Aetna (if you have Aetna HMO, you will need a referral from your PCP prior to making your appointment. If you have Aetna Memorial Hermann, we are out of network; you need to see a Memorial Hermann psychiatrist.)
BCBS PPO and Anthem PPO (We do not take BCBS HMO because we are out of network with their mental health plan, Magellan.)
select plans under Multiplan (contact billing to verify)
We are out of network with Medicare (this includes any Medicare plan under Aetna, BCBS, and Cigna), Medicaid, Humana, United Healthcare, Beacon, Value options, and any other plans not listed above.
This highly varies, ranging from zero to $250. Contact us for the exact amount.
Your copay/coinsurance could be anywhere from $0 to $250, depending on your plan. If you have not yet met a deductible, it is going to be the most expensive. If your deductible is met, you usually pay a percentage. If your max out of pocket is met, you may pay zero.
This could be due to change in plan or your deductible/out of pocket reset. Your deductible/out of pocket resets once every 12 months.
In-network claims are denied for many reasons. Sometimes it is due to the company using a third party mental health provider with whom we are out of network. It could be due to a coding error or an error on the processing side. It could be an unmet deductible that they failed to disclose. It could be due to obtaining similar services on the same day or within a certain time period. Whatever the reason, we will work hard to try to correct the claims and sort out any misunderstandings with your insurance.
We usually contact your insurance, correct any errors on our end, and resubmit your claim multiple times. If ultimately your insurance does not pay, it is your responsibility to cover the services rendered.
This is because every plan within an insurance company is different. For example, not all BCBS plans cover the same thing.
Please send us a copy before your next appointment: firstname.lastname@example.org.