Insurance

Insurance

What does it mean to be out-of-network?

“Out-of-network” means that we are not contracted with your insurance company and will not submit bills on your behalf to your insurance company.

What does that look like when it comes to paying for sessions?

Any couples with out-of-network plans are required to pay out-of-pocket for sessions at the time of the session.

How much will my insurance company reimburse me for our sessions?

Reimbursement is based on your specific insurance plan. Please check with your insurance company directly to obtain specific reimbursement information.

How do I request obtaining special OON coverage if I have a managed care plan?
You can submit a request for out-of-network (OON) coverage directly to your insurance company.
What do I say to my health insurance in asking for OON coverage?
  • Ask your health insurance if they will cover family therapy OON.
  • You should also inform your insurance company that there is currently a shortage(national and local) of couples therapists and that you need to seek OON coverage due to the specialized nature of marriage and family therapy and that there are no comparable (and available) services in your area that are in-network
What is the out-of-pocket fee for sessions?
Our fees range from $240 to $280 per 90-minute session, depending on your therapist’s rate. We also offer sessions with our clinical intern, which are $100 per 90-minute session.
How do I submit for OON coverage?
We will provide you with superbills monthly. You then submit those superbills to your insurance company.
What is a Superbill?

A Superbill, also known as a Statement for Insurance Reimbursement, is a document the therapist provides to their client for insurance reimbursement. This document is similar to a statement but includes additional information like CPT codes and a client’s diagnosis code(s).

Superbills include:

  • Diagnosis Code (only the primary code will appear)
  • Client Insurance Information, if desired
  • Client DOB
  • CPT Codes and descriptors
  • The amount charged and payments received
  • Reimbursement Recipient
How will I get a Superbill?
You can access a Superbill through your client portal in SimplePractice or request it be sent to you by your therapist.
What do I do with it?
Once you’ve acquired your Superbill through the client portal, you can send the Superbill directly to your insurance company (please get in touch with an insurance agent for specific instructions on how to do this).
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