FAQ

Billing Questions

Are you an in-network insurance provider?

No, I am an out-of-network insurance provider.

What is an out-of-network provider?

An out-of-network provider doesn't have a contract with your insurance company, so care is paid for directly rather than billed to your insurer.

What are reasons people choose an out of network provider for evaluations?

No insurance-driven limitations — Evaluations aren't restricted by approved test batteries, session limits, or time constraints, so the assessment is driven by your child's needs alone.
Specialized expertise — You can choose a provider with specific experience in autism and complex presentations, rather than being limited to who's available in-network.
Health Privacy - out-of-network care allows you to keep your health records private

Can I still use my insurance?

Yes, it is your choice to seek out out of network benefits if you have them. If your plan includes out-of-network benefits, you may be eligible for reimbursement. I'm happy to provide a superbill — a detailed receipt with the necessary billing codes — that you can submit to your insurance company following your evaluation.

What kind of reimbursement can I expect from out of network benefits?

This is heavily dependent on the allowable rates of your insurance plan compared to the billed rate. You will need to call your insurance company and and request that they provide you with information on allowable rates for each diagnostic code. Diagnostic codes for testing typically used include 90791, 96136, 96137, 96130 and 96131. Diagostic codes for therapy can include 90834, 90846 or 90847. Your reimbursement will also depend on your deductible, copayment, and co-insurance amounts.