Frequently Asked Questions
Billing
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We currently partner with the Network for Victim Recovery of DC (NVRDC) and offer sliding scale fees to survivors of domestic violence and sexual assault. We also offer reduced fees to families in need.
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As an out-of-network (OON) practice, we do not have a contract with any insurance company. However, you may still be able to use out-of-network benefits to pay for services. When you get services from an out-of-network provider, you pay the entire cost of the session upfront. Then, you file a claim with your insurance company and they reimburse you for some of the money you spent. Filing a claim means filling out paperwork about the services you received and sending it to the insurance company. We will provide you with a document called a superbill to include with your claim. A superbill shows the insurance company exactly what kind of service you received.
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Patients can submit claims to their insurance company either by mail or online through the insurance company's website. We recommend the online submission method as it provides an easier way to track and receive updates on the status of the claim. When completing the online submission, patients will be required to upload their superbill, ensuring that all necessary details are included for a streamlined and efficient reimbursement process.
Need Help Submitting a Claim?:
Reimbursify is a new platform that aids the process of submitting insurance claims for patients by empowering them to effortlessly self-file for out-of-network medical and mental health insurance reimbursement in as little as 10 seconds, providing a seamless and efficient solution for claim submissions.
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Many insurance companies offer partial reimbursement for “out of network” providers. We are currently “out of network" providers but can provide a monthly receipt which you can submit to the insurance carrier for reimbursement. When you call your insurance company, you should ask:
What are my Out Of Network, Mental Health insurance benefits?
What is my deductible and has it been met?
How many sessions per year does my health insurance cover?
What is the coverage amount per therapy session?
Is preauthorization (e.g. pre-approval, pre-certification) required from my insurance company or primary care physician?
Am I able to use a health savings, flex spending, or other similar types of accounts to cover the cost of treatment?
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Maryland Single Case Agreement (SCA) for Psychotherapy
Maryland's Rule on Getting Specialized Care:
What's the Rule?
Insurance carriers must have procedures for members to get referrals to specialists even if these doctors aren’t on the company’s regular list. If the insurance company doesn’t have the right kind of doctor for your issue, or if seeing their doctor is too hard because of wait times or travel, you can see someone else.
Referrals are valid if the insurance carrier lacks an in-network specialist for a particular condition or can't provide reasonable access to one without causing the member undue delay or travel.
For billing purposes, services from these referred specialists will be treated as in-network.
Decisions by carriers to deny access based on medical necessity constitute an adverse decision.
Why would you need an SCA?
SCAs can be sought for various reasons, including:
Lack of specialized in-network providers.
Unavailability of in-network providers suitable for a patient’s specific needs.
Continuity of care after an insurance plan change.
Financial burden of out-of-network fees.
Absence of any in-network options for Medicaid and Medicare plans, especially for specific levels of care.
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Understanding Single Case Agreement (SCA)
A Single Case Agreement (SCA) is essentially a special arrangement between an insurance company and an out-of-network provider. This allows a patient to use their in-network benefits with that provider. With an SCA, the patient typically pays their standard in-network co-pays, and the service fee is negotiated between the insurance and the provider.
Setting up a Single Case Agreement (SCA)
Initial Contact: Speak to your desired healthcare provider about the possibility of an SCA. You should be ready to discuss your medical background and any previous treatments.
Duration: SCAs generally span the treatment duration. For any subsequent treatments, you might need a new SCA.
Steps to Advocate and Set Up an SCA:
Reach Out to Your Insurance: Contact your insurance's member services (often the behavioral/mental health number on your card) to request in-network providers specializing in your treatment needs.
Explain the Situation: If no in-network providers are available, ask about out-of-network benefits. Mention if you've explored all available options and found none suitable.
Seek a Behavioral Health Case Manager: They are your internal advocates within the insurance company, linking you to in-network resources and aiding in SCA setups.
Research and Connect with Treatment Centers: Find centers that might consider an SCA with your insurance. Start with local facilities.
Collaboration: After finding a suitable center, they'll instruct you on the SCA process. Your outpatient providers can communicate with this center to support the need for an SCA, solidifying your case for "medical necessity criteria."
Remember, it's essential to stay persistent and keep communication lines open with your insurance, healthcare provider, and treatment center.
Other
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“Play is the work of the child.” ~Maria Montessori
Of course you want to reconnect with your child after they’ve been behind a closed door for the last 45+ minutes, but most children won’t want to open up immediately after therapy sessions.
They’re probably still reflecting on their experience.
You might try asking a question or two, but be sure to read their cues if they’re letting you know they need some space. Let your child decide when and what they want to tell you about their sessions. The therapist will share anything that arises in session relating to safety or anything urgently important.
A key component of the therapy process is the privacy your child is granted during sessions in order to allow for self-expression. Allowing your child to keep their sessions private will help them benefit from the therapeutic process.
DO’s:
Share your own experience… “Hi, I’m so happy to see you!”
Validate that play can be hard work… “I bet you’re tired. You’ve been working hard.”
Offer space for child to share… “Hey sweetie, how are you feeling?”
They may or may not choose to.
Let them know you’re there for them… “If there’s anything you want me to know about your session, I’m here to listen whenever you’re ready.”
Just give a hug
Offer options of how they can say goodbye to their therapist… “Do you want to give a wave, a hug, or a fist bump?”
Model the behavior you hope for them to learn… “Bye, thank you!”
DONT’s:
Ask the child to evaluate the session… “Did you like it?” “How was it?” “Did you have fun?”
Ask the therapist questions about what happened... “How’d s/he do?” “How’d it go?”
Prompt a “thank you” from the child. Kids thank their therapists in many different ways!
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Yes! Betina Myers has extensive experience and a passion for supporting families in search of infant mental health support.
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Infant Mental Health
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Infant and Early Childhood Mental Health (IECMH) is all about helping little ones, from birth to five years old, develop emotionally, socially, and cognitively. It’s about nurturing their ability to form close relationships, express emotions, and explore the world around them with confidence and security.
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A child’s emotional well-being is deeply connected to their family’s values, traditions, and experiences. Mental health professionals take cultural backgrounds into account to ensure that care is respectful, inclusive, and tailored to each family’s unique needs.
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Every child is unique, but some red flags to look out for include excessive fussiness, trouble sleeping or eating, difficulty bonding with caregivers, or delays in reaching developmental milestones. If something doesn’t feel quite right, trust your instincts and reach out for support.
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Unlike older kids or adults, infants can’t express their feelings in words, so professionals assess their behavior, development, and relationships with caregivers. A thorough evaluation considers family background, cultural influences, and environmental factors to get the full picture of a child’s well-being.
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Experiences like neglect, family stress, or separation can affect brain development and emotional well-being. But here’s the good news: with the right support, children are incredibly resilient! Early intervention can help them build the skills they need to feel safe and thrive.