This is a question we receive quite often. Many people use insurance for medical care and are used to a simple copay for services. They go to the doctor expecting coverage to address much of their service needs, so it is natural to think about using it for counseling services. We understand this thinking because we approach the use of medical care in a similar way.
However, we do not take insurance for counseling service. We have several reasons why we do not. Let us explain.
- Insurance companies require a diagnosis for mental disorder be made for coverage to be considered. This will become part of the patient’s permanent medical record. This can be uncomfortable for some, so they would not use insurance.
- Marriage problems often do not have a diagnosis that is covered.
- The insurance company may not cover services rendered by a counselor (as apposed to a psychologist or psychiatrist)
- Working with insurance companies to get reimbursed can be a lot of work (yeah, we know. It sounds like we are lazy).
- What they determine to pay to compensate for services is often less than what we normally charge (we like to get paid what we are worth).
However, some patients have “out of network mental health care coverage.” In which case, they can file a claim and be reimbursed. The patient is responsible to determine if they have this coverage and how to utilize it is.
If you are considering filing on your own for reimbursement for services rendered by the staff of Legacy Counseling Center, we suggest you call your insurance company and asked the following questions.
- 1.Do I have “out-of-network mental health care coverage?”
- 2. What deductible is associated with this coverage?
- 3. What are the credentials the providers must?
- 4. What amount/percentage will be covered once the deductible is met?5. What forms are necessary for me to correctly submit claims?
What about medical savings accounts?
Some people have established an account funded with tax free money to cover health care expenses that are not covered by insurance benefits. These funds may possibly be used for counseling. Some of these accounts are accessed through a credit card. We may be able to take payment this way.
Patients may decide to file for insurance reimbursement from their coverage or healthcare expense account. To assist in this, Legacy Counseling Center will provide a bill describing the services provided to document the patient’s attendance and payment.