Out of Network/ PPO Insurance Reimbursement Questions:

1. Does my policy include mental health benefits?

2. Does my policy cover out-of-network therapists? If I see a provider who is not part of your network, do you provide any coverage? Are there any additional out-of-pocket costs?

3. If yes, does my policy cover Licensed Clinical Psychologists (PhD)? Does that provider need to be on your out of network list?

4. If yes, how much will my policy pay for a 60 minute psychotherapy session (procedure code 90837)?

5. How much psychotherapy is covered per year? Are there any dollar or calendar limits to my coverage?

6. Is my mental health deductible part of, or separate from, my medical deductible?

7. What is my yearly mental health and/or medical deductible?

8. How much of my deductible have I met this year?

9. Can I pay my therapist out-of-pocket and submit a Superbill for reimbursement?

a. If yes, to whom should I mail or fax the Superbill?

b. Once I mail in a Superbill, how long before I receive a reimbursement?

10. Do you require pre-approval or pre-certification of sessions?

a. If yes, who must obtain the pre-approval or pre-certification? Myself? My therapist? Either? b. Can this be done over the phone? If not, what is the procedure?

13. How many sessions will likely be pre-approved at a time?

14. Who should be contacted to authorize the pre-approval?

15. Is there anything else I should know?