A Few Notes About Using Your Health Insurance and/or EAP
At this time (2023), I accept a limited number of insurance and EAP plans, however, please check to ensure whether I am in-network or out-of network with your particular insurance company and plan. I am not a Medicade or Medicare provider at this time. I will courtesy bill most major insurance companies when appropriate if I am out-of-network to facilitated your being reimbursed directly after you have paid me.
Please note that the person with the health insurance must qualify as the person with the condition that requires "medically necessary treatment" and will therefore be named as "the client".
If utilizing your EAP, the covered member of the EAP will be named as "the client".
Please also note that whomever enters the room with "the client" will have information documented about them in "the client's" chart which can be reviewed/audited by the insurance and/or EAP being used.
You are responsible to pay your co-pay/co-insurance (and your deductible if you have not already met it) according to your policy. Please be familiar with your benefits prior to our first session - you can access your benefits online through your insurance company's website - or for more accurate/understandable information you can call the number on the back of your insurance card and speak with a representative.
If you have approved sessions from an EAP that I participate on, service charges will be covered by the EAP company. If the company you use rejects your claim you will be responsible for the session fee. Please be sure to call your EAP provider prior to the first session to attain required authorization - they will provide you with a referral, authorization or certification number.
**Please understand that health insurance companies (excluding EAPs) DO NOT pay for couple, marital, or family counseling as per say. Health insurance companies pay for the coverage/treatment of mental health/medical conditions that need to be treated out of medical necessity (i.e. Major Depressive Disorder, Generalized Anxiety Disorder, Adjustment Disorder with Depressed Mood, etc) - during the course of that treatment MOST insurance companies will pay for the member's "conjoint therapy" sessions (i.e. marital/couples or family therapy, CPT code 90847) as it relates to the covered member's mental health/medical condition (THIS DOES NOT MEAN MARITAL ENHANCEMENT WORK!!!). If a member seeks counseling/therapy utilizing their health insurance for couple, marital, or family therapy and the covered member does not qualify for a mental health/medical condition - the insurance company will not pay for the services and the individual/member will be personally held responsible for payment. If you have further questions about this please ask me.
***Many EAP and insurance carriers require an authorization number for out-patient mental health, while a few others do not. Please be sure to contact your EAP and insurance to verify your benefits that include deductibles, co-pays, number of sessions per year and the authorization requirement. If you need an authorization they will provide you with the number. Please bring that number with you to your appointment. If you have a referral from your employers EAP, you always need an authorization. If an authorization is required and you do not have one, you can not be seen and if you were seen you will be held liable if the insurance company does not pay for your session charge.
Print