance begins to reimburse you. Unfortunately, insurance companies often set high deductibles, which can create additional financial barriers to care.
For example, if your deductible is $2,000, you’ll need to pay this amount in therapy or other medical expenses before your insurance starts covering any portion of the cost.
2. Co-Insurance
Once your deductible is met, your insurance will cover a percentage of the allowed cost for each session, and you’ll be responsible for the rest.
For example, if your insurance covers 70% of the allowed cost for therapy and my session fee is $200, you may be reimbursed for 70% of what your insurance considers the “reasonable” fee for the service.
3. Allowed or Allotted Amount
Insurance companies determine a “reasonable” fee for services, called the allowed amount. However, this amount often doesn’t reflect the actual cost of therapy.
For instance, if my session fee is $200 and your insurance company’s allowed amount is $150, your reimbursement will be based on $150 rather than the full fee.
How I Support You
At the end of each month, I will provide you with a detailed superbill—a statement of services that includes all the information your insurance company needs to process your claim. While I know this process can be confusing or frustrating, I am here to help you navigate it and answer any questions you have along the way.
If using your insurance still makes therapy unaffordable, please don’t hesitate to discuss this with me. I hold slots in my schedule for clients who need a sliding scale, as I am committed to ensuring that working with me is accessible to everyone. Together, we can find a path forward that works for you, both financially and emotionally.
Your mental health is important, and I am here to support you every step of the way.
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