Using insurance for mental health services can help reduce out-of-pocket expenses, making therapy and counseling services more affordable and accessible for most people. If you’re already paying for coverage, it makes sense that you would want to use it to cover the care you receive!

While insurance coverage can be instrumental in accessing care, there are a few things you should be aware of before you use your benefits. First, in order to use your insurance, you must receive a valid diagnosis that indicates medical necessity for services. This diagnosis must be shared with insurance, and they may request records to continue to authorize care from time to time. Sometimes there are unforeseeable circumstances that cause a denial of insurance claims. If they are not due to an error by the practice, you will be responsible for the full fee of a session. While we can complete an eligibility and benefit verification check, it is not a guarantee of payment for services by insurance.

Insurance uses a lot of specific terminology, and the meaning isn’t always clear. Here’s a quick guide for you:

In-network: In-network refers to healthcare providers or facilities that have contracted with a specific insurance company to provide services at pre-negotiated rates. Choosing in-network providers often results in lower out-of-pocket costs for the insured individual.

Out-of-network: Out-of-network refers to healthcare providers or facilities that do not have a contractual agreement with a particular insurance company. Seeking services from out-of-network providers may result in higher out-of-pocket costs for the insured individual.

Deductible: A deductible is the amount of money an individual must pay out of pocket for covered healthcare services before their insurance plan begins to pay. Once the deductible is met, the insurance plan typically covers a percentage of the costs.

Coinsurance: Coinsurance is the percentage of covered healthcare costs that an individual is required to pay after the deductible has been met. For example, if the insurance plan covers 80% of the costs, the individual would be responsible for the remaining 20%.

Copayment (Copay): A copayment, commonly known as a copay, is a fixed amount that an individual pays for covered healthcare services at the time of the visit. Copays are typically set amounts (e.g., $20 for a therapy visit).

Coverage limits: Coverage limits refer to the maximum amount that an insurance plan will pay for certain covered services within a specific time period. For instance, there may be annual or lifetime limits on certain types of treatments or services.

You can call your insurance carrier directly using the number on the back of your insurance card to verify your benefits. You can also simply reach out to us at admin@ashamh.com with your insurance plan information and we would be happy to help you understand your coverage and any potential out-of-pocket costs associated with your care.

Definitely not. If you prefer not to use insurance, we also offer the option of direct payment, or private pay. This ensures maximum confidentiality and control over your mental health care experience, since no third party can dictate what services you receive or have access to any of your information. We offer the convenience of credit card payments via client portal or via autopay to help make this process as easy for you as possible.