Fees and Billing
Health Insurance Plans
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 co-payment and deductible requirements are, and how your insurance will reimburse any out-of-network provider. There may be some flexibility in terms of our fees and the billing arrangements, if your insurance will not cover the entire fee for our services, or offers an out-of-network coverage. Our services are able to be applied to your deductible. If you are a member of a health plan with which we are considered as an out-of-network provider, we will provide you with a detailed statement in order for you to file for reimbursement with your insurance carrier. However, you will be expected to pay the full session fees at the time of service. We recommend for you to contact your insurance provider to determine what your actual cost for our services would be. Historically, majority of our clients have received 50-80% reimbursement from their insurance companies if they had out-of-network coverage for psychotherapy and biofeedback. .
In-Network Insurance Plans:
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:
- Empire Blue Cross Blue Shield
- Horizon BCBS of New Jersey
- United Healthcare/Oxford
Out-Of-Network Insurance Plans:
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.
Here’s how it works:
- Download the iPhone app or Android-compatible web app to sign up.
- Send us an email, with your superbill from Avita Integrative Care LLC attached, to [email protected]
- Better works with your insurance to get you paid
What Services Are Covered
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.
Questions To Ask Your Insurance Company
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:
- What are my mental health benefits?
- Is biofeedback 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?