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OUT OF NETWORK PROVIDER

 

Benefits of paying out of pocket: 

1. No mental health information will need to go on your permanent medical record like it does when using insurance.

2. I do not need to give you a diagnosis for the purpose of justifying "medical necessity," which is required by insurance.

3. You and I get to make decisions on the frequency and length of treatment versus following what your insurance plan covers.

4. Private pay clinicians are usually specialists in their area of expertise, and insurance providers often need to be generalists due to the nature of the contracts they have agreed to.

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If you are interested in full or partial reimbursement for services there may still be ways you can do this depending on your individual coverage. 

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1. You can often times use your flexible spending account or health savings account for mental health services. Check with your insurance company about how to go about doing that if you're unsure.

2. Check your "Summary of Benefits" to learn more about what might be offered to you. You might see an "Out of Network Deductible" or a description of "Co-insurance." In both of these cases you may need to pay a portion or the full amount up front, and then submit a claim for your insurance to reimburse you fully or partially. I can provide you with the  documentation for the claim (also known as a super-bill). Be aware that this document will have some information about your treatment (such as a diagnosis) to justify medical necessity to your insurance.

3. You can call your insurance company and ask them questions on what your options are for an "out of network" service.