How to Bill Insurance As A Client
Our office is out of pocket and we do not work directly with insurance companies, but we want to make counseling as accessible as possible. We offer lower cost services with our interns and associate-level counselors (LMFT-A, LPC-A or LMSW). Interns and associate-level counselors are not eligible by most insurance plans for coverage. Sessions with fully licensed therapists (LMFT, LPC or LCSW), are often eligible for insurance reimbursement. Below are steps for how to check your insurance benefits and bill insurance as a client.
Using your Out-of-Network benefits can help offset the cost of therapy. We recommend the following steps to help make it easier on you.
1. Check your Benefits. You can do this by calling the number on the back of your insurance card or you can use our insurance checker. As an out-of-network practice, we have partnered with Mentaya to help our clients save money on therapy. Use our insurance checker to see if you qualify for reimbursement for our services. Please note that only our fully licensed therapists qualify for OON reimbursement and that insurance policies covers individuals (not families or couples).
2. Attend and pay for sessions and save your invoices. Invoices generated by our fully licensed therapists are considered “Superbills” or Insurance Reimbursement Receipts. You can use the information and codes on these invoices to help you with claim submissions with your insurance.
3. Submit claims to your insurance. This can be done directly with your insurance company or through a third party, for usually a minimal cost. We recommend you document everything and prepare for a wait. Our practice is registered with Reimbursify, which is an application that clients can use to make submitting claims easier and faster. Our office receives no benefit from clients using their services, but some of our clients have found that this application has been helpful to get their OON benefits. You can visit Reimbursify and file your first claim for free at: https://reimbursify.com/individual-page/
Your "Good Faith Estimate" Rights
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.
Central Texas Child and Family Counseling includes Good Faith Estimates in our intake packet. Counseling is a very personal and individualized experience. We recommend staying in communication with your provider about your goals and their treatment plan recommendations.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 512-651-1009 ext 0