Insurance, Fees, and Payment Options

If you are planning on using insurance to get your mental health care needs met, it is important to me to be as transparent as possible about this process. When using your insurance, there are a few things that are required and need to be considered for your care with us at TMH Psychotherapy.

• When scheduling the initial intake session with TMH Psych, we will ask to provide a copy (picture via text or email) of the front and back of your insurance card, along with your photo ID (or at least DOB). We will use this information to verify your benefits, including any copays, deductibles, and/or coinsurance you may have. We will then let you know if and how you are covered. The client is responsible for any copays, deductibles or coinsurance amounts, and this is collected at the time of session.
• Using your insurance requires a documented diagnosis each and every time I submit a claim for session. Diagnoses need to be made as early as the very first session. It is important to note that this will be part of a permanent medical record. With time and more information, diagnoses can and do change. When this happens, we will have a conversation around these changes, and this will be documented on any submission of claims. Please note that many people come to therapy for reasons that do not require a diagnosis. If this is you, and utilizing insurance is a necessity, we can discuss our options if we decide we are a good fit for working together.
• Medical Necessity- When an insurance company has ‘accepted’ your diagnosis, they have deemed your care ‘medically necessary’. This means that in order to continue to receive coverage for your care, medical necessity must be documented each session. If at any time an insurance company denies coverage for not meeting the threshold of medical necessity, we can discuss our options in continuing our work together, or I can provide you with referrals or resources to help meet your needs.
• Other Important Considerations- Insurance requirements, allowances, regulations, and coverage can (and does) change at any time. When I am made aware of these changes, you will be made aware. Should any of these changes impede on your ability to receive care, we can work together to develop a plan that works for you. Additionally, insurance companies can contact me at any time and request our session notes and other private information for their review. While I will always notify you when this occurs, contractually, we are required to submit whatever they request.