Private Therapy & Insurance
1. Can I get reimbursed for my therapy sessions by my insurance company?
Many clients receive reimbursement for 50-80% of their counseling fees, however, some must meet their deductible first. I am considered an out-of-network provider (private practitioner), and many insurance carriers offer out-of-network benefits for counseling sessions. You are responsible for paying the full amount of your session when you come, and then you get reimbursed directly from your insurance company.
2. What questions should I ask my insurance company when I call to find out if I have Out-of-Network benefits and/or mental health coverage?
• What are my Out-Of-Network Mental Health Benefits?
• What percent of the sessions will you, the insurance company, cover?
• What is my out-of-network deductible?
• Have I met my out-of-network deductible?
• How can I get a claim form to file for reimbursement?
• How long does it take for me to receive my reimbursement?
3. Can I use my HSA (Health Savings Account), FSA (Flexible Spending Account), flex plan or “cafeteria plan” credit card to pay for therapy sessions?
Absolutely! I take MC, VISA, DISCOVER, & AMEX, HSA & FSA cards – so as long as your card is one of these, then you can use it.
4. After I know that I will receive reimbursement, how do I go about filing the paperwork?
Your insurance company usually has a simple form that you fill out. Sometimes there is an online form that you can submit. You will receive a detailed payment receipt from me, upon request. The receipt that I provide you will have all the necessary coding that the insurance company might need. Once they receive your completed claim, you should typically get reimbursed. You will need to check with your insurance company on the time-frame for reimbursement, as this varies with providers.
5. Does the ‘Detailed Payment Receipt’ mentioned above have to include a diagnosis code related to my treatment & mental/emotional health?
Yes, it does have to have a diagnosis code.
6. Why don’t you take insurance?
There are various reasons that many private practice therapists do not take or file insurance. There are time and manpower issues, ethical and legal concerns, confidentiality and quality of treatment issues. If you have any further questions regarding this, I will be happy to discuss with you. (303) 495-0317.
You have the right to receive a
“Good Faith Estimate”
explaining how much your mental health care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for mental health services.
- You have the right to request a Good Faith Estimate for the total expected cost of services.
- You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.