INSURANCE
If you need to use your insurance, see the information below.
Below are questions you ask about reimbursement from your insurance company.
Photo By Joy Dryer
THE 4 INSURANCE QUESTIONS: FOLLOW THESE STEPS:
Before you phone me for a consultation, call your insurance's membership phone line:
PLAN A: ask what is your Co-pay for an "IN-network" PhD. Psychologist? Then for a Social Worker [MSW/ CSW]?
PLAN B: Ask if your particular contract will reimburse you for an OUT-OF-NETWORK Psychologist? or Social Worker? The CPT-4 codes [scroll to end] determine what fee is paid. If YES, these reimburse for Out-of-Network, then ask 4 questions:
What is your Deductible?
What is the Cap?
A money cap? Time cap? Or both?
(e.g they could reimburse you up to 30 sessions... or a $1,000... whichever is reached first.)What is the calendar "year"?
i.e. do they start counting sessions (after the deductible of course!) starting Jan 1st ? or some other start date (e.g. when you signed your contract, like Sept 1st).The reimbursement can be a percentage of what they consider a "reasonable and expected" fee for the region. Ask what is that fee? both for individual therapy, and for group therapy (see CPT-4 codes below).
You may need to say: that I'm a Ph.D. Clin. Psychologist, with an office in one of these 3 counties: Poughkeepsie office in Dutchess, Brooklyn Heights office in Kings, or Grand Central office in New York.
Your bill receipt from me will have Procedure Code information:
CPT-4 90847 Family or Couples Therapy
CPT-4 90791 [Intake Evaluation - no medical services]
CPT-4 90834 [Individual Psychotherapy (45 min.) or 90837 Individual Psychotherapy (60 min or more)]
CPT-4 90853 Group Therapy [other than multi-family]
After you get your insurance information, and are clear about your budget and what you can afford, I welcome your call or email to make a consultation appointment.
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