Q: Insurance reimbursement: How and how much can I get reimbursed?
A:
In our experience, the process can be surprisingly smooth, but often it is tedious. The insurance companies are less familiar with subscribers paying for private therapy, and they are also more reluctant to pay for private therapy because it costs the insurance company more money. You need to be an educated consumer and advocate for yourself.
We can tell you this, while it may be effortful, it is NOT futile. In fact, you may find-out that you are eligible to receive 80% or more reimbursement. In our experience, all our clients have had success submitting receipts as medical expenses if they have flex spending accounts (FSA). And many clients receive reimbursement from insurance, if they have a private insurance policy. (In our experience, medicaid and medicare and other subsidized health insurances, do not reimburse for private therapy.)
Unfortunately, we don’t know the specifics of your policy, so you should contact your insurance company or representative. Specific details can differ policy to policy, even within the same insurance company.
Find out the specific details of your policy, and the process of “submitting a claim” for reimbursement. When speaking with your insurance company (agent or representative), make the following very clear:
You are receiving treatment from an “out of network” provider (that’s “insurance-language” for “private practice”)
You are paying the fee to the provider, and you are seeking reimbursement from the insurance company.
The insurance company may confuse this and they may assume that the provider is looking to join the insurance “in-network” list, or they may assume the provider is seeking payment from the insurance.You will be submitting a “paid superbill” (paid receipt) which includes the medical coding and the provider information. you will paid the, after seeing a “private, out-of-network provider.”