Insurance

TRICARE and Employee Assistance Programs

I am a TRICARE Overseas Program (TOPS) provider and also contracted with a few Employee Assistance Programs (EAP) in Japan. Please let me know at the beginning of our work together what coverage you currently have. Please let me know if your coverage ever changes.

Important things to know and consider before using insurance:

  • You are required to have a mental health diagnosis if you use your benefits, this means:
    • Your insurance/EAP will know and store this information about you
    • It can negatively impact you in the future, in unforeseen ways
  • Think about how you would feel knowing insurance is seeing your diagnosis and the fact they may see your treatment records about our work together
  • Using insurance is inviting an invisible third-party into our work together. It can impact how you engage in therapy: how often you come, what you say in session knowing records may be requested, and in many other ways
  • Please talk with me about any concerns you may have about insurance and our work together

Japanese National Health Insurance

The services I provide are not be covered by Japanese National Health Insurance.

Other Insurance

If you have other insurance coverage please understand that I do not work with your insurance. This means:

  • I do not have an agreement with your insurance company
  • I cannot bill your insurance on your behalf
  • You will need to pay out-of-pocket at the beginning of each session

You may be able to get fully or partially reimbursed by your insurance by submitting a superbill to your insurance company. I’m happy to assist in your reimbursement, but there are some limitations:

  • You will need to tell me at the start of our work together that you will need a superbill; I will not provide superbills retroactively.
  • I will not submit superbills to your insurance on your behalf
  • I will not submit records to your insurance on your behalf
  • I will not communicate directly with your insurance
  • I cannot guarantee reimbursement for a few reasons:
    • I’m not contracted with your insurance and do not know their requirements for reimbursement
    • My documentation may not meet their standards
    • Therapy may not be covered under your plan
    • The reasons you are seeking therapy may not be covered by your plan

Other important things to consider before filing your superbill for reimbursement:

  • Superbills require a mental health diagnosis, this means:
    • Your insurance will know and store this information about you
    • It can negatively impact you in the future in unforeseen ways
  • By submitting a superbill, your insurance now has an interest in our work together. This means:
    • They may request to see treatment records at anytime during or after our work together
      • If you deny their request, they may deny reimbursement and/or ask for you to pay back prior reimbursements
      • If you provide your records to them, they will see and store these sensitive documents about your condition and our work together
    • They may deny reimbursement or even ask for you to pay back prior reimbursements¬†if:
      • Documentation does not meet their standards
      • They do not agree with the frequency of sessions or reasons you are seeking therapy
      • You file superbills late
  • Your diagnosis may change during our work together; this will influence your reimbursement
  • If insurance reimburses one superbill, it does not guarantee future reimbursement
  • Insurance does not reimburse for late fees. A superbill will not be provided for late fees

Some recommendations:

  • Check with your insurance prior to starting therapy to better understand what will and what won’t be reimbursed. Here may be some helpful questions to ask your insurance:
    • What percentage is reimbursed for an out-of-network master’s level, Licensed Marriage & Family Therapist?
    • What’s my deductible and has it been met?
    • Is there a maximum fee that is allowed per session?
    • How many sessions are allowed each calendar year?
    • Is there a maximum number of sessions that are allowed?
  • Never pay more than you can afford as reimbursement is never guaranteed
  • If you decide to submit a superbill, it’s best to submit them regularly so if there are any claim denials, you will know sooner and can better understand your out-of-pocket costs
  • Think about how you would feel knowing insurance is seeing your diagnosis and the fact they may see your treatment records about our work together
  • Using insurance is inviting an invisible third-party into our work together. It can impact how you engage in therapy: how often you come, what you say in session knowing records may be requested, and in many other ways
  • Please talk with me about any concerns you may have about insurance and our work together