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Insurance

Insurance - What you need to know

​Adriana does not currently accept insurance and is private pay only. HOWEVER!!! I do accept HSA and FSA funds. 

If you are looking to use insurance, you will find therapists available through platforms such as Psychology Today. You will be able to locate a therapist that works with your specific areas of concerns and one who takes your insurance. 

 

If you feel strongly enough to work with Adriana but need financial assistance to afford the full rate, please contact  her directly and she can connect you to a non-profit organization that provides scholarships/grants for those seeking help (if available). ​

You can also choose to meet less frequently, like every other week, or join a therapy or support group led by Adriana. 

About Out of Network Insurance Benefits

Most insurance plans provide In-Network AND Out-of-Network benefits.  You would need to verify your benefits by calling the Toll Free number on the back of your insurance card.

 

Things to ask your insurance carrier: 

1. Is Mental Health a Covered Service?

Does your insurance plan cover any mental health benefits, even Out of Network? If so, what is the reimbursement rate for the following services: 

90837 - 52- 59 minute session

90834 - 38-51 minute session

2.  Copay or Deductible?

Is there a copay for sessions? If so, what is the SPECIALIST Copay? Therapists are classified as a specialist.

3. How does my Deductible work?

Is there a deductible that needs to be met? If there is a deductible, what is the amount? A deductible is the amount you are responsible for paying at 100% of the cost of the appointment before the insurance will help you offset the costs with coinsurance. Usually your Out of Network deductible/Out of pocket max tend to be higher than the In Network deductible/Out of Pocket Max. 

After the deductible is met, does your plan subsidize a portion of the cost?

Are there any limits on how many sessions you can attend?

 Providing a Superbill is not a guarantee of reimbursement. Please contact your insurance provider for further detail on you plans specific coverage for mental health benefits. 

 

If you are interested in filing Out-Of-Network provider benefits, please be aware that your therapist will be required to provide insurance with a diagnosis that will become a part of your permanent health record.

If you would still like to file with insurance, you may request a Superbill which will provide you with a diagnosis and detail of sessions you have attended. You will be responsible for submitting the Superbill to your insurance provider for Out of Network benefits.

This policy is subject to change at any given moment at the discretion of each Licensed Professional Counselor. 

About your Out of Network Insurance Benefits

About Out of Network Insurance Benefits

Most insurance plans provide In-Network AND Out-of-Network benefits.  You would need to verify your benefits by calling the Toll Free number on the back of your insurance card.

 

Things to ask your insurance carrier: 

 

1. Is Mental Health a Covered Service?

Does your insurance plan cover any mental health benefits, even Out of Network? If so, what is the reimbursement rate for the following services: 

90837 - 52- 59 minute session

90834 - 38-51 minute session

90791 - Initial/Diagnostic 

There are several other codes, but these are the most commonly used in individual therapy. If you would like additional codes to inquire about, your insurance rep will be able to further assist you. You can also view this helpful link of codes here!

2.  Copay or Deductible?

Is there a copay for sessions? If so, what is the SPECIALIST Copay? Therapists are classified as  specialists.

3. How does my Deductible work?

​Is there a deductible that needs to be met? If there is a deductible, what is the amount?

A deductible is the amount you are responsible for paying at 100% of the cost of the appointment before the insurance will help you offset the costs with coinsurance.

Usually your Out of Network deductible/Out of pocket max tend to be higher than the In Network deductible/Out of Pocket Max. 

After the deductible is met, does your plan subsidize a portion of the cost?

4. Are there any limits on how many sessions you can attend?

Unfortunately, many insurance plans restrict the amount of sessions and the type of diagnosis that will be covered. In Private Pay, you get to focus on the therapy without the hassle of insurance claim denials or limitations. 

5. How do you reimburse Out of Network sessions?

Many plans will reimburse you a set amount for the session AFTER you have submitted a SUPERBILL (available upon request) of the sessions you have already completed and paid for at the time of service.

Superbill

If you are interested in filing Out-Of-Network provider benefits, please be aware that your therapist will be required to provide insurance with a diagnosis that will become a part of your permanent health record.

If you would still like to file with insurance for Out of Network benefits, you may request a Superbill which will provide you with a diagnosis and detail of sessions you have attended. You will be responsible for submitting the Superbill to your insurance provider for Out of Network benefits.

A Superbill is not a guarantee of reimbursement.  A Superbill contains the providers National Provider Identification, a diagnosis, and the dates, type of service (length of session), and the Diagnosis which will be on your medical record PERMANANTLY - required for insurance to reimburse. 

Also, please note that Insurance carriers often request documentation about your private and HIPAA protected session discussions. Yes, they read your session notes, even if you file Out of Network Benefits.

Please contact your insurance provider for further detail on your plans specific coverage for mental health benefits.

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