501 Silverside Road, Suite 145
Wilmington, Delaware 19809
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Are you in my insurance network? Do you accept Medicare or Medicaid?
At this time, no. We are a fee for service, out-of-network provider and do not accept insurance.
I am a veteran and am concerned about payment. Do you have an option to help me?
We support our men and women in uniform. Lower cost treatment for post-traumatic stress disorder (PTSD) is offered for veterans and active duty persons suffering as a result of trauma connected to service or otherwise.
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 of our clients use their HSA or FSA to pay for sessions. This is an excellent option for paying for treatment as FSA and HSA accounts are tax advantaged. To learn more: http://www.irs.gov/publications/p969/ar02.html
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. We urge you to contact your insurance provider to verify your specific benefits coverage and out-of-network deductible. Some clients have a very low annual deductible (ie $500) while others have very high deductibles (ie $12,000). In many cases, 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. For example, the allowable rate for a psychologist might be $110, $125, or another amount for a 60-minute session. Note in some instances, the allowable rate may be lower than the rate we bill.
What do I need to ask when I call my insurance provider?
The questions you should ask include:
a.) How much is my annual out-of-network deductible (dollar amount)?
b.) What is the reimbursement rate for outpatient psychotherapy?
c.) Is preauthorization required for 60 or 90-minute psychotherapy sessions? (CPT Codes are: 90837 and 90837+99355, respectively)
d.) What paperwork do I need to start a reimbursement claim, and where do I send it?
My insurance company said my plan requires pre-authorization or pre-certification. Can your office do that for me?
Yes. Because pre-authorization must be done by the provider, 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.
What do I need to submit to my insurance provider for out-of- network benefits?
You will need to submit a completed out-of-network claim form along with your session receipts. The claim form is different for different insurance providers. You should be able to find it online. If you need help filling out the form or would like us to look it over for completion, we would be happy to help you with that.
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.