How does Insurance Work with Therapy?
UNDERSTANDING THE COMPLICATED BUSINESS OF INSURANCE
Long Island Counseling is often asked whether Aetna, Cigna, BCBS (Blue Cross Blue Shield) United Healthcare, or other insurance is accepted.
Because of skyrocketing administrative costs and minimal reimbursement schemes, Long Island Counseling no longer accepts any insurance plans. Therefore, while you may eligible to receive reimbursement from your provider for treatment provided by Long Island Counseling, you are still responsible for payment of your full therapy fees at the time of service.
HERE’S HOW IT WORKS:
At the end of each month, you will be provided with a fully coded medical claim form that you can submit to your insurance provider for reimbursement, or that you can submit to your HSA (Health Savings Account) or Flexible Spending Account if you maintain either of these accounts. If you are eligible, your reimbursement will fall into the out-of-network category, and typically this comes to about 80% of a portion of your sessions and will be paid directly to you.
Do you know what your deductible is? This is the amount of out-of-pocket funds you must expend per year before you are eligible to receive payment on a claim. If, for example, you have a $5,000 annual deductible, you must show that you’ve spent that amount before your plan will begin to pay on your claims.
However, your deductible will likely be different for each medical provider who treats you, depending upon whether he or she is an in-network or an out-of-network provider. Long Island Counseling is an out-of-network provider.
The success of your claim depends upon a number of factors including a properly coded invoice and perseverance in the submission process. You are strongly urged to call your provider and to inform yourself of the extent and terms of your mental health insurance coverage.