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Frequently Asked Questions - Insurance

HEALING & BALANCE LLC – CHRISTINE MILOVANI, LCSW

 

 

Frequently Asked Questions (FAQs) - About Insurance

Q: Do you accept insurance payments?

A: Direct billing of your insurance is not an option at this time. I can give you a monthly form that you can submit for out of network benefits (for psychotherapy sessions only).

Please see information about out of network insurance benefits below.

 

Q: Can I submit my receipt for FSA or HSA accounts?

A: Yes, you can submit your invoice and billing statement found in the client portal for reimbursement, if you are eligible through your Flexible Spending Account or Health Savings Account. This is available for all sessions provided by Healing & Balance LLC.

Q: Can I use out of network insurance benefits for psychotherapy sessions?

A: Yes, this is an option for psychotherapy sessions only, and sliding scale fee is not eligible for sessions being billed to insurance. See detailed information below that may be helpful to navigate this benefit option.

 

  • If you are eligible for reimbursement from your insurance for out of network benefits, you can request a "super bill" from me as your provider that you can submit to your insurance company for partial reimbursement.

 

  • ​The session fee is paid at the time of the session, and then you submit the “super bill” to your insurance company for partial reimbursement, depending on your policy and benefits.

  • If you are submitting to insurance, please be aware that your therapist will need to provide a clinical diagnosis and other necessary information to meet the billing requirements. 

  • You can contact your insurance company in advance to verify your out-of-network benefits for psychotherapy sessions (CPT billing codes 90834 or 90837).

Some helpful questions to ask your insurance company about out of network benefits:​​​

  • Does my plan provide out of network reimbursement for mental health psychotherapy?

  • Are telehealth video psychotherapy sessions covered as part of out of network benefits?

  • Will video telehealth option be permanent, or is there an end-date to this feature?

  • Is there am out of network deductible I need to meet before you will start to reimburse me?

  • Is there a maximum amount insurance company will reimburse within a year, or a set period of time?

  • Do I need to obtain preauthorization to have out of network benefits applied?

  • What is the company's determined 'usual and customary' or 'maximum allowable' psychotherapy fee?

  • What percentage of the 'usual and customary' or 'maximum allowable' fee does the insurance company reimburse for out-of-network benefits?

  • Example for 60% coverage:

    • You would pay the full session fee of $120 for 45 min, and insurance might reimburse you $60.00 (which is 60% of a $100 maximum allowable fee for 45 min session).

  • Example for 80% coverage:

    • You would pay the full session fee of $120 for 45 min, and insurance might reimburse you $80.00 (which is 80% of a $100 maximum allowable fee for 45 min session).

 

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