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Insurance

Will my insurance cover therapy?

Call the 800 number on your card and ask about your mental health benefits. Some carriers will only pay for therapy provided by a therapist pre-approved by them or will reimburse at a lower rate for non-approved providers. To ascertain your benefits, ask your insurance carrier the following questions:

1. Do I have mental health benefits?
2. What is my deductible?
3. How many sessions per calendar year does my plan cover?
4. How much do you pay for an out-of-net provider?
5. Is there a limitation on how much you will pay per session?

Some insurance plans require advance authorization before they will reimburse for mental health services. Often they will only pre-approve a limited number of sessions, and it will be necessary to seek approval if additional sessions are needed. If you exceed the number of sessions allowed by your plan, or if they do not agree additional sessions are "medically necessary," you will be faced with either paying for more sessions out of pocket or discontinuing therapy. Insurance companies may not reimburse for missed appointments or additional fees incurred for other than direct therapy services.

Please remember that you, and not your insurance company or a third party payer, are responsible for full payment of the fee.

How do I get reimbursed?

Usually I provide you with an itemized bill for services that you can submit to your insurance company for reimbursement, and I will fill out any forms that may be required so that you can be reimbursed by the insurance company. I do not bill insurance companies directly.

What do you have to tell the insurance company?

Insurance companies usually require the therapist to give a diagnosis, provide the dates of service, and include the relevant procedure codes. In some cases, insurance companies may require more information, such as a treatment plan.

What happens to information disclosed about me?

Whatever information is disclosed to your insurance company will become part of the insurance company files, and in all probability, some of it will be computerized. All insurance companies claim to keep such information confidential, but once it is in their hands, I have no control over what they do with it. In some cases they may share the information with a national medical information data bank.

Remember, you have the right to pay for my services yourself and avoid disclosing personal information to the insurance company.

Dr. Joyce Nash, PhD    (650) 329-1000