Appointments & Insurance

Appointments

We welcome the opportunity to serve you with all your therapy needs. Call us at 330-666-1817 to schedule a psychotherapy appointment. If we are unavailable, the Medical Service Bureau will take your message and immediately notify us. You can expect a return call at the next open hour. Our current schedule allows for appointments three evenings each week in addition to daytime hours.

Does my health insurance cover psychotherapy services?

Most health insurance policies cover mental health services under "medically necessary" guidelines. This typically means coverage for face-to-face sessions in an office for a diagnosable mental health problem. The amount of coverage varies according to your policy. In addition, a managed care company that specializes in mental health benefits may be providing the actual coverage. This means you need to find out who provides your coverage and what the benefits really are.

How do I find out this information?

Look for a toll-free number on the back of your insurance card. Call and obtain the information about your actual coverage.

Can I see anyone I choose?

Some plans may limit your selection of mental health providers. Some allow you to see anyone but you will pay a higher deductible and higher co-pay.

Do I need preauthorization for office visits?

Some insurance carriers require pre-authorization, which you can obtain initially by calling the toll-free number. Once the original authorization has been used, the therapist is required to submit a form explaining the need for more sessions. This typically requires sharing some confidential information about your problems and describing the plan for resolving those problems. Preferred Provider Organizations (PPOs) may or may not require pre-authorization. Contact your provider to learn more.

Are there advantages to paying out of pocket?

Despite the higher cost, you gain certain advantages by paying for your own therapy. Using your coverage means that some of your data is entered into a national database managed by insurance company employees. Some insurers attempt to have an active say in treatment plans. If you are paying for your own therapy, you can see whomever you want and at whatever frequency you and your therapist decide is in your best interest-while maintaining confidentiality.

What services are not covered?

These may vary according to your plan, but services such as court testimony, school visits, telephone and email consultations and collaboration with other professionals are not covered. Certain specialized services (e.g., hypnotherapy, biofeedback) may not be covered as well.

What is the most important issue for me to keep in mind about insurance coverage?

It is your responsibility-not the therapist's-to confirm the nature and extent of your coverage. While most therapists can help with this process, they should not make assumptions about your coverage or assume responsibility to confirm it. Keep in mind that you do not automatically receive the full coverage offered in your policy. This only occurs if the insurance company approves requests to use all benefits.

One final note...

As either an employee or insured individual, you have the power to appeal decisions if requests for services are denied. You should inform your employer or insurer if you are dissatisfied with your mental health coverage.



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