FAQ

Thriving Minds accepts Traditional and PPO Blue Cross Blue Shield. We make every effort to determine the coverage of patients; however, we also ask that patients explore their own coverage and are knowledgeable about co-pays and deductibles prior to the first appointment.

Out-of-Network: Thriving Minds is an “out-of-network” provider for all other insurance carriers. We are sensitive to clients’ needs for affordable mental health care and can help clients navigate the process of submitting claims for reimbursement.

Navigating Out-of-Network: To determine if your insurance company will reimburse you for payments made to Thriving Minds, ask if you have “out-of-network benefits” for mental health services and, if so, at what percentage you will be reimbursed for each session. You may also have out-of-network benefits that would cover all or a percentage of our fees. Most patients report obtaining 60-100% coverage out-of-network. If you’d like to find out whether your insurance company will reimburse you for the cost of therapy or testing with us you should contact your insurance company.

Thriving Minds checks insurance benefits for our internal billing purposes, but we do not reach out to inform clients about their coverage details. It is the client’s responsibility to confirm their coverage directly with their insurance provider before starting services. We strongly recommend calling your provider, writing down who you spoke to, and noting the date and time of the call. This ensures you are fully aware of your coverage and any potential costs you may owe.

When contacting your insurance provider to understand your coverage for behavioral health services, consider asking the following questions:

Is Thriving Minds Behavioral Health an in-network provider?

Confirming this can help you avoid higher out-of-pocket costs associated with out-of-network services.

Do you offer out-of-network benefits?

If Thriving Minds Behavioral Health is not in-network, inquire about coverage options and potential reimbursement rates for out-of-network services.

What are my coverage details for the following CPT codes:

• 90791: Psychiatric diagnostic evaluation

• 90834: Psychotherapy, 45 minutes with patient

• 90837: Psychotherapy, 60 minutes with patient

• 90785: Interactive complexity add-on

• 90846: Family psychotherapy without the patient present

• 90847: Family psychotherapy with the patient present

Understanding your coverage for these specific services will help you anticipate any out-of-pocket expenses.

Is pre-authorization required for any of these services?

Some insurance plans require prior approval for certain services. Knowing this in advance can prevent unexpected denials.

What are my copayment, coinsurance, and deductible amounts for behavioral health services?

Clarify your financial responsibilities to better plan for any costs not covered by insurance.

Certainly! Here are those questions rewritten in a FAQ format:

What is my deductible, and how much of it have I met?

Your deductible is the amount you need to pay out of pocket before your insurance begins covering services. You can check the current status of your deductible by logging into your insurance provider’s online portal or contacting their customer service line. This will tell you how much of your deductible you’ve already met for the year.

How do I access the forms needed to submit a reimbursement request?

Many providers offer downloadable forms online, and their customer service representatives can guide you through the submission process.

Is there a limit to the number of sessions covered per year?

Some plans have annual caps on the number of covered therapy sessions.

Are telehealth or online therapy sessions covered?

With the rise of telehealth, it's important to know if your plan includes coverage for virtual therapy sessions.

Are there any exclusions or limitations for behavioral health services?

Understanding any restrictions can help you avoid unexpected expenses.

By asking these questions, you can gain a comprehensive understanding of your insurance coverage for behavioral health services and make informed decisions about your care.

Health insurance can be confusing and challenging to navigate. This information is not meant to replace information from your specific health insurance company, but to assist in understanding how families can potentially seek out-of-network benefits at Thriving Minds.

Thriving Minds is only in-network with Blue Cross Blue Shield PPO and Traditional. All other insurances would be considered “out-of-network,” meaning that Thriving Minds does not directly accept the insurance and therefore does not process the claim on the family’s behalf.

Some insurances have out-of-network benefits. Thus, families can submit their “superbill” (treatment receipts) for reimbursement and/or a credit toward the deductible (the amount of money insurance requires the holder to pay prior to coverage for health costs). In this scenario, the family pays Thriving Minds “out of pocket”, or at the full rate, then submits the superbill (typically online) and the insurance company pays the family directly with a check.

However, depending on what kind of insurance the family has, it could mean that:

1. The insurance company will not reimburse at all for treatment costs (more common of HMO plans)

2. The insurance company may reimburse for a portion of the treatment costs, but at a rate lower than they would cover for an in-network provider

3. The insurance company will not credit the deductible at all

4. The insurance company will credit the out-of-network deductible instead of the in-network deductible. This might make it difficult to meet the deductible(s).

How to Get Started

Here are the steps to find out about your potential “out-of-network” coverage:

Call the number on the back of your insurance card (some cards have a different number for behavioral health). Speak to a customer support representative asking about your out-of-network benefits and how to access those.

The representative may ask for CPT codes, which are codes used for describing the procedures conducted in the session (e.g., psychotherapy).

Specific CPT codes to reference for therapy include: 90791, 90837, 90834, 90832, 90846, 90847.

Specific CPT codes to reference for testing/evaluations include: 96130, 96131, 96132, 96133, 96116, 96136, 96137, 96138, 96139.

Ask if you have an out-of-network deductible and what that amount is. This tells you what you would be responsible to pay before insurance starts to cover a portion of the sessions.

If you do have an out-of-network deductible, ask what your insurance coverage is after the deductible is met. Specifically, you can ask, “What percentage of the out of network costs does [insurance company] cover after the deductible is met?”

Ask what the process is for you to get reimbursed for out-of-network services. Some companies have an online portal for uploading the superbill for reimbursement, while others require that the information is mailed in. Be sure to regularly submit these superbills; many families submit them monthly.

Make note of the date, time, and person’s name you spoke to on this call.

If you are coming to Thriving Minds seeking specialty treatment (e.g., selective mutism, school refusal, etc.), explain that there are no specialists in network. The insurance may be willing to give an out-of-network exception, which means that if the insurance cannot find a specialist in-network, they may be willing to pay for services. A network exception means that your insurer applies your in-network benefits to out-of-network services.

90791 (60-90 minutes) = Intake appointment

90834 (45 minutes) = Individual Psychotherapy

90837 (60 minutes) = Individual Psychotherapy (most frequently used code for therapy at Thriving Minds)

90846 (60 minutes) = Family Therapy without client

90847 (60 minutes) = Family Therapy with client

96136-37, 96138-39, 96130-31, 96132-33, and 96116 (60 minutes) = Psychological Testing. Please note that testing time includes scoring, interpretation, report writing and time spent contacting other professionals, in addition to face-to-face meetings.

The initial consultation is approximately $250. Following that, therapy sessions range from $150 to $250 per hour, depending on factors such as the type of therapy and the clinician's degree.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit CMS.gov website.

At Thriving Minds, we specialize in Cognitive-Behavioral Therapy to treat children and their families, but we also provide services to young adults.  Cognitive-Behavioral Therapy can be used with children as young as three. No matter the treatment used, parents are considered an integral part of their child’s treatment.

Yes, therapy has been proven to be effective in children. Therapy is a place where children can express their feelings. It teaches important skills, like relaxation, social skills, as well as facilitating the process in which children learn to identify their problematic thoughts and behaviors.

Many people are nervous after scheduling the first therapy appointment and wonder what the first session will be like.  The goal of the first appointment is primarily information-gathering.  One or both parents, or the teen or adult themselves, will meet privately with the therapist to discuss their concerns, as well as background and any other relevant information. In order to develop the best treatment for yourself or your child, together you and the therapist will spend approximately 60-90 minutes discussing these things in detail, including educational, medical, and psychological history. At the end of the session, the therapist will have a better idea of the most effective course of treatment and will answer any questions you have about this plan or the therapy process in general.

CBT is a brief, effective type of psychological treatment supported in the research literature. This approach focuses on the inter-relationships between one’s thoughts, emotions, and actions. Through the use of collaborative goal-setting, therapy aims to teach specific skills that allow the child, adolescent, or adult to accomplish small steps that eventually lead to large changes

Each client we see at Thriving Minds is unique, presenting with his or her own history and concerns. That being said, there is no exact, “magic” amount of therapy sessions. Treatment is tailored to the individual and his or her specific needs. Together, you and your therapist will discuss progress throughout treatment and set goals you, the therapist, and your child (if appropriate) agree upon. However, overall cognitive-behavioral therapy regimes generally range somewhere from 10-20 sessions depending on disorder under treatment, symptom severity, how long these symptoms have been present, and other factors.

A new patient calls our intake coordinator, Nancy, at (734)433-5100. After checking your insurance, Nancy will send you intake documents online and schedule you with the therapist who is the best fit for you and your specific needs.

The therapist will send you a link to the online therapy platform via email, and will call you by phone to see if you have any questions.

At the time of your appointment, you will click on the link and enter an online “waiting room,” where you can wait privately until your therapists starts the online session. Our online platforms allow us to share screens, watch therapeutic videos together, or send messages securely, so even young children can engage in treatment.

Research suggests that teletherapy is comparable (and just as effective) as face-to-face treatment for many individuals and presenting issues, including even young children! In studies, participants in teletherapy report high patient satisfaction (indicating that it works well for them, feels natural, and is easy-to-use).

Our teletherapy platform is easy to use and can be accessed by anyone with an internet connection. Our therapists have learned fantastic strategies for engaging and maintaining a relationship with even young children online, and much can be accomplished in online treatment.

Our licenses require that we follow the Code of Ethics from the American Psychological Association (APA). This code considers “virtual relationships” to be equivalent to face-to-face relationship and the code generally discourages multiple relationships with clients. Further, the code states that therapists are prohibited from engaging in a personal virtual relations with individuals with whom they have a current counseling relationship (e.g., through social and other media). Therefore, our practice policy shall be to not knowingly accept a “friend” request (or similar virtual relationship that uses another term) on any social networking platform from current clients or in any case in which I believe that blurring of counselor-client relationship may be adversely affected. This policy includes (but is not limited to) the following social media platforms on which we may have a personal presence: Facebook, Twitter, Instagram, Linked-In, GroupMe. 

We maintain a professional presence for our practice (Thriving Minds) on Facebook. This presence exists solely to provide information to the public pertaining to the practice and related topics. It also assists in directing interested individuals to the official practice website.

It shall be the policy of our clinic not to knowingly communicate with clients via instant messaging, “chatting” or similar technologies. This includes, for example, instant messaging through Facebook and other social networking sites.

Email:

It is our policy to only communicate through email with clients through the secure email system that is accessible through the a secure portal. 

Texting: 

It is our policy to not communicate with clients via texting. The best way to contact us is by phone call.

Since your appointment time is reserved specifically for you, 24 hours notice of a cancellation is required to avoid being charged a fee of $100 per missed session. Occasional exceptions occur if it is agreed that a late cancellation was unavoidable (e.g., illness, family emergency, etc)