Frequently Asked Questions
Our fees range from $180 to $250. We are not participating providers with any managed care companies. Many of our clients elect to use out of network benefits. We can verify if you have these benefits for you for a small fee (see below), or you can verify these benefits yourself by calling the member services number on your insurance card and asking “do I have out of network mental health benefits?” AND “what are my benefits for telehealth?” Many of our clients use HSA, FSA, or credit card to pay for our services. If you have out of network benefits, we can provide a type of receipt called a “superbill” each month that you may submit to your insurance company so that costs can be applied to your deductible and so that reimbursement can be sent to you.
Note: there is never any guarantee of reimbursement.
Our business and billing manager, Alison Schenck, is able to answer questions about billing and insurance benefits. She has an extensive background in medical billing and knows how to navigate the complicated world of insurance benefits. Alison can be reached by phone at (203)343-0837 or email at firstname.lastname@example.org.
While we remain an “out of network” group (non participating with insurance plans) we will now be offering a la carte services that meet most of billing and insurance needs. All clients are expected to pay their balance each session, but we now offer the below support, with costs as listed below:
- Claims submission: $5.00 per date of service. We can electronically file claims, which includes making sure that diagnostic codes, CPT codes, etc. are entered properly before submission
- Verification of insurance benefits: $10.00 per verification. A verification of benefits is a way to confirm if you have out of network reimbursement as part of your plan, if you have a deductible and how much remains, etc. and can inform decisions about whether you are likely to be reimbursed for an in-office or telehealth visit.
- Obtaining an out of network authorization, $10.00 per authorization. If an authorization renewal is required we can take care of this as well!
- Administrative time can also be offered for appeals made to managed care groups for your services. The cost is determined by the extent of the request and would be discussed with you prior to any work being completed or you being charged.
To make an appointment, please fill out the form below and someone will get back to you in 24-48 hours. We know it is hard to wait, especially when feeling distress, and rest assured that we will do our best to get back to you as soon as possible! Please don’t hesitate to call our client coordinator, Machaela, to find out more about our services at (203)453-2220 x5.
CALL YOUR HEALTH CARE PLAN/MANAGED CARE PROVIDER
One strategy is to call the number on the back of your insurance card and ask for a representative. Please note you will be given a lot of information, we encourage you to write things down. You will want to get answers to the following questions:
- Do I have out of network benefits?
- Do I have an out of network deductible?
- How much is my deductible and how much has been met to date?
- What is my co-insurance?
- Do I have out of network benefits for telehealth services?
CALL OUR BUSINESS MANAGER
Our business manager, Alison Schenck, can verify your benefits for you for a small fee. Many clients opt to utilize her support, because it can be time consuming to call any managed care provider. Alison can be reached at (203)343-0837 or at email@example.com .
Submitting an out of network receipt is what is required if you wish to utilize out of network benefits provided by your managed care provider. If your managed care provider offers out of network benefits, they will ask you to submit a certain type of receipt for your services called a superbill. Our electronic medical system uses the title statement for insurance reimbursement; this is exactly the same as a superbill. Each superbill must include a CPT, or procedure code, a diagnosis, and information about the location you received services. This document also includes the National Provider ID of your therapist and of the practice.
You should receive a superbill in your email on the first of each month that captures the previous month of services. The superbill is automatically released from our electronic medical records system, and comes from a “noreply” email from the software program. Superbills are emailed to the email address that you first used when you completed your intake paperwork. If you do not receive this in your inbox, it may mean that the superbill landed in your junk mailbox, or it may mean that we mistakenly did not check on specific box when we got you set up in our system. Feel free to email us at firstname.lastname@example.org and we will make sure it is set up properly.
The first person to reach out to is your provider. Therapists can answer questions about specific invoices, and can correct minor billing errors. For more complicated billing queries, please email our business manager, Alison, at email@example.com and cc your therapist so they are aware of billing issues. If you continue to need support beyond this, reach out to the practice director, Dr. Warner, at firstname.lastname@example.org.
If we submit your claim, this happens in the beginning of the month.