If interested in seeking reimbursement for out-of-network treatment, Jennifer provides a free service for clients to verify their access to OON benefits and to streamline filing claims for reimbursement. As a part of this service, you will also be provided with a monthly superbill.
Do I have out-of-network benefits for mental health coverage? If so, what percentage is covered?
Is there a session limit, and if so, in what time period?
Do I have a deductible? What is it and how much of it have I met?
What is the reimbursement for CPT code 90791 (intake)? 90834/37 (individual)? 90847 (couples)?
What percentage is covered if so?
How do I submit a request for reimbursement?
Effective January 1, 2022, the No Surprises Act (NSA) protects self-pay individuals from many unexpectedly high medical bills.
If an individual does not plan to use that insurance to pay for health care items or services, they are eligible to receive a “good faith estimate” (GFE) of what they may be charged, before they receive the item or service.
A new patient-provider dispute resolution (PPDR) process is available for uninsured or self-pay individuals who get a bill from a provider that is substantially in excess of the expected charges on the good faith estimate (GFE; $400 or more).
Under the NSA, self-pay individuals should receive a single, comprehensive good faith estimate that includes expected charges for:
The primary item or service that will be furnished by the convening provider or convening facility and that is the initial reason for the visit.
All items and services that are reasonably expected to be provided in conjunction with the primary item or service, provided during a defined period of care.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.
Provision of Psychotherapy Disclaimer:
Good Faith Estimates (GFE) require the inclusion of a diagnostic code, treatment code and estimated duration of care in order to provide a client with a cost estimate that is unique to their need(s). Although an initial diagnostic impression can be determined within the first session, a formal diagnosis requires ongoing assessment over several sessions. Similarly, duration of care is determined through recurrent evaluation of treatment engagement and progress toward client-identified goals. Due to this, the initial GFE is solely based on the limited information available at the time of the pre-treatment telephone consultation. Upon initiating treatment, if there are changes to the initial diagnostic impression and proposed treatment plan, it is your right to receive an updated GFE.
For questions or more information about your right to a Good Faith Estimate for the services provided by JP Psychotherapy LLC, please contact Jennifer directly or address this in session.
Serving clients in the Greater Boston Area and throughout the State of Massachusetts (MA), Connecticut (CT), Florida (FL) and South Carolina (SC).
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