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Reimbursement FAQS

To Find Out How Much Your Health Insurance Company Will Reimburse

Consult your health insurance brochure, And/or

  1. Call your health insurance company, either before or after your first visit, and have the following conversation:

    • Tell the person with whom you are speaking that you are seeing an “out-of-network” provider.

    • Ask how much you will be reimbursed for CPT (Current Procedural Terminology) Code 90792 or 99205 for psychiatric initial evaluation, follow-up codes such as 99213, 99214 (office visit) and 90833, 90836 for psychotherapy with E&M.

    • Ask how much is your annual deductible and coinsurance

    • Ask how many certified visits you have per calendar year

  2. Submit a detailed invoice or "superbill" (ask the staff if you want a detailed bill), see how much reimbursement you receive, and read the enclosed E.O.B (Explanation of Benefits). Most health insurance companies are required by law either to pay the claim, or tell you why they are not going to pay, within 30 days, you may call your health insurance company and ask about the “status” of your claim.

  3. You should then have all the information you need to know how much insurance reimbursement you can expect to receive for your treatment. If, after having a conversation with someone working for your insurance company, you still do not know how much you will be reimbursed for your treatment, we will gladly call your insurance company on your behalf to further clarify the issue.

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