Confirming coverage for mental health counseling

Clients pay RCA counseling for services at each session. We  will provide you with a superbill which you submit to your carrier for reimbursement to you.  We do not do insurance billing. You will need to determine your plan’s coverage and are responsible for your fee even if insurance denies your claim.

You may have an unrestricted plan that covers any practitioner of your choice. PPO plans cover us as out-of-network providers. HMO plans such as Kaiser do not cover our therapists and we are not Medicare or Medical providers. Some of our therapists take CHAMPUS clients. Counseling qualifies as a medical expense for HSA accounts through your employer. If you claim medical deductions on your taxes  counseling fees can also be included in that total.

To determine if your insurance will cover your counseling: 1. Look up the information in your insurance benefits manual/website. OR 2. Call the company directly to ask them. The phone number will be on your insurance card, usually on the back. Mental health services are sometimes covered at different rates than medical services. Rates may also differ for Outpatient (seen in an office like RCA) and Inpatient (admitted to a hospital).

Information you will need to understand how much insurance will reimburse you:

    • Deductible for Policy $_________     (amount of the bills you must pay before your insurance provides coverage)
    • The amount of the deductible you have already met $_________
    • Amount insurance pays per visit for outpatient mental health services $_____
    • Maximum visits allowed per calendar year for mental health services ______
    • Maximum amount paid per calendar year for mental health services ______
    • Ask if they cover the DSM diagnosis of _____________  (You may have received a preliminary diagnosis code from your therapist during the first session).

Ask the insurance company to send you their claim form or print it yourself from their website. Get the mailing address since you will be submitting this claim form to the insurance company.

Claim form – fill out the patient information on the top half. Attach the RCA superbills to the bottom half. RCA gives you a superbill at each session when you pay for the counseling. You attach 4 or 5 superbills to the claim form and mail it to the insurance company for them to reimburse you.