*If you purchased PacificSource through an open market plan, I may not considered an in-network provider. Please check with your insurance.
**If you work for Providence you may have Optum instead of Providence for behavioral health benefits, and I am not in-network with Optum. However, check to see if you have EAP benefits through Lyra with your HR department.
I can do out-of-network(OON) billing for you (even if you don't have benefits, services go towards your annual OOP max.)
Don't know if you have OON benefits. Here's how to find out:
Call your insurance company directly, and ask them the following question:
Do I have out-of-network benefits for behavioral health?
If no, talk with your HR representative about how you can sign up for a plan with out-of-network benefits during your next open enrollment period.
If yes, ask the following questions:
What is my out-of-pocket responsibility?
What is my out-of-network deductible for outpatient mental health?
How much of my deductible has been met this year?
What is my reimbursement rate for (most commonly used service codes below)…?
90834 – Individual Therapy, 45 minutes
90837 – Individual Therapy, 55 minutes
90846 & 90847 – Family Therapy with and without Client Present
Do I need a referral from an in-network provider to see someone out of network?
Do I need any other prior authorization to receive these benefits?