Resources

Insurance, Out-of-Network, and Sliding Scale

Vibrant You Counseling is a private-pay practice. Many clients use their insurance carrier's out-of-network reimbursement to cover a portion of the fee. Here is how that actually works.

What private-pay means

You pay the session fee directly at the time of service. There is no claim filed by the practice on your behalf. You receive a superbill (an itemized receipt with the codes the insurance carrier needs) on request.

How out-of-network reimbursement works

You submit the superbill to your insurance carrier. They reimburse a portion of the fee, based on your specific plan's out-of-network mental health benefits. Reimbursement varies widely. Some plans cover 50 to 70 percent after the deductible; some cover much less.

Questions to ask your insurance carrier

  • Do I have out-of-network mental health benefits?
  • What is my out-of-network deductible, and how much have I met?
  • What percentage of the allowed amount is reimbursed after the deductible?
  • What is the allowed amount for CPT codes 90791, 90834, and 90837?
  • Is preauthorization required?

Sliding scale

A limited sliding scale is available when financial access is a barrier. Please raise it during the consultation; cost is a real conversation, not an unspoken obstacle.

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