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  • Writer's pictureYvette E. McDonald, LCSW-QS

4 Questions to Ask About Your Out-of-Network Benefits



During the months of November and December, most people have open enrollment for their medical benefits including HSAs (Health Savings Accounts) and FSAs (Flexible Spending Accounts) which bring some big changes come January. With those big changes however it also brings big questions as people try to navigate through the in’s and out’s of their new policy changes or new policy all together.


Untangling the complexity of Out-of-Network Benefits for Counseling

With the dance of insurance being a tricky one for some, we do our best at Traveling Light to make the process as easy as possible. Below are some questions to ask your insurance company relating to navigating the nuances of your insurance if interested in using your out-of-network benefits for counseling services.


  1. Do you have out of network benefits. Depending on the insurance plan you choose you may not have out-of-network benefits.

  2. What is your out-of-network deductible? Knowing your deductible will allow you to know how much money you will have to pay out of pocket before you insurance begins to cover sessions fully or require you to pay a co-pay.

  3. Do they cover counseling services. There are times depending on the policy that your insurance will have a different system and/or deductible for Mental Health Out-Patient services. Ask if they cover code 90837 or 90834 (for individual counseling only).

  4. How do you submit for reimbursement? Some insurance companies allow the practice to submit the necessary paperwork which makes the process easier and we are glad to help with. However, there are a handful of insurance companies, such as Blue Cross Blue Shield, in which you will have to submit a Superbill for reimbursement. A Superbill is a document your therapist will provide via your online portal in which it includes all the necessary information required by the insurance company to process the claim. It’s really important to ask this when speaking with your insurance representative as each insurance company has different procedures when submitting a Superbill.

For those having to submit Superbills to their insurance I am happy to recommend Better, a resource to help you with out-of-network insurance reimbursements. Better has an app that makes filing out -of-network claims quick and easy.

How does it work?

Signing up for a Better account only takes 1-2 minutes! Simply download the Better iPhone app or sign-up online, take a photo of your insurance card and Better handles the rest!

Pricing

For all claims that are filed towards your deductible to others ineligible for reimbursement, Better is free of charge. They charge a 10% service fee for the insurance reimbursement you receive.



We look forward to continuing to work with you and your family! If we can be of further assistance please feel free to ask.



 

Traveling Light Counseling is in the heart of Port Saint Lucie, FL and easily assessable from both Vero Beach and Martin County due to our close proximity to US1 and the Turnpike. I am committed to helping relationships be the best version they can be. Nothing excites me more that helping relationships level up and find fun and creative ways to connect, learn and grow. I offer relational support, education and help to individuals, couples, families and parents. Please do not hesitate to bring me onto your journey, I'd be honored. Please give me a call at 772-361-8448 for a free, 15-minute phone consultation.

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