Out of network benefits?
Morning! I'm popping in to make a quick little blog post, quite honestly, just so I can link it when needed.
It makes sense that some of the most common questions I get are related to insurance. . find me something more confusing (and frustrating). I don’t understand much of it myself and I won’t lie, I end up angry most of the time when dealing with insurance companies, mine included. It seems like benefits, coverage and payments are overwhelmingly complicated, and often it’s in such a vulnerable time of our lives. Over the years, I’ve worked in community mental health, large organizations, and private practices, and most of what I know now I had to learn to help clients get what they need. This being said, I hope it’s obvious that I am absolutely no expert when it comes to accessing and utilizing insurance. I may be wrong about some of this.
You have to talk with your own company about your specific coverage plan, of course.
So, here’s some quick Q & A overview:
#1. What is a self pay practice?
Take Root is primarily a self pay practice. We are not in network with most insurance companies. Sessions are charged to a card on file at midnight after the session is complete. The rates are set and do not change without sufficient notice (1 month, minimum). The rates are listed here. This is all done automatically through the client portal. There are limited spots available at reduced rates.
#2. Is Take Root in network with any insurance?
Aetna. That’s it for now. United is a possibility in the future, however, the outcome of this is out of my hands.
#3. What is this about out of network benefits?
Okay, so. You can contact your insurance company to see if you have out of network benefits, what they are, and how to utilize them. Take Root is a specialized practice that offers evidence based treatment for OCD and PTSD. OCD requires specialized treatment that not all providers offer, and it can be difficult to find someone who is in network. But this is what we have out of network benefits for. Once sessions are complete and paid for, the client portal generates something called a superbill. A superbill is essentially an itemized receipt that shows information for the sessions, including CPT and diagnosis codes, as well as the amounts paid for sessions. These can be submitted to your insurance company for direct reimbursement. This essentially means that do you pay Take Root for services, and then your insurance company reimburses you for those payments.
#4. Do I have to use out of network coverage?
No, absolutely not.
#5. Do you have anything that can help me talk with my insurance company?
Yes! Click here.
I hope this helps!
