FREQUENTLY ASKED INSURANCE QUESTIONS
Are you a participating provider in any health insurance plans? No. We do not accept insurance. It is best to call your insurance company before making an appointment so that you can fully understand what the cost will be to you. A sample conversation you can have with your insurance company could be:
“I am going to a clinical psychologist for an initial intake and likely follow up with weekly psychotherapy. She does not accept any insurance so I would like to know what my out of network benefits are. Dr. Sachs' NPI # is 1700229663, and the CPT codes that she will most likely use will be 90791, 90834, and 90847. Based on that, can you tell me what percentage/dollar amount I can expect to be reimbursed?"
Some follow up questions:
1. Is there a cap (maximum amount) you will pay for an office visit/given year?
2. Do I have a deductible I must first meet? If so, how much is that?
3. Do I need preauthorization? If so, can you grant me preauthorization to see this provider with the information I just gave you.
4. Is there a specific claim form I must use to submit claims and if so, where can I access that?
5. How much time after a doctor’s visit do I have to submit a claim?”
Will you provide Superbills to submit to my Insurance for Reimbursement? We try hard to meet the needs of all patients. While none of the doctors accept insurance or Medicare, we will provide any necessary paperwork to submit to your insurance company if you pursue out of network benefits. While insurance companies may provide reimbursement, as is the case with any out-of-network psychologist, there are no guarantees for reimbursement. If your insurance denies reimbursement and working with us becomes cost-prohibitive, please inquire about our sliding scale policy. Superbills are provided to all of our patients on a monthly basis.
Are you a Medicare participating provider? No. We do not accept Medicare. If you are currently enrolled in Medicare and wish to be seen by us, we can enter into a private contract in which you will be charged regular fees. We can provide you with a copy of the Medicare opt-out affidavit upon request.