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Insurance Information

About insurance, I have chosen to be out-of-network for all insurance panels, so the way it works is different than a medical doctor, yet a lot of therapists in private practice do as I do.
The way my practice works, I request full payment at the time of the session ($130 for 50 minutes and $205 for 85 minutes) and you can download receipts from my client portal at omaratime.com where you schedule session, complete forms, and make payments.  These receipts can be mailed to your insurance provider for you to seek reimbursement.
The actual amount of reimbursement you receive will depend on your out-of-network benefits.  By choice, I am not in-network for any insurance providers.  To find out your actual level of out-of-network benefits, you simply contact the customer care # on your insurance card and request the following information:
  1. What are my out-of-network mental health benefits for mental health with a PhD (in Clinical Sexology, if they ask)?**
  2. What is my out-of-network deductible?
  3. How many sessions am I allowed per year?
  4. Where do I send claims for reimbursement?
  5. What is the typical length of turn-around time it takes you to reimburse a claim?

**You may also want to be sure to ask what their “usual and customary” rate is for a session.  What this means is that, regardless of what I charge, they may have a standard rate that they are willing to honor when it comes to a particular service. So, for example, if you see me in office for 50 minutes (CPT 90834) and I charge $130, they may only recognize $100 of that rate, and if they pay 80% of your benefits, this means you will get reimbursed $80, not $104.  If they ask you for a diagnosis and a CPT code to run a sample session, use the diagnosis F43.20 (Adjustment disorder, Unspecified), and the CPT codes 90834.  That will give you something to use to get the information you need.

I do offer the use of MC/Visa to offset the delay between payment and reimbursement.