My priority is the quality and integrity of your care. By working outside the constraints of insurance panels, I can dedicate the necessary time and use the most appropriate assessment tools for your unique situation, ensuring a truly comprehensive and accurate evaluation.

 

While I do not bill insurance companies directly, my services are eligible for reimbursement under most PPO insurance plans with out-of-network benefits. Many of my clients are successful in receiving significant reimbursement (often between 50-80%) for their evaluations. 

Navigating this process can seem daunting, but I am committed to making it as straightforward as possible for you. Here is a step-by-step guide.
 

Step 1: Contact Your Insurance Company Before Your First Appointment

Call the member services number on the back of your insurance card and ask the following questions. I recommend you write down the answers, the date of the call, and the name of the representative you spoke with.

 

Key Questions to Ask Your Insurance Provider:

 

1-"What are my out-of-network benefits for outpatient mental health services?"

 

2-"Do my benefits cover psychological or neuropsychological testing?"

 

3-"What is my annual out-of-network deductible, and how much of it have I met this year?"

 

4-"Once my deductible is met, what percentage of the fee will you reimburse me for?" (This is your "co-insurance" rate).

 

5-"Are there any limits on the number of sessions or services I can receive?"

 

6-"Do I need pre-authorization for psychological testing? If so, what is that process?"

 

7-"What are the reimbursement rates for the following CPT codes:"

 

90791 (Psychiatric Diagnostic Evaluation)

 

96130 & 96131 (Psychological Testing & Evaluation Services)

 

96136 & 96137 (Psychological Test Administration & Scoring)

Step 2: My Approach to Payment​

I understand that a comprehensive assessment is a significant investment. To support my clients, I have designed a payment plan to spread the cost over a period of several weeks.

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Instead of a single lump-sum payment, I ask for an initial $500 deposit to secure your appointment series. The rest of the fee is then broken down into simple, equal payments that are made at each of your sessions (typically taking place over several weeks). This hopefully allows for a predictable and more manageable payment schedule. I am happy to accept all major credit cards, including HSA and FSA cards.

 

Step 3: Receive Your Superbill

After your assessment is complete, I will provide you with a detailed receipt called a "superbill." This is a specialized medical document that contains all the information your insurance company needs to process your claim, including:

 

-Your diagnosis codes (ICD-10)

-The service codes for your evaluation (CPT codes)

-Dates of service

-My practice information and license number
 

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Step 4: Submit Your Claim for Reimbursement

You will then submit the superbill to your insurance company through their claims process (often via an online portal or mail). They will process it and send you a reimbursement check directly.

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*For clients who would prefer assistance with submitting claims, services like Reimbursify can manage the entire process for a small fee*​​​​