Health plans differ in terms of their policies on coverage and reimbursement. Therefore, it is recommended to become familiar with these policies prior to your first session. For example, you may need to find out what the copayment and deductible requirements are, and how your insurance will reimburse any in and out-of-network provider ( see below our recommended questions to when you call your insurance). If your insurance plan is not contracted with our group practice to cover the fees for our services, or offers out-of-network coverage, please do not be discouraged as we can discuss an affordable out-of-pocket option. Importantly to note, that none of the insurance plans cover any missed or cancelled session fees, which will be at the discretion of your psychotherapist and the practice to charge directly. We encourage you to discuss your financial needs and the billing arrangements directly with your assigned psychotherapist and our billing team.
To determine if you have mental health coverage, the first thing you should do is check with your insurance carrier. Check your coverage carefully and find the answers to the following questions. When contacting your insurance plan please use Avita Integrative Care for New Jersey / Avita Integrative Psychological Care For New York or Dr. Kalman Khodik PsyD to find the correct contract, and if asked mention the CPT codes 90791 for Intake, 90837/90834 for regular out-patient mental health psychotherapy services:
Are the above mentioned group practices contracted with the insurance plan or maybe reimbursed as out-of-network?
What are my mental health benefits? What are my deductibles and coinsurance/copayment responsibilities?
Is (biofeedback / couples counseling / marriage counseling, etc.) covered by this plan?
What is the coverage amount per session?
How many sessions does my plan cover and what limitations are there?
How much does my insurance pay for an out-of-network provider?
Is approval required from my primary care physician?
As a part of our service if our patients request to use their healthcare insurance plans, we will submit the claims for each session on the behalf of the client. However, benefits are not guaranteed by the insurance plans. Each carrier will hold the patient responsible for covering the partial or full cost of sessions according to their policy, especially if they fail to pay their premium to maintain enrollment in the plan. Therefore, we remind our patients to be fully informed about the status of their coverage and benefits and any coverage limitations prior to the appointment. If the insurance plan declines part or full coverage, each patient may be charged automatically for the balance without any prior notification. If we are able to be reimbursed by the insurance plan, we will credit any extra charges back to the credit card that is held on file. We are considered as an In-Network provider for the most of the larger insurance carriers as listed below, however there maybe other plans that will reimburse for services which are not yet listed:
If you are a member of a health insurance company we are not contracted with, therefore considered as an out-of-network provider, we will provide you with a detailed statement in order for you to file for a possible full or partial reimbursement with your insurance carrier. However, you will be expected to pay the full session fees at the time of service. We recommend that you contact your insurance provider to determine what your actual cost for our services would be. Historically, the majority of our clients have received 50-80% reimbursement from their insurance companies if they had out-of-network coverage for psychotherapy and biofeedback. To reiterate the above mentioned – if your insurance plan is not contracted with us or will not reimburse for our services, we will gladly discuss with you an affordable out-of-pocket option. We encourage you to discuss your financial needs and the billing arrangements directly with your assigned psychotherapist in coordination with our billing team.
In addition to accepting most credit cards and personal checks, we accept Flexible and Health Care Spending Accounts which are securely managed through our client portal. Please let us know about your preferred payment method at the point of paying for your copayment or deductible. The best way to start the conversation is to speak about your financial needs with your psychotherapist and ask them to coordinate with the billing to come up with the most affordable and sustainable per session fee and payment schedules.
We are In-Network with the below listed plans, and as a part of our service can submit the insurance claims for each session on the behalf of the patient. However, benefits are not guaranteed and each insurance carrier will hold the patient responsible for covering the partial or full cost of sessions according to their policy. Therefore, we remind our patients to be fully informed about their insurance benefits and any coverage limitations, prior to the appointment. If the insurance declines part or full coverage, each patient will be charged automatically for the balance without any prior notification:
Any plan that offers Out-Of-Network benefits and covers psychotherapy
We have partnered with Better – an app that helps patients who pay out-of-pocket to get reimbursed by their health insurance. After each visit, simply submit the superbill you receive via the Better app. They work with your insurance to get you reimbursed.
Below you will find the information you need in order to sign up with our partners, Better, to submit your bills for reimbursement from your insurance company. Once you sign up with their app and send Better a photo of your insurance card, you can upload the superbills we provide you with to simplify the reimbursement process from your Insurance. Better will submit your superbills to your health insurance on your behalf.
At Avita Integrative Care, we are proud of the lengths we go to help our clients by making our costs as affordable as possible while maintaining the high quality of services. We are also dedicated to making our services available to those individuals who rely on health insurance to cover their medical expenses, therefore we accept many major insurance plans for most services provided.
While normally most insurance carriers have adopted a general policy that allows for coverage of psychotherapy and family psychotherapy, most insurance companies do not cover biofeedback, marriage counseling, couples therapy, divorce mediation or premarital counseling. If you are seeking these types of services, we encourage you to call and verify your policy limitations with your insurance provider. Otherwise, if you plan to pay out-of-pocket for these services, we will be happy to discuss with you some payment options.
In addition to accepting most credit cards and personal checks, we accept Flexible and Health Care Spending Accounts. Please let us know about your preferred payment method at the point of paying for your co-payment or deductible.