Insurance

Insurance can be a difficult and trying field to navigate. This guide should help you understand the terms and steps involved so you are educated and can make the most of your benefits. Feel free to visit your member portal from our Resources page!

Terms

In-Network - Providers that are considered in-network are contracted with that particular insurance company for an agreed rate to provide you with lower costs.

Out of Network - Providers that are considered out of network are NOT contracted with a particular insurance company. Rates are usually reimbursed at a lower rate than in-network and are a higher cost to the consumer. However, rates are still lower than if no insurance is accepted at all.

Deductible - This is the amount dictated by your specific insurance plan that you have to pay initially before any benefits begin. This number varies based on the plan and resets once a year (typically in January). Clients can have both In-Network and Out of Network deductibles.

Co-pay/Co-insurance - This is the amount you are responsible for each session, which can be a set amount or a specific percentage. 

How does it work?

The first thing to do is to contact your insurance provider to ensure that our therapists are in-network with your plan prior to your first session. This will make you aware of fees that will be charged per your specific plan. If our providers are in-network with your insurance, we will bill your sessions directly to them. Any payments for which you are responsible will be charged to your card on file with us. This can be a credit card, debit card, or HSA card. 

Out of Network

If we are not in network with your insurance you can still make an appointment and begin therapy. You should contact your insurance company to determine what your Out of Network benefits will be. Clients with an HMO plan may not have any Out of Network benefits. If we are not in your network, you are responsible for the full fee at the time of your session. You will receive a statement of your payments which you can use to submit to your insurance company for reimbursement. The insurance carrier will then reimburse you at the rate they have determined for your benefits.

Failed Appointments/Late Cancellations

Insurance companies cannot reimburse for services that are not given. Therefore, if you fail to attend an appointment or if you cancel within 24 hours of your appointment, insurance cannot cover this charge. The client will be solely responsible for the full cash rate of the session (not just your co-pay) as it is time set aside specifically for you and will not likely be able to be used for another client.

Good Faith Estimate

If you do not choose to use insurance benefits you may ask for a Good Faith Estimate that will help you determine what your expected costs will be.