Dr. Abrams is currently an “in-network,” provider for Aetna. For other insurance companies, she is considered an “out of network,” provider and does not bill insurance companies directly. You may have an “out of network,” benefit, which allows you to see any therapist, pay directly at time of service, and be partially reimbursed by your insurance provider. Dr. Abrams can provide you with a receipt for services so that you have documentation to submit to your insurance company for reimbursement. Many insurance companies will cover at least 50% of fees.
The best way to determine what portion of fees will be reimbursed by your insurance company is to contact them directly by calling the customer/member services number on the back of your insurance card. (There may be a separate number for "mental health" or “behavioral health.”) When speaking with your insurance company, you will want to ask them the following questions:
- Do I have “out of network” outpatient mental health benefits?
- If so, what is the amount of my deductible (the amount of money you have to pay before your insurance company will start to reimburse you) for out of network providers? Have I already paid/met any of my deductible?
- Are there any limitations to outpatient mental health services (i.e. only a certain amount of money allowed for these reimbursements, a limited number of sessions, reimbursement only for certain types of diagnoses, etc.)?
- Do I need any special kind of referral (i.e. from a primary care doctor or my university counseling center) before I can be reimbursed?
- How do I submit my receipt? How long will it take to get reimbursed after I send my receipt?
- Do my benefits cover online counseling sessions?
Many individuals with health insurance choose not to use it to cover mental health services, and instead pay “out of pocket,” for these services. Some individuals use their flexible spending or health savings accounts. Most often, this is due to concern about the privacy of their health information and the potential release of this information to health insurance companies and their affiliated entities. Dr. Abrams is required to provide insurance companies with a DSM-V diagnosis if you choose to use your insurance benefits to cover fees.