Are You Eligible for
Follow the steps below to get the information you need from your insurance company!
Step 1: Call Your Insurance Company
You can locate the member services phone number on the back of your insurance card.
Step 3: Find out if you owe a deductible before the coverage kicks in
Ask the rep: "Do I have a deductible for out-of-network mental health services, and if so, what is the remaining amount I would have to pay before my health plan starts to reimburse me for any fees I pay out-of-pocket?"
Step 2: Find Out if you have out-of-network benefits
Ask the rep: "Does my plan include *out-of-network* benefits for mental health care? Specifically, for outpatient psychotherapy?"
Step 4: find out how much your plan will reimburse you
Ask the rep: "What is the maximum amount my plan will reimburse for mental health service code 90837 with a psychotherapist?" If the rep does not provide a clear answer, ask: "What is the maximum allowed amount for mental health service code 90837 with a psychotherapist, and what percentage of the maximum allowed amount will my plan pay?" (This percentage of the maximum allowed amount is the amount you would receive as reimbursement.).
What information is shared with an insurance company in a superbill?
Proof of the type of services rendered (i.e. individual counseling, couples counseling, et cetera...) in the form of a CPT code, along with the date and time of the service provided.
Actual payment received from the client.
The psychotherapist's name and their professional identifying information and signature.