Private practice therapy, considered outpatient mental health care, is the least intensive treatment level. Sessions last up to 60 minutes, held in an office or via HIPAA-compliant Telehealth.
Medical necessity is required for both self-pay and insurance-covered therapy. Clearly identifying and documenting treatment needs is crucial for reimbursement or utilizing plan benefits.
Insurance defines medical necessity as meeting criteria for a covered mental health diagnosis with symptoms present during services. Treatment seekers should also experience an impact in social, occupational, educational, or family roles.
Please verify if your provider is 'In-Network' provider with your insurance plan. You're responsible for payments if insurance coverage lapses. Late cancellation or no show fees aren't covered by insurance and will be charged accordingly.
When utilizing out-of-network (OON) benefits, clients cover service costs upfront and later seek reimbursement by submitting a Superbill to their insurance provider. Superbills facilitate reimbursement from your insurance provider, but it's important to note that it may not guarantee full reimbursement.
If your provider is not in network with your insurance or credentialed with the insurance plan, you can request a Superbill for services. Please reach out to your insurance provider to clarify your out-of-network benefits, including deductible requirements, prior to start of treatment.
Please remember to regularly review your insurance benefits to ensure their availability for services. It is the client's responsibility to verify the accuracy of their benefit information and disclose any multiple insurance policies, identifying the primary one.
A complimentary 15-minute consultation is available to assess your therapy needs, establish compatibility for collaboration, and guide you through the process of initiating therapy and booking your initial session.