r. Cox is an out-of-network provider for insurance companies. She cannot submit any paperwork to your insurance company for you, but can provide you with monthly bills which you, yourself, submit. These bills have all of the information insurance companies require in order to reimburse you for payment.

If you are uncertain whether or not your insurance company has an out-of-network benefit, call them and ask them. You are the subscriber; you have the right to know what your insurance covers.

If you do have an out-of-network benefit, to find out what you can expect your insurance to pay, consider the following,

  • While Dr. Cox’s fees are well within what most insurance companies describe as “customary and reasonable”, a few companies have lower guidelines. Ask what is considered a “customary and reasonable” fee for outpatient psychotherapy.
  • Some insurance companies provide an out-of-network benefit only after a rather large deductible is met. Ask what your deductible is and if it has been met.
  • Some companies try to limit, or “cap”, the number of sessions per year for which a subscriber may be covered. Ask if there is a cap on the number of sessions per year that are permitted.
  • Sometimes a subscriber will have spent a significant sum on medical bills, all of which have been applied to the deductible, only to find there are suddenly new annual deductible requirements. Find out whether or not the start date for the year of coverage is January 1 or some other date.