CHECK INSURANCE BENEFITS

Like many private practices in New York City, we are out-of-network providers, which means we do not accept any insurance directly. That doesn’t mean insurance won’t cover our sessions!

Individuals who have out-of-network mental health benefits often find that their insurance company can reimburse between 30-100% of the therapy fee. It really depends on your insurance.

In order to simplify the insurance reimbursement process, we offer 2 options. Firstly, we provide “superbills” (weekly invoices) to submit to your insurance company for reimbursement. Secondly, we use a platform (Thrizer) in which you do NOT need to pay full session fee upfront. With Thrizer, you only pay your responsibility for your sessions while they cover the rest of the fee and wait for reimbursement on your behalf.

Let’s check to see if your insurance provides out-of-network benefits.

FAQs

Why aren’t you in-network for insurance companies?

1

Unfortunately being in-network with insurance can be quite time consuming for us providers. Some companies can request notes about your treatment, limit the work we do together, or reimburse 6-8 weeks after the session. We’ve heard horror stories and quite frankly, we rather spend our time doing what we love…helping YOU than going back and forth with insurance about the care you deserve. Additionally, that added time we have can be spent with further trainings since we provide specialized care and prevents burnout (so we can fully show up for YOU).

What forms of payment do you accept?

2

Payment is expected at the time of the session via credit card that is saved on file.

Sessions cancelled with less than 24 hours notice will be charged in full.

What makes you different?

3

What sets our practice apart is how we work. We combine trauma-informed expertise with a deeply human approach, prioritizing tailored treatment plans that honor each client’s unique needs, alongside collaborative care and lasting change.

5

I want to check benefits on my own. What should I ask insurance company?

4

What is the No Surprises Act and Good Faith Estimate?

  • Do I have out-of-network benefits to see a licensed clinical psychologist?

  • If so, what percentage of the session fee do you cover?

  • Is there a session limit?

  • Is pre-authorization required?

  • What is the deductible, and how much of the deductible have I met?

  • How do I submit claims?

  • Is there a difference between in person or virtual sessions?

It is often necessary to provide the CPT code for the services. The CPT code for a 45-minute individual therapy session is 90834-95 (for virtual; 90834 for in person), and the CPT code for an intake assessment is 90791-95. After submitting for reimbursement your insurance company will process your claim and reimburse you directly.

No Surprises Act

Effective January 1, 2022, a ruling went into effect called the "No Surprises Act," which requires mental health practitioners to provide a "Good Faith Estimate" (GFE) to patients who do not have insurance or patients who have insurance but are out-of-network. The Good Faith Estimate's purpose is to show the cost of services to avoid an unreasonably large bill. Your treatment and cost of treatment will vary based on your individual needs, amount of therapy sessions needed/wanted, and the type and length of services you attend. Please remember you can always discuss billing, cost, treatment plan, length of sessions, and amount of sessions with me at any time.

Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

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 items or 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 (800) 368-1019