Dr Kaushansky is an out of network provider for all PPO insurance plans. At the end of every month, Dr. Kaushansky will provide you with an invoice (also known as a “superbill”), which you can submit to your insurance company for reimbursement. Typically, you pay the full fee upfront and receive a percentage of it back, with the amount varying from plan to plan.
In order to get an accurate idea of your out-of-network insurance benefits, here are some questions you can ask your insurance provider:
Call the number on your insurance card and ask:
- "What percentage am I reimbursed for routine behavioral health care out of network"
- "What is my deductible?" Find out if you have a deductible for out of network providers and how much it is.
- "How much of my deductible have I already met?"
- “Is there an “allowable amount” for behavioral healthcare (this is sometimes referred to as “reasonable and customary fees”)?
- If needed, you can ask what the reimbursement is for CPT/procedure code 90837 (a typical 60-minute therapy session), and CPT/procedure code 90791 (your first session with Dr. Kaushansky where he will conduct a diagnostic interview).
With the above information, you will learn what amount you have to spend for your benefits to kick in (your deductible). You will also learn what percentage insurance will pay you back once you reach that point.