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    Insurance

    Using Insurance For Psychotherapy

    We do not accept insurance in-network but we can accept insurance plans as an out-of-network provider. We provide you with an invoice (also known as a “superbill”) at the end of every month, which you can submit to your insurance company for reimbursement.

    You pay the full fee upfront and get a percentage of it back, but that varies from plan to plan and reimbursement is not a guarantee. We find that this balance can work well with clients because clients often have difficulty finding a good in-network therapist that has availabilities. Additionally, you should be aware that submitting claims to insurance requires that diagnosis be provided.  If you do not wish to have a diagnosis in your medical health record, it will be best to self-pay (pay out of pocket) without involving insurance companies.

    If you decide to try and get reimbursed from your insurance, here are some questions you can ask your provider to get an accurate idea about your out-of-network insurance benefits. Make sure you follow these directions in detail.

     


    STEP 1

    Find out what percentage is covered for “out-of-network” or “non-participating providers.”


    STEP 2

    Find out the “maximum allowed amount” per session (this is sometimes referred to as “reasonable and customary fees”) for TELEHEALTH for Masters Level or LPC clinicians. Jason Duenas’ license number is 75825 (Texas) and 13773 (Florida) if needed, and the CPT/procedure code is 90837 (if they need approval for that procedure code, you can tell them 90834). Often, insurance reps aren’t well trained and don’t know the maximum allowable amount, so be sure to ask for a supervisor if they can’t help you.  Also, confirm that TELEHEALTH for mental health service is even covered by your provider.


    STEP 3

    Find out if you have a deductible for out of network providers and how much it is.


    STEP 4

    Follow your insurance provider’s instructions on how to submit the claim. Each insurance has a different procedure, so make sure to ask.

     

    **An alternative to this approach could be utilizing the Reimbursify app which clients have found to simplify the process and make it easier.

    **These suggestions are provided for your convenience.  We are not responsible for insurance providers not reimbursing you.

     

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