- What are my out-of-network mental health benefits for mental health with a PhD (in Clinical Sexology, if they ask)?**
- What is my out-of-network deductible?
- How many sessions am I allowed per year?
- Where do I send claims for reimbursement?
- 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.