Can Therapy Sessions Be Covered With Insurance?
At Connect Clinical Services, we operate as an out-of-network provider, meaning we don't directly accept insurance payments. However, we're committed to assisting you in maximizing your insurance benefits. We've outlined a comprehensive four-step process for out-of-network coverage.
Many of our clients successfully file for and receive reimbursements for individual therapy, typically 50% to 80% of the session cost, once they've met their deductible. Since many highly qualified therapists also operate as out-of-network providers, it's worthwhile to inquire about insurance coverage when searching for the therapist who best suits your needs.
Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA)
If you have a HSA or FSA, you can use this to cover the cost of therapy.
Navigating insurance can be daunting, but we're here to simplify it and empower you with knowledge. Here's a step-by-step guide below.
Step 1: Understand Your Out-of-Network Coverage
Look at your insurance card. If it indicates PPO or POS, contact the number on the back. If you spot multiple contact numbers, look for "BH," which stands for "Behavioral Health," and start there. Be prepared to share some numbers from the front of your card. If your card mentions HMO, you likely don't have out-of-network benefits.
Ask these essential questions:
"Do I have out-of-network coverage for behavioral health?" This clarifies if your insurance plan covers out-of-network therapy.
"What deductible must I meet before receiving reimbursement?" This reveals the amount you must pay out of pocket before your insurance covers some of the session costs. Deductibles can vary significantly, but knowing this helps you plan your expenses. Even if you initially didn't plan to use insurance, meeting your deductible might be worthwhile for eventual reimbursement.
"What percentage of the costs do you cover?" This percentage can vary, typically from 50% to 80% of the allowable reimbursement set by your insurance company. For instance, if Connect Clinical Services charges you $150 but your insurer's allowable reimbursement is $125, they'll pay you 60% of $125, not 60% of $150. The exact reasons behind this calculation are insurance-specific. However, in the given example, you'd still receive a $75 reimbursement for each session, reducing your cost for CCS therapy sessions to $75 once you receive the reimbursement.
Step 2: Use Reimbursify
Download the Reimbursify app for a user-friendly experience (note that it charges $3.99 per claim). Alternatively, you can contact your insurance company to learn their unique process for submitting out-of-network claims.
Step 3: Request a "Superbill" from Your Therapist
Inform your therapist that you require a "superbill." This document is a specialized invoice detailing the services you received, the clinician's information, and the diagnosis. Insurance coverage typically requires a diagnosis they're willing to cover, which your therapist can discuss privately. Ensure the superbill contains all necessary information.
Step 4: Upload Your Superbill to Reimbursify (Takes About 2 Minutes)
Utilize Reimbursify to simplify this process. Uploading your superbill for the first time will take approximately 2-5 minutes. Still, subsequent submissions can be expedited with a "clone" or duplicate feature, reducing the time to about 30 seconds.
No More Steps!
Once you've reached your deductible, your insurance company will send reimbursement checks to your mailing address. Congratulations, you've now mastered the process of submitting out-of-network benefits. From here you can get your sessions with us or any other therapist you wish to choose.
If you're looking for a group of experts doing EMDR Therapy in Houston or Neurofeedback, contact us! We will be happy to guide you through your journey of unleashing your hidden potential. We can also help you accomplish you're insurance coverage that you rightfully can be approved for. Call us today!