Insurance Benefits

To receive reimbursement from your insurance company for our work together, you will need to be in a plan with out-of-network benefits.

Each month, I will provide you with statements of service that can be submitted to your insurance company for reimbursement.  With your written permission, I will also provide information to the insurance company to facilitate reimbursement should they request it.

Determining Your Benefits

In order to determine what your benefits are, please do the following:

1.  Call the customer service number on the back of your insurance card (the Mental Health number).

2.  Tell them you will be seeing a licensed clinical social worker who is an out-of-network provider, and ask them for information regarding your mental health benefits.

3.  Here are the specific questions that I suggest you ask:

• What is the reimbursement rate for out patient psychotherapy with a licensed clinical social worker?  This rate varies between different companies and contracts.  If the rate is given as a percentage, then ask if this is of the total fee or if the insurance company sets a usual and customary rate (UCR).  If it is the latter, ask them to tell you what the UCR is.
  
  
• Do you need to meet an annual deductible before your benefits go into effect?
  
  
• Is there an annual or lifetime limit on what they will pay?
  
  
• Is there a maximum number of visits allowed per year?
  
  
• When does your contract year start each year?

I know that this is a long list of questions, but my experience has taught me that it is important to be clear about all of these items in order to know exactly what your benefits are.

4.  And last, be sure to write down the name of the person you spoke with and the date of your telephone call.

© 2010-2023 Katharine Rossier