Verifying Insurance Benefits
For many, it can feel helpful to know what to expect to pay for therapy. These questions can serve as a guide to gather the information you need to feel comfortable starting therapy. Many clients find it helpful to take notes and keep them for future reference. It will also be beneficial to share this information with me if you decide to start therapy. We can talk through questions you may have about verifying benefits during the consultation phone call.
If you have Providence, Aetna, or Regence BCBS insurance:
Call the customer service number on the back of your insurance card and let them know you are interested in starting outpatient therapy services with a psychologist who is In-Network. Questions to ask:
Are teletherapy sessions covered? For how long?
What is my copay (flat fee) or coinsurance (percentage) and do these also apply to teletherapy visits?
Do I have a deductible I have to meet before insurance helps cover therapy sessions?
Do I have unlimited therapy sessions?
Do I need any pre-authorizations for therapy services? (If yes, please call me and let me know).
If you have a different insurance:
In this case I am considered an Out-of-Network provider so you should call the customer service number on the back of your insurance card and ask the following questions:
Do I have out-of-network mental health coverage? (If no, this means you would have to pay out of pocket for therapy).
How much is my deductible for out-of-network services? What about copayment (flat fee) or coinsurance (percentage)?
Are teletherapy appointments covered? How long will teletherapy be covered?
Do the same deductible/copayments/coinsurance apply to teletherapy?
The provider I want to see is a licensed psychologist. What can I expect as a reimbursement rate for a 45-minute teletherapy appointment?
How would I submit the receipt for teletherapy services for reimbursement?
Thoughts to consider for Out-of-Network or Self-Pay clients
When considering the costs of paying an out-of-network provider, it can be helpful to consider how much you would be spending on in-network copay amounts, how out-of-network payments can be applied towards yearly deductibles, and if you can use employee flexible spending account funds or a health savings account for services.
Also consider the benefits of on out-of-network provider: potential additional privacy and freedom to choose your provider and length/type of treatment, which can enhance your ability to do the therapeutic work you are hoping to do. With the increased freedom, pursuing out-of-pocket therapy is often a comparable cost/benefit.