Things to Know
- I am an in-network (INN) provider with Blue Cross Blue Shield of North Carolina State Health Plan. I am out-of-network (OON) with all other insurance programs.
- For both in-network and out-of-network clients, I file insurance claims on their behalf. Clients may elect to file claims themselves and I'm pleased to provide a superbill for clients who choose to do so.
Things to Do
Many insurance plans include out-of-network (OON) coverage for psychotherapy. If you find a therapist who is a good fit but is OON, don't rule them out just yet. Consider calling your insurance company, or referencing your policy manual, with these questions:
- Does my insurance policy include coverage for an OON mental health provider?
- Is there an OON deductible and if so, what is the OON deductible amount, how much have I met to date, and how much remains to meet it?
- When does my OON deductible, or plan-year, reset?
- What is my co-payment and/or co-insurance rate for the following CPT codes: 90791, 90834, 90837?
- What is the allowable amount for OON psychotherapy CPT codes: 90791, 90834, 90837?
- Does my insurance policy require prior authorization for OON services?
- Does my insurance policy limit the number of psychotherapy sessions for the plan year? Or for the lifetime of the plan?
- How long can I expect to wait before receiving my reimbursement check from the insurance company?