TherapyWorks is an “out-of-network” provider for all insurance providers. Some of our services are reimbursable by insurance on an “out-of-network” basis. Other services are not.
Although we understand that many clients are interested in using their insurance benefits, we believe it’s important to inform you of the following:
- When using insurance, treatment needs to be “medically necessary”, therefore a mental disorder diagnosis is required.
- When using insurance, a diagnosis remains on a client’s permanent record and could possibly lead to a long-standing impact on one’s healthcare.
- When using insurance, you must be “sick enough” for coverage to be provided. In other words, to continue therapy each session must be clinically justified. Many normal life struggles and transitions we serve do not meet criteria for a justifiable and reimbursable diagnosis.
- When using insurance, the amount and quality of your care is left in the hands of the insurance company — not you and your therapist. The course of treatment is often dictated by a utilization review process.
- When using insurance, your confidentiality and private details are not maintained. Third-party members become involved in the process and have access to you and your family’s sensitive mental health record.
On a monthly basis we can provide a comprehensive statement which you may submit to your insurance provider for reimbursement. Although each insurance provider is different, some clients have reported up to 80% reimbursement rate.
We recommend that you contact your insurance provider prior to our initial meeting to better understand your insurance benefits and the reimbursement policy for an “out-of-network” provider. To learn more about your mental health coverage, here are a few recommended questions for your insurance provider.
- Does my policy cover out-of-network outpatient psychotherapy for me?
- Is there a limit to the number of visits allowed?
- Is a physician’s referral required?
- Do I need pre-authorization?
- Do I have a deductible? Have I met the deductible for this year?
- What percentage of my therapy costs will be covered?
- Which address do I send statements to?
- Are there additional forms to be sent with my statement?
Many client’s have been successful in utilizing a Health Savings Account (HSA) and/or Flexible Spending Account for reimbursement of accrued therapy expenses. Please note, it is our standard policy to provide a monthly electronic copy of each client’s statement for personal record or reimbursement purposes.
We understand that financial concerns may lead you to use an in-network provider. Please be aware that there are also several local non-profit agencies that provide low-cost counseling services.