Insurance for Therapy
Do you take insurance?
No, we do not participate in any insurance plans. We accept FSA and HSA cards, if your plan allows. However, in many cases, insurance companies will pay for 50-80% of the cost of therapy through out-of-network benefits. We can help you understand your benefits so that therapy is more affordable for you. We can provide documentation for you to submit to your insurance company for out-of-network reimbursement.
How do I find out how much insurance will pay for therapy?
To find out what your out-of-network benefits are, pull up this webpage and call the number on the back of your insurance card and ask the following questions:
Do I have benefits for out-of-network psychotherapy?
Is there a deductible? How much have I reached? When does the deductible reset (usually it is January 1)?
What are the out-of-network benefits for CPT codes 90791 (initial assessment), 90834 (individual psychotherapy), 90837 (individual psychotherapy), and 90847 (conjoint/family therapy)?
Do I have coverage for therapy via teletherapy (video or phone), with the modifier code 95? This is usually indicated on your receipt or claim by adding "95" to the billing code, i.e. 90834-95 is for an individual session via teletherapy.
Do I need any pre-authorization to receive these services out-of-network?
Can I submit claims electronically? How long does it take to process?
For insurance purposes, our billing zip code (business address) is 20009. Camille Espinoza is a clinical social worker in MD, VA, DC and MA. Alexis Logan is a supervisee in social work in Virginia, and practices under supervision from Camille.
What information do I have to share with the insurance company?
In order to receive out-of-network insurance benefits, you will have to meet the criteria for a mental health diagnosis (such as anxiety, depression, etc.). This diagnosis will become part of your medical record and will go to the insurance company.
At any time, you can request a “superbill,” which is documentation for insurance reimbursement. The superbill will have your name, details and the provider details, along with the CPT code (the code that says what kind of service you received, such as individual therapy) and diagnosis code.
Please feel free to discuss any concerns with your therapist.
How do I get help filing my insurance for therapy?
There are many services that will do all the work of filing for your insurance reimbursement for you, for a fee. They specialize in helping therapy clients receive out of network benefits. Here are some options; note that we are not affiliated with any of these services, and therefore cannot guarantee the quality or pricing of them.
Reimbursify will file claims for you and offer reimbursement, for about $4 per claim, with packages available.
Thrizer will instantly confirm your insurance benefits, and if applicable, offer a standard reimbursement directly to your bank account in a few weeks, or instant reimbursement now. Fees start at $2 per session, plus 1% of the session cost for standard reimbursement, or 10% of the session cost for the instant reimbursement option.
In addition, we have a lot of experience in this field, and will be happy to help you navigate the insurance process as much as we can. If you have any questions, please feel free to ask.
Why don’t you take insurance?
Good question. We think about this all the time. Unfortunately, insurance companies pay a small percentage of the costs of therapy, so it’s just not feasible. More importantly, we would rather spend all of our time focusing on YOU, not paperwork or insurance requirements. We will gladly help you utilize your out of network insurance benefits to the fullest. If you have any questions, just ask and we are happy to help.