Insurance and Fees

Insurance Overview

The Cognitive Behavior Therapy Center of Sacramento Valley is an “out-of-network” provider. If you have an insurance plan that allows you to go out-of-network (often called a “PPO” plan), you may be eligible for some level of reimbursement when seeing an out-of-network therapist. As an out-of-network provider, the CBT Center can invest in the staff training and resources to provide our clients with a high level of service and expertise in treating anxiety, OCD and anxiety-related disorders.

Unfortunately, there are very therapists who understand and know how to treat Anxiety and OCD using evidence-based treatments incorporating cognitive restructuring and exposure and response prevention therapy. Our clients seek us out because we are highly specialized and extensively trained in the most effective treatment methods for anxiety, OCD and anxiety-related problems. It is difficult, if not impossible, to find an expert in anxiety and OCD within the insurance networks since most therapists tend to be generalists.

Since every plan is different, please contact your insurance company to discuss your benefits and obtain pre-approval, if needed. As a courtesy, we may be able to submit your claims electronically so you don’t have to do the paperwork. For more information about insurance, see the frequently asked questions about insurance below.

Do you accept my insurance?

This practice is not “in-network” with any insurance companies so we do not accept insurance directly. Our practice is “out-of-network,” which means you would pay for your therapy sessions at the time of service and submit the claims to your insurance company for reimbursement. If you have mental health benefits that allow you to see an out-of-network therapist (often called a PPO), you may be able to receive partial reimbursement for therapy services. In addition, we may be able to submit claims electronically for you. Keep in mind that insurance companies will require that you have a valid mental health diagnosis and may limit coverage by diagnosis, procedure code or number of visits. In addition, you may need to meet a deductible before your insurance company starts to reimburse you and the percentage of reimbursement is usually based on an “allowable amount,” which may be lower than the actual fee charged. Kaiser, other HMOs and Medicare will not cover any portion of the fees for an out-of-network provider. Please call your insurance company to review your benefits and obtain pre-approval (if required) before starting therapy.

 

What is the process for you to submit claims for me?

As a courtesy, we can submit claims electronically to most insurance companies if you have a PPO with out-of-network benefits. Our clients keep a credit card on file and we bill the credit card the morning of the appointment and then submit the claim electronically after the appointment. If your insurance company will allow us to submit claims for you electronically, then you won’t need to fill out the claims paperwork and the insurance company will send the reimbursement checks directly to you. While it can take up to 3-6 weeks to receive the first reimbursement check, we submit claims weekly, usually the same day as the appointment. Once the process gets started, you should be receiving reimbursements on a regular basis. Since all plans are different, please contact your insurance company to find out about your benefits.

Your responsibilities are to:

  • Call your insurance company before starting therapy to review your benefits and obtain pre-approval (if required).
  • Pay for therapy sessions in full by credit card, check or cash at the time services are delivered.
  • Provide us with information about your insurance plan so we can prepare the claims and submit them electronically on your behalf.
  • Follow-up with your insurance company after the claims are submitted electronically if you have questions about your claim status and when you’ll get reimbursed.

Why should I consider going out-of-network for CBT therapy?
While it can seem less expensive to see an in-network, insurance-based therapist, there are several benefits to seeing an out-of-network CBT specialist:

  • Adherence to CBT Model: Most in-network, insurance-based therapists are generalists and not trained in the evidence-based protocols of CBT. As described earlier, CBT is a highly sophisticated type of therapy and requires extensive knowledge and training to execute effectively. Most therapists have only received a little bit of CBT training in graduate school or taken a couple of CBT workshops. As a result, most therapists integrate a few aspects of CBT into an eclectic framework but do not follow the entire CBT model.
  • Specialized Skills: There are very few certified and highly trained CBT therapists in the Silicon Valley who follow the evidence-based practices for the various forms of anxiety and obsessive compulsive disorders. If you are looking for a therapist with specialized skills and training in anxiety and OCD, you may need to see a specialist.
  • Results-Oriented: CBT is structured, targeted and scientifically-based and research indicates it gets better results than supportive talk therapy. If you have specific goals, CBT may be a more effective investment of your time and resources.
  • Insurance Coverage: If you have a PPO or similar plan, your insurance benefits may cover a significant portion of the cost of therapy with an out-of-network therapist. Call your insurance company to verify your coverage and benefits.
  • Electronic Claims Submission: Unlike most out-of-network therapists, the CBT Center may be able to submit claims electronically for you after every session and the insurance company will mail qualifying reimbursements directly to you. This saves you the time and effort of filing claims yourself. Most out-of-network therapists will provide you with a receipt and you’d still need to complete the paperwork to get reimbursed.

If you want to see an in-network therapist on your insurance panel, please call your insurance company for referrals.

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(916) 778-0771
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Anxiety & OCD Therapy Experts (916) 778-0771