We are not In-Network with any insurance plans. This decision was made to allow me to best support my clients.
Many clients choose not to involve insurance. This allows us the freedom to work outside of mental health diagnostic codes and treatment plan limitations, which insurance companies require. Having a diagnostic code added to your insurance record can impact you negatively in the long run. Without using insurance, we can more specifically focus on your presenting concerns and deepen the holistic work. Insurance companies may also request notes and have access to all of your mental health records and data.
Our psychotherapy sessions are eligible for insurance “out-of-network” reimbursement benefits in most cases if you have out-of-network benefits. I can provide you with a medical receipt that you can submit to your insurance provider to be reimbursed for up to 60-80% of the session fee, depending on your insurance plan.
*Good Faith Estimate Notice: You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).
Many people aren’t sure what “Out-of-Network” (OON) benefits mean. This quick guide will help you understand how they work and what to ask your insurance company.
Out-of-Network benefits are the part of your insurance plan that may help reimburse you for therapy with a provider who is not contracted with your insurance company. At North Shore Professional Therapy, we are considered an out-of-network provider for most insurance plans. This means:
If you choose to use your insurance benefits for therapy a mental health diagnosis is required for insurance reimbursement (our therapists can provide this diagnosis)
Any time insurance is involved in paying for therapy, a diagnosis must be included in your medical record and shared with your insurance company. By staying out-of-network, we are able to offer clients the option to private pay and receive therapy without a mental health diagnosis being submitted to an insurance company.
For some clients, this added privacy is important. Once a mental health diagnosis is shared with insurance, it becomes part of your insurance record and may be accessible to insurance or employment companies in the future. Having a diagnosis on your insurance record can impact you. For example, having a documented mental health diagnosis may impact your ability to obtain a life-insurance policy or increase your premium, it can also effect your ability to obtain certain licenses or pursue certain career such as becoming an aircraft pilot.
Most plans work like this:
When you call your insurance company, ask these exact questions:
A deductible is the amount you must pay out-of-pocket before your insurance starts reimbursing you.
Many clients choose out-of-network care because it allows:
We are happy to provide you with a superbill and support you in understanding how to submit your claim.
If you would like to check your benefits, feel free to use this instant benefits calculator.
*It is recommended to double check the information provided with your insurance*