Insurance & Other Third-Party Payers
Summary:
I take insurance using a billing service that does all the work for you to get reimbursed (see tool below). This is for psychotherapy only.
HSA/FSA cards are accepted for psychotherapy, supplements, and lab work.
You can use in-network coverage if you see me at River Hollow Mental Health, but only for basic psychotherapy.
I am willing to work with bishops, grant programs, or other third-party payers if needed.
Insurance
I am currently in the process of getting set up to take in-network insurance through my own practice. Stay tuned!
Please note that using insurance, whether in-network or out-of-network, requires an official diagnosis that goes on your permanent medical record. If you are concerned about privacy or eligibility for life insurance, a pilot license, or military service, finding another way to pay for therapy may be better for you.
HSA/FSA cards are accepted for all psychotherapy services, supplements, and labs.
If I don't take your insurance, you can utilize out of network (OON) benefits. If you, like many, stigmatize out-of-network providers, please keep reading! I have a solution.
What are out-of-network (OON) benefits?
There's sometimes a stigma associated with using out-of-network benefits, with the belief that it's a lot of work for the patient. But in reality, using insurance at all, whether in-network or not, is always going to be a headache for someone. Insurance companies are very difficult to deal with, in general (to the point that I would even say they are sometimes unethical in their business practices).
Medical doctors make a lot of money, so they can usually afford to hire someone whose full-time job is to deal with insurance claims. We can thank them for making using health insurance such a ubiquitous expectation.
Unfortunately, therapists often don't make very much money. Because of this, it's fairly common for us to not take insurance since it's such a costly process. But it's a lot easier with the way I do it!
Here's a breakdown of how it works:
If your insurance plan offers out-of-network benefits, it means they will cover a portion of the cost when you see a therapist who doesn't have a direct contract with your insurance company.
Unlike in-network providers, who bill your insurance company directly, with out-of-network therapists, you typically pay for the session up-front and then submit a superbill to your insurance for reimbursement.
Insurance companies often reimburse a percentage of the therapist's fee, usually after you meet an out-of-network deductible. For example, if your deductible is $500, you will have to pay that first, then your insurance may reimburse 50-80% of the session cost!
Out-of-network benefits give you the flexibility to choose a therapist based on your needs and preferences, not just those in-network. That gives you more freedom for which providers you want to see.
Typically, to access OON benefits, you'd have to submit a superbill on your own and dispute any rejections that arise.
Here's what makes me different from the conventional OON method
To make OON billing easier for all of us, I use a billing service called Mentaya that negotiates on your behalf. You don't need to submit your own superbill or worry about disputing anything.
Instead, Mentaya submits all the necessary paperwork and they will do everything in their power to make sure you get reimbursed. They charge a 5% fee for their services, but if you get money back, it's definitely worth their fee! The 5% is refundable if, for some reason, they can't to get you reimbursed. The below tool is helpful to see if reimbursement is possible for you. Check your benefits (or contact your insurance directly) ahead of time if you are worried about getting reimbursed.
Unfortunately, I’m not able to take insurance for nutrition by itself. Insurance will only cover nutrition services with a registered dietitian, and even then, they require an official diagnosis from a healthcare provider (doctor or therapist). Dietitians can't diagnose.
A special note for those who prefer in-network coverage (psychotherapy only):
You might have found me listed on your insurance company's website as an in-network provider. Yes, I am in-network with many Utah insurance companies, but "in-network" providers are only approved to take insurance at specific clinic locations, not just anywhere (if you're wondering, it's a cumbersome application process).
If you have met your deductible or have a really good in-network policy that will cover a large portion of therapy, you may choose to see me at River Hollow Mental Health, which is also located in Logan or online. Please note that we only offer psychotherapy sessions at River Hollow. No nutrition or other holistic services are offered. So while it may be cheaper for you, it is a lesser service.
If you don't think you'll meet your deductible soon, I advise paying the cash rate and not going through insurance. The financial cost will be about the same, in most cases, but paying cash makes it easier on everyone and preserves your privacy.
Other Third-Party Payers
Bishops/church leaders will usually pay for services for those in need and I'm happy to work with them to make sure you are taken care of.
If someone else is paying for you (such as a parent or church leader) and you are a legal adult, you'll need to sign a release of information in case I need to contact them.