Out of Network Benefits
4 Steps to Find Your Out of Network Benefits:
1. Consult your health insurance brochure or:
2. Call your health insurance company, either before or after your first visit, and have the following conversation:
a) Tell the person with whom you are speaking that you are seeing an “out-of-network” psychiatrist.
b) Ask how much you will be reimbursed for CPT (Current Procedural Terminology) Code 90792 (psychiatrist initial evaluation) and follow up codes such as 99214 (psychiatrist follow up) or 90837 (psychotherapy follow up).
c) Ask how much your annual deductible will be
d) Ask how many certified visits you have per calendar year
3. Submit an invoice, see how much reimbursement you will receive, and read the enclosed E.O.B (Explanation of Benefits). Most health insurance companies are required by law to pay the claim or tell you why they are not going to pay within 30 days.
4. You should then have all the information you need to estimate the amount you can expect to be reimbursed for your treatment.