North Berkeley Couples Therapy Center
is a boutique style private therapy center, rather than a managed-care driven mental health clinic.
It's helpful to see therapy as an investment in yourself that will take resources, money and time, for you to see results.
CAN I USE MY INSURANCE TO PAY FOR SEX THERAPY & COUPLES COUNSELING SERVICES?
North Berkeley Couples Therapy Center is a boutique style private therapy center, rather than a managed-care driven mental health clinic. We work for you, not the insurance companies.
If you choose to use insurance for therapy reimbursement, your clinician can work with you as an out of network provider. Usually PPO or POS plans are in this category.
Many of our clients who use their OON (out of network) benefits get reimbursed 65-80% of the counseling fee. Others use their Health or Flex Account, which may cover all of it and allows tax advantages.
You’ll need to check your plan first to determine your benefits for licensed counselors as OON providers, if there’s a deductible and if its been met, and what percentage they cover for individual or family counseling.
Please note that only licensed medical professionals can diagnose and provide superbills, so even those whom are doctors of human sexuality, psychology, Sexologists and certified coaches are not able to provide SuperBills to insurance companies.
Your psychotherapist or psychologist can provide you with a receipt, called a superbill, with the necessary info to obtain counseling fee reimbursement based on your plan.
Psychologists & psychotherapists who choose to directly contract with insurance companies have to make concessions, as do their clients. Rather than focus on a diagnosis, we believe in treating you as a whole person whose issues are rooted in the context of your life, rather than in disorder or illness. It’s important to us to preserve the integrity of the therapeutic process and avoid issues with a managed care company at times requiring personal therapy data and details about your treatment.
We strive to offer a premium couples counseling and sex therapy experience without involvement from insurance companies or the various entities they now employ or outsource to for managing their electronic data. However, we also understand that without insurance reimbursement, the therapeutic support you need may not be financially accessible. Therefore, we are happy to provide you with a superbill (please note it will be required by the insurance company to contain a clinical diagnosis c
INSURANCE REIMBURSEMENT
Please note that North Berkeley Couples Therapy Center does not work with insurance panels, but does provide therapy invoices to the client to submit to their insurance for out-of-network reimbursement after full payments. Services may be covered by your health insurance or employee benefit plan if they offer out of network services. Please keep in mind that all insurance companies require a diagnosis to approve your claim. If you do have out of network coverage, we are happy to give you an invoice (called a superbill) to submit to your provider.
SUPERBILLS
Payment for therapy is made at the time of your visit. Your clinician will provide you with an invoice of services on a monthly basis. You must submit this invoice to your insurance company to receive reimbursement. We are considered an "out of network" provider. If you are considering using health insurance to cover the costs of therapy, it is important to know that insurance companies and plans vary according to their coverage of mental health benefits. It is important, therefore, to research your coverage prior to commencing therapy. You would pay us and then get reimbursed if that is the arrangement you have with your insurance provider. We cannot guarantee reimbursement but are happy to walk you through a list of questions to ask your insurance provider.
INSURANCE QUESTIONS CHECK LIST
Please check your coverage carefully by asking the following questions:
Do I have “Out-of-Network” insurance benefits for “Outpatient Mental Health Services”?
Is individual couples, sex or family therapy covered?
What is my deductible and has it been met?
How many sessions per year does my health insurance cover?
What is the coverage amount per therapy session (percentage and monetary amount)?
Is approval required from my primary care physician?
