501 Silverside Road, Suite 145
Wilmington, Delaware 19809
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Are you in my insurance network? Do you accept Medicare or Medicaid? We do not offer services as an in-network provider for any of the insurance companies. We are a fee for service, out-of-network provider. Additional information about utilizing out-of-network benefits is provided below.
Is it possible I am eligible for partial reimbursement from my insurance plan for the sessions I have paid for or pay for in the future? Yes, if your insurance plan includes out-of-network coverage. We urge you to contact your insurance provider to verify your specific benefits and out-of-network deductible. Some have a very low annual deductible ($500.00) while others have very high deductibles ($12,000.00). Once annual deductibles are met, clients receive between 10%-70% reimbursement for sessions based on “allowable rates.”
What is an “allowable rate”? This varies by plan, but broadly speaking it is an amount set by your insurance provider relative to the type of provider by whom you are being treated.
How do I compute my out-of-pocket expense? Example: You see a licensed psychologist whose fee is $150/hour. Your insurance plan will reimburse 60% of the allowable rate which they set at $120 ($120 x 60% = $72)
What do I need to ask when I call my insurance provider? The questions you should ask include:
My insurance company said my plan requires pre-authorization or pre-certification. Can your office do that for me? Yes. Sometimes pre-authorization must be done by the provider and we are happy to complete the necessary paperwork. Please remit all materials to be completed to your clinician at least 72 hours in advance of your first appointment. Please also note we do not enter into “single case agreements” with any insurance companies.
I will need an itemized statement to send them for a reimbursement claim. Will you provide that? Yes. We are happy to provide this type of statement upon your request in hard copy or electronic format.
How long does it take to start receiving reimbursement from insurance? It can take anywhere from a few weeks to two months to start receiving reimbursement from your insurance company. If you submit your claim electronically or by fax, it will take less time than by mail.
Can I use my Health Savings Account (HAS) or Flexible Spending Account (FSA) to pay for my sessions? We urge you to verify this with your insurance plan provider. Many clients use their HAS/ FSA to pay for sessions. It is an excellent option for payment as both accounts are tax advantaged.