We accept all PPO insurance plans as out-of-network providers. We provide you with an invoice (also known as a “superbill”) at the end of every month, which you can submit to your insurance company for reimbursement.
Usually, you pay the full fee upfront and get a percentage of it back, but that varies from plan to plan. We find that this balance usually works well with clients. In our experience, clients have had a hard time finding a good in-network therapist.
Here are some questions you can ask your insurance provider in order to get an accurate idea about your out-of-network insurance benefits. Make sure you follow these directions in detail.
Find out what percentage is covered for “out-of network” or “non-participating providers.”
Find out the “maximum allowed amount” per session (this is sometimes referred to as “reasonable and customary fees”) for zip code 90401 for Masters Level or LCSW clinicians. Brooke Sprowl’s license number is LCS29126 if needed and the CPT/procedure code is 90837 (if they need approval for that procedure code you can tell them 90834). Often insurance reps aren’t well trained and don’t know what the maximum allowable amount is so be sure to ask for a supervisor if they can’t help you.
Find out if you have a deductible for out of network providers and how much it is.
Find out if there is a difference in coverage for “parity” diagnoses and if so, repeat questions 1-3 for parity coverage.