Creating Lasting Connections Therapy Center is not part of any insurance panels.

• Clients who carry insurance should remember that professional services are rendered and charged to the client and not to the insurance company. You will be given a bill (aka “super bill”) to submit to your insurance company at the end of the month upon request. Please submit for reimbursement to your insurance company directly. We do not submit on your behalf.
• Not all issues/conditions/problems, which are the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage.
• It is also your responsibility to let us know of any changes to your health coverage and/or billing.

There are several important questions you’ll need to ask your insurance company before you attend your first session:

1. Will my plan reimburse me directly when I go to an out-of-network provider? Creating Lasting Connections Therapy Center is considered out-of-network.
2. Does my plan cover mental health benefits? Specifically, will they reimburse for the following codes:

90834 – most important for individual work

90837 – most important for individual work

90846 – most important for couples & family work

90847 – most important for couples & family work

3. What are the terms of my plan—do I have a deductible and has it been met?
4. What paperwork does my insurance carrier require? This is usually a one-page claim form that the carrier provides to you upon your request.
5. How many sessions per calendar year does my plan cover?
6. How much does my plan cover for an out of network provider?
7. What is the coverage amount per therapy session?
8. Is approval required from my primary care physician?

Clients who carry insurance should remember that professional services are rendered and charged to the client and not to the insurance company. You will be given a bill (aka “super bill”) to submit to your insurance company at the end of the month upon request. Please submit for reimbursement to your insurance company directly. We do not submit on your behalf.

• Not all issues/conditions/problems, which are the focus of psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage.
• It is also your responsibility to let us know of any changes to your health coverage and/or billing.

Will my Insurance pay for Marriage/Couples Counseling?

If you are seeking Couples Therapy, It is important for you to understand what your insurance actually covers, and what it does not. With very few exceptions, Health Insurance reimburses only for the diagnosis and treatment of mental illness or what they consider to be “medically necessary”. Even though, most insurance companies will pay for Procedural Code 90847 (Procedural Code 90847: “Family psychotherapy, conjoint psychotherapy with the patient present.”), they rarely pay for DSM-5 Diagnostic Code Z63.0 (“Z63.0: Counseling for Marital and Partner Problems”). Most often, it is the Diagnostic Code that causes the claim to be rejected. Therefore, it is important that you ask your insurance company “Do you specifically pay for the Diagnostic Code Z63.0?”. If they say “Yes”, you have a rare plan that covers Marriage/Couples Counseling.

The Good News! If your insurance company doesn’t cover Marriage/Couples Counseling, some tax programs may help you pay for your couples therapy, even if you are self-employed. These tax laws allow couples to use Pre-Tax Flexible Spending Medical Accounts (FSA’s) to pay these costs. Marriage Counseling is usually not covered in HSA’s. You may check with your Accountant or Compensation and Benefits Administrator if you qualify for either program.

Below you will find a few reasons why we have chosen not to contract with insurance panels.

1. When using insurance, treatment needs to be medically necessary; therefore a mental disorder diagnosis is required.  This diagnosis remains on a client’s permanent record and could possibly lead to long-standing consequences in later life.
2. When using insurance, you must have a diagnosis per DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) for coverage to be provided.  In other words, in order to continue therapy each session must be clinically justified.  Many normal life struggles and transitions do not meet criteria for a justifiable diagnosis.
3. When using insurance, your privacy and confidentiality is not maintained.  Third party members become involved in the process or reviewing your record.

Cancellation Policy

If an appointment is cancelled or missed without 24 hours notice, you will be billed for the entire session regardless of your insurance policy, except in extreme emergencies. The missed appointment cannot be billed to your insurance. It is our policy to bill for missed visits starting, 1 April 2015, which have not been cancelled at least 24 hours prior to the scheduled appointment time, including weekends. The one exception to this policy is a true emergency that affects your health.

1. We will discuss any such circumstances with you if such an emergency causes you to miss an appointment.
2. Direct email or a phone call is best for quick, administrative issues such as changing appointment times.
3. Parents are responsible for payment of missed visits by minor or dependent children.
4. If you miss your appointment and you wish to reschedule, an additional charge of a $25.00 fee will be charged for scheduling an appointment in the same week if there is availability.