Out Of Network Benefits

Understanding insurance and working with Dr. Strait

I understand working with insurance can be confusing and frustrating at times.  I want to do my best to help you navigate the process and figure out whether our sessions would be covered by your insurance plan.

Coverage for counseling services is highly variable and ever changing.  Coverage often depends on what benefits you and your employer select, deductible amounts, specific diagnoses, and maximum yearly allowances.  In other words, coverage does not depend on whether I am an in-network or out-of-network provider.

An out of network provider has not been credentialed or signed a contract with a particular insurance company.  You may have a lower deductible or copayment for selecting an in-network provider.

I chose to be out of network providers for most insurance plans so that I can devote my time to you and your care instead of administrative time spent appealing insurance payments. Because I believe in what I do, I always hope your plan covers my services! Choosing to be an Out-of-Network provider was a difficult decision I made as a result of previous experience working directly with insurance companies.

Payment for services is collected at the time of our visit. You will be provided with a superbill for reimbursement. A superbill is a detailed receipt with billing and diagnosis codes. If you are used to paying a co-pay and having your doctor submit directly to your insurance plan, then this is the exact opposite of your usual process.

A superbill does not guarantee reimbursement but there are some things you can do to understand if your plan covers our visits. Please remember it is your responsibility to understand what your plan does and does not cover.  

Here are some necessary steps in understanding your coverage:

Call the member services number on the back of your insurance card and ask:

  • Does my plan cover psychotherapy services?  Yes No
  • If yes, how many sessions are allowed?
  • Is coverage limited to certain medical diagnoses?
  • Does my plan only cover visits that are considered “medically necessary?”
  • Do I have a deductible to meet first?     Yes No
  • If yes, how much? _______ How much has been met? __________
  • Do the stated benefits differ between for In- or Out-of Network providers?  

(Note: reps will often automatically quote In-Network benefits, so it is important to ask this)

  • Do I need a physician referral? Yes      No
  • Record time called, representative name, and ask for a reference number for your call:

If you’re still unsure if your insurance will cover any cost of the sessions, please schedule a free 15 minute consultation with me, and I’ll check your benefits.

It’s normal to feel frustrated or overwhelmed when working with your insurance policy. Deciding to finally get better takes so much energy that doing something like calling your insurance company, can feel like yet another hurdle between you and your goals.

But in fact, it’s the first step on your journey towards a new chapter in your life. Hang in there, don’t give up, and ask for help. Kiddos to you for taking these steps towards feeling your absolute best. You’re almost there!

Call Now



1506 E Winding Way Drive, Buiding 110, Suite 606
Friendswood, TX 77546

strait@windingwaytherapy.com
(281) 816-6460

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