Fees,  Payment  & Insurance

Insurance

I am an out-of-network, outpatient provider.  Presently, Crossroads Counseling, PLLC does not contract with or bill insurance providers directly. Because some insurance companies will reimburse clients for out-of-network services received for individual counseling, you may request from me and self-submit an official insurance billing form for services rendered for each calendar month detailing services provided. I cannot guarantee reimbursement from any given company. Your best defense against unexpected out-of-pocket expenses is to have a thorough understanding of your mental health or behavioral health insurance benefits prior to receiving services.

Prior to contacting me, research thoroughly your insurance benefits for counseling.  A complete understanding of your benefits (including in- and out-of-network deductibles, copays, exclusions and reimbursement procedures) will better protect you from costly unanticipated expenses.

Some helpful (somewhat redundant) questions you may ask your insurance carrier:  

• What is my out-of-network deductible and my in-network deductible?

• What are my “outpatient mental or behavioral health counseling benefits” for out-of-network and for in-network providers?

• How many therapy sessions does my plan cover?

• Do I need a referral from my primary care provider?

• Does my plan cover (55-minute) individual therapy (specifically, “CPT Code 90837”)?

• Does my plan cover (55-minute) couples/family therapy (specifically, “CPT Code 90847”)?

• Do I have a copay?  If so, what is my copay for out-of-network and for in-network, outpatient, mental health providers?

• If applicable, you might explain that you live in a small, rural, “under-served” community for mental health services and request a “benefit level exception” allowing you to access services from an out-of-network provider but for in-network rates.