Insurance Coverage:
Due to the number of different insurance companies and the differences in policies, it is difficult to generalize insurance company coverage and practices. Insurance plans can change and many insurance carriers offer multiple plans, so it is important that you verify your benefits directly with your insurer. Your insurance carrier is your best source of information on your specific benefits.
Kelly Lewis Counseling & Healing is currently contracted provider with Blue Cross Blue Shield, Blue Care, Cigna and Optum/United Health Care. If you have a policy through one of these carriers, we accept reimbursement as in-network providers. Depending on what your insurance policy states, you may either have a deductible to meet before services are fully or partially covered, or you may only be responsible for the copay or coinsurance associated with your policy. Please verify with your insurance whether or not you have a deductible for an in-network provider.
With all other providers Kelly Lewis Counseling Healing is considered an out-of-network provider. With these policies, you will be responsible for payment for the session fee at the time of treatment. Your insurance company will then process your claim and provide any reimbursement to you. We can assist you in submitting your claim either by submitting an electronic claim at the time of treatment or providing you with a “Superbill” that you can submit to your insurance carrier. You are strongly encouraged to contact your insurance company at the number on your insurance card prior to receiving any services in order to understand your benefits and your responsibility of any incurred charges.
Questions to Ask Your Insurance Company
Please check your coverage carefully by asking the following types of questions to make an informed decision.
When you speak with your insurer, here are some of the important things to ask:
Do I have behavioral health insurance benefits?
What is the name of the company that pays my behavioral health benefit? (It's not always what your insurance card states.)
What is my deductible?
How much of my deductible has it been met this year?
Do I have a copay and/or coinsurance?
What is my copay per session?
Do I have coinsurance in addition to or in lieu of a copay?
What is the rate for service code 90791 and 90837?
To whom is the check cut--the subscriber or the provider?
How many sessions per year does my coverage allow?
Do I have out-of-network coverage?
Are there exclusions (e.g., court-ordered therapy, telemedicine/virtual sessions, work-related injuries, etc.) associated with my coverage?
If my insurance lapse or terms while I’m receiving treatment, who is responsible for the fees subsequent to the lapse or term date?
Please note: If service gets denied by your insurance company you are fully responsible for that service.
Some reasons why some individuals choose to opt-out of using their insurance:
Lack of Privacy and Confidentiality. When insurance companies pay for your treatment, it also means that their employees (clinicians or not) will audit treatment plans and read what is talked about in session notes.
Assumption of Illness. Insurance companies operate on a medical model, which means they require a diagnosis to establish that you have “a medical necessity” to seek services in order to pay providers. The vast majority of insurance companies don’t consider relationship issues, existential issues, life-transitions, personal development, or self-improvement as “a medical necessity”.
Negative Consequences in your Future. If given a diagnosis, the diagnosis will become a part of your medical record. While that might not be such a big deal right now, it may become one later on if you want to: get life insurance, work in the financial sector managing other’s assets, regularly handle firearms, or seek employment in any sector in which your decision-making might be called into question due to your emotional state.
If the patient requests a restriction from using his/her insurance. An attestation will need to be signed.