Insurance Questions

We are in-network insurance with USHealthcare/Optum, Cigna, Anthem BCBS of VA, and some plans from Highmark (Western PA). Many clients can receive some reimbursement of the fee for out-of-network providers by their insurance or Flexible Spending/Health Savings Accounts by submitting the invoices we provide. To do this, we will be required to provide a (medically necessary) diagnosis for you, and we will discuss this together.

It is best to call your insurance company to find out what your benefits are, to see if you are eligible for reimbursement. If we are not a participating provider, then you are eligible for self-pay costs.

Questions to ask

  • Do I have mental health insurance benefits with this provider NPI #s 1285898130 or  1255674578?

  • What is my deductible and has it been met?

  • How many sessions per year does my health insurance cover?

  • What is the coverage amount per therapy session for an out-of-network mental health provider?

  • What out-of-pocket cost do I have to pay for Behavioral Health benefits?

  • Can I get EAP benefit coverage from my employer?

Why I don't accept other Insurance plans?

Whenever insurance is used for psychotherapy, the treatment must be "medically necessary", which means that your therapist must give you a psychiatric diagnosis. This becomes a part of your permanent health care record, and may lead to limitations such as denial of quality life insurance or health insurance later on, additionally, since a mental health diagnosis must be made to obtain reimbursement, the insurance companies may ask for detailed personal information.

When you pay out of pocket, you may seek psychotherapy for any reason you choose; personal growth, coping with stress, and relationships dysfunction.