I am a provider with several local and national health insurance companies.     I also work with therapy clients on a Private Pay basis.   Private Pay offers advantages of greater privacy because sensitive personal information is not shared with an insurance or managed care company to qualify for reimbursement.  This may also be true for “employer sponsored” health plans, as some employers may have access to sensitive information (such as a diagnosis) when a claim is submitted for reimbursement.

The insurance companies listed below are meant to give an example of who I am contracted with.  This may not be a complete listing as insurances may change ownership and affiliations with managed care companies, and providers are not always informed in advance:

Insurances & Fee for Service Information

CALIFORNIA 

Medicare (part B) California

Cigna

Out of Network

WASHINGTON STATE

Regence of Washington

Premera of Washington

First Choince Health Network

Cigna

Oftentimes, a client’s health insurance offers “OUT of NETWORK” benefits.  That means that they reimburse for services, but at a different level than “IN NETWORK” (meaning I am contracted with them).  Sometimes reimbursement is similar to “In Network”, and other times it may mean a higher co-payment.  While I may not be contracted with any particular insurance company, that does not mean they will not reimburse for services. 

If I am not “In Network”, check with our insurance company to find out about what benefits you have for working with me.  

ADDITIONAL INFORMATION ABOUT HEALTH INSURANCE

In addition, Some insurance companies or networks I contract with have mental health benefits that are sub-contracted or “carved out” to a third party managed care company.  That means your primary health insurance company handles claims for medical benefits only, and the subcontracted company manages psychological and mental health  services.  I may or may not be covered under the sub-contracted company, even though I am contracted with your primary insurance.  In that case, the services I provide may not be covered.  It is not unusual for an insurance company sub-contract the mental health benefits without notifying providers of this arrangement.

Clients are responsible to be familiar with all healthcare coverages and exclusions or limitations, reimbursement rates, annual deductibles, co-payments and co-insurances, and extent of benefits (covered and non-covered services).   Therefore, it is very important to check with your insurance company to determine what your mental health benefits are, and whether these benefits are sub-contracted to a managed care company.  I often do not know a new client’s benefits prior to starting therapy, unless it is an insurance I deal with on a routine basis.  Be sure to read the fine print on the back of your insurance card to see if there is a need to call a third party for “pre-authorization”, or check your benefits book to see whether pre-authorization is needed or not, and/or call your insurance company to ask about benefits and any pre-authorization requirements, and who manages mental health benefits.

Motor Vehicle Insurance – PIP Coverage

Some clients may require therapy as a result of work or auto collision related injuries.   Oftentimes, these clients may need to go through the “Personal Injury Protection” (PIP) coverage of motor vehicle insurance.  Private insurance may not provide coverage until benefits under PIP auto coverage is either exhausted or denied.  Insurance coverage in these circumstances will need to be clarified and authorized prior to the start of therapy.