INSURANCE
Cary Therapy accepts Blue Cross Blue Shield (all plans EXCEPT Blue Home, Blue Value and Blue Local) and Aetna.
Out of Network INSURANCE FAQs:
Can I use my health insurance to get reimbursed for services?
Maybe! As a Licensed Marriage and Family Therapist in private practice, the only insurance companies I work directly with are Blue Cross Blue Shield and Aetna. With other insurance compaines, I am an out-of-network provider, which means that if your insurance policy covers out-of-network mental health services, you may be able to be partially reimbursed for our work together. If you have Health Savings Account (HSA), you may also be able to use funds from this account to pay for mental health services. Always ask your insurance company directly about each type of service you hope to have covered.
How does reimbursement work?
You will be responsible for payment in fulI at the end of each session. At the end of each month, upon request I will provide you with a “superbill,” which is a statement with all the information your insurance company needs to file your out-of-network claim. You will then submit this superbill to your insurance company and wait for reimbursement. Please note that each insurance company has a different process for out-of-network reimbursement — it's important to contact your insurance company directly to better understand your specific out-of-network benefits for mental health services.
What information will I need to provide to my insurance company?
Typically, insurance companies need the following information in order to reimburse you: session date(s), the Current Procedural Terminology (CPT) code for the service(s) provided, and the diagnosis. All of this information is included on the superbill. I wish there were a way around having to provide a diagnosis (especially since my belief is that we could all benefit from therapy at times in our lives, diagnoses notwithstanding), however most insurance companies still adhere to a medical model and will require this information. If you’re not comfortable sharing this information with them, they may not reimburse you for services. Please note that if you do choose to pursue reimbursement, the information you share with your insurance company is protected by HIPAA and is therefore still confidential information that they are not allowed to share without your permission.
How can I learn more about my specific out-of-network mental health benefits?
Call your insurance company’s Benefits Department (usually this phone number is on the back of your insurance card) and ask the questions below. Insurance can be confusing to navigate, so be sure to ask for clarification on anything you don't understand. It’s a good idea to take notes during this phone call so that you can refer to them later if you have questions or need a refresher.
Does my policy cover out-of-network Licensed Marriage and Family Therapists? (My license numbers are 1131 for NC clients and 41892 for California clients — teletherapy only in CA).
My therapist will provide the following information on a superbill: date(s) of sessions, diagnosis, and CPT code. Is this acceptable, or will you require additional information?
Does my policy cover:
Psychotherapy Initial Intake Interview — CPT code 90791 (an initial intake session for therapy)?
Individual Psychotherapy — CPT code 90834 (a 45-minute session))?
Individual Psychotherapy — CPT code 90837 (a 55-minute session)?
Family Therapy Session — CPT code 90847 (a 45-minute session for a family, e.g. client and family member(s) together)?
Telehealth
Are there any mental health diagnoses that are not reimbursable?
How many sessions are covered per year?
What is my lifetime maximum for mental health benefits?
What is my deductible for out-of-network services? Has it been met?
What is the Allowed Amount for therapy fees? (This is the maximum amount your insurance company will pay toward each therapy session.)
What percentage of the Allowed Amount will be reimbursed?
What is the process for filing a claim?
Do you require my claim to be submitted within a certain number of days from the date of service in order to be considered for reimbursement? If so, what is that time period? Please inform your therapist of this time period in order to ensure your Superbills will be generated with ample time for processing.
What is the payment schedule? (This is the amount of time it will take them to process your paperwork and reimburse you.)
What is the phone number for the Claims Department to follow up on the status of claims?
Is there a way to streamline the process of getting reimbursed?
There are apps such as Reimbursify (and others) that will file your out-of-network claims for you. You can take a picture of your superbill and upload it to Reimbursify, and they will file the claim for you, keep track of receipts, You can find more information here.
CLIENT INTAKE FORMS
Client forms are available via email or mail. Please contact amy@carytherapy.com to request an intake packet if you would like to schedule an appointment.