Frequently Asked Questions
As a specialist, quality and expertise is a must. Due to the state of our insurance laws, to uphold high standards I am an out of network provider. Being an in-network provider requires the insurance company dictates each term of your treatment. intervention modality, and length of stay. A one size fits all recovery that conflicts with personalized care is not best practices. You deserve a dedicated clinician with a proven track record and national recognition to empower the process.
Therapy is reimbursable by most insurance companies as an out-of-network provider. Many insurance companies will pay you after each session depending on your benefit plan.
As an advocate for eating disorder care, I will work with you and your insurance to ensure the able to utilize your benefits to the fullest extent possible.
For eating disorder care, navigating insurance reimbursement can be overwhelming. Check out the National Eating Disorders Association (NEDA) website for a comprehensive set of resources on simplifying the insurance process.
Specialists and the Single Case Agreement
Many New Jersey Insurance Networks do not have specialists trained in modern and highly responsive therapeutic interventions. These include DBT, FBT, CBT and Eating Disorder care including management. Some insurance will allow coverage on a case-by-case basis. There is a good chance they will reimburse you at the “in-network rate” often called a “single case agreement.”
A formal request for using this benefit should be available from your insurance company. This requires you to determine that a fully trained Eating Disorder Specialist, certified by the governing board (IAEDP) is unavailable in your area. Please note that many clinicians who claim to be eating disorder specialists do not have the intensive training and certifications. They may employ mixed ideas and techniques, including some basic eating disorder knowledge. They lack the formality which is necessary for such a complex need. Most insurers do not verify credentials or specialties. They just check state licensure.
What questions should I ask my insurance company?
- Does my plan cover psychotherapy sessions?
- Does my plan cover out of network services?
- Is there a deductible I have to meet?
- Do I have a copay?
- What is the coinsurance? How much of the does the coinsurance cover?
- Is there a maximum amount per session the insurance will cover for an out of network provider?
- How much time do I have to file a claim for out of network services?
- What is the process to get reimbursed for out of network services?
What are your fees?
Please contact me for further information and to schedule a discussion. As a specialist, I am in line with the current trends in cost throughout our tristate area.