Employee Assistance Plans (EAP)

Out-Of-Network Provider

Starting January 1, 2023, I will no longer be a contracted in-network provider with any insurance company. I will remain an in-network provider with Lyra Health (EAP). Check with your employer to see if they use Lyra EAP.

Other than being contracted with Lyra EAP, I am what’s known as an out-of-network provider. This means that while I am not contracted with any insurance companies, your plan may include out-of-network benefits. With these benefits, you are eligible for insurance reimbursement for our work together. Using out-of-network benefits means that you’ll pay for therapy at the time of service, then submit claims to your insurance for reimbursement (reimbursement for services is based on your specific insurance plan coverage).

If you would like to use your out-of-network benefits for our work together, I will provide you with what’s known as a Superbill that you can use when submitting claims to your insurance company. Please note that included on this form will be a diagnosis.

Your Health Care Coverage

When calling your insurance to check your mental health benefits I recommend asking the following questions and keeping this information for your records:

-What are my outpatient mental health benefits?

-Do I have out-of-network coverage for behavioral health?

-Do I need prior authorization before seeing a therapist of my choosing? If I need this, how do I get prior authorization to see the therapist of my choice?

-Is there a limit on how many sessions will be covered and/or a dollar amount that is covered?

-What is my yearly in-network deductible, and what is my out-of-network deductible? Please note that often plans have a DIFFERENT in and out of network deductible.

Once my deductible has been met, at what percentage does my plan cover out of network behavioral health services? How much of Heather’s fee will you cover?