Out-of-Network Benefits

Thank you for choosing Houston Anxiety & Wellness Center for your mental health care. We're committed to providing you with the highest quality, specialized and evidence-based treatment for anxiety, OCD, and related conditions.

We understand that navigating insurance coverage can sometimes feel as challenging as the anxiety you're seeking help for. That's why we've created this comprehensive guide to help you understand:

• The reasons we’ve chosen to be private pay,
• How to find and maximize your out-of-network benefits, and
• Other options to help you afford care.

Our goal is to make the financial aspect of therapy as transparent and manageable as possible, so you can focus on what matters most: your healing journey.

Please don't hesitate to reach out if you have any questions after reviewing this guide.

Houston Anxiety & Wellness Center operates as a private-pay practice by design. This allows us to deliver truly client-centered treatment while maintaining the highest level of confidentiality. This means we are out-of-network with all insurance companies, however, we are happy to support clients who opt to use their out-of-network benefits.

• Many clients receive 50-80% reimbursement through their out-of-network benefits
• We happily provide detailed superbills after each session to simplify insurance submissions
• You maintain control of all insurance communications, keeping your information private

At Houston Anxiety & Wellness Center, our decision to remain out-of-network with insurance companies comes from our deep commitment to providing you with the best possible care. Here's why this approach benefits you:

Specialized Expertise

As anxiety and OCD specialists, we provide targeted, evidence-based treatments that often require customized session lengths and approaches that insurance companies typically restrict. Our therapists have advanced training in specialized treatments like Exposure and Response Prevention (ERP) for OCD, which many insurance panels don't fully support.
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Quality Over Quantity

Insurance networks often require providers to see more clients in less time. By remaining independent, we can dedicate the time you truly need without rushing through your session. This means:

• Longer sessions when needed
• Thorough assessment and treatment planning
• Time for detailed skill-building and practice
• Flexibility to provide the exact type of care that works best for you
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Clinical Freedom

We believe treatment decisions should be made between you and your therapist—not determined by insurance companies. This ensures you receive effective care tailored specifically to your unique needs. With out-of-network care, we can:

• Use the most effective treatment approaches, not just the ones covered by insurance
• Provide specialized therapy for complex conditions
• Focus on your unique and personal goals rather than insurance requirements
• Develop a treatment plan based on clinical needs, not arbitrary session limits

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Privacy and Confidentiality

Out-of-network care provides an additional layer of confidentiality. While we still provide diagnosis codes for reimbursement, you have more control over your mental health information. This means:

• Less detailed information shared with insurance companies
• Reduced risk of your mental health information affecting future coverage
• Greater control over what becomes part of your permanent medical record
• Protection of sensitive personal information

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Access to Specialists

Many highly specialized clinicians choose to remain out-of-network. Our approach allows us to bring together the best anxiety and OCD specialists to serve you. This means you get:

• Access to therapists with advanced specialized training
• Treatment from experts who focus exclusively on anxiety-related conditions
• Care from professionals who continuously update their skills with the latest research and techniques

Before Beginning Therapy: Check Your Out-of-Network Benefits

The best way to get accurate information about your specific coverage is to contact your insurance provider directly. We cannot verify benefits or eligibility for you.

Call your insurance company and ask about:

(The phone number is usually on the back of your insurance card)

1. Verification of Benefits
   
   • "Do I have out-of-network mental health benefits?"
   • "What types of mental health providers are covered?" (psychologists, licensed professional counselors, etc.)
   • "What mental health services are covered?"
2. Coverage Details
   
   • "What is my out-of-network deductible for mental health services?"
   • "How much of my deductible have I met so far this year?"
   • "What percentage of out-of-network charges will be covered after I meet my deductible?"
   • "Is there a maximum allowable amount per session? If so, what is it for individual therapy?"
   • "How many therapy sessions are covered per year?"
3. Claims Process
   
   • "What information needs to be included on my superbill for reimbursement?"
   • "How do I submit out-of-network claims?"
   • "How long does reimbursement typically take?"
   • "If a claim is denied, what is the appeals process?"

Helpful Tip: Write down the date of your call, the representative's name, and detailed notes about what they tell you. Keep this information for future reference—it may be helpful if there are any questions about your coverage later.

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Prefer a Helping Hand?

If navigating insurance feels overwhelming, services like Reimbursify and Thrizer can verify your benefits and handle claims for you for a small fee. Many of our clients find these services incredibly helpful for managing the reimbursement process.

These services typically:

• Verify your specific insurance benefits
• Submit claims on your behalf
• Track the status of your claims
• Follow up on delayed or denied claims
• Provide reports on your reimbursements and outstanding deductible amounts

After your therapy session, you'll receive a superbill from us. If you have OON benefits, you'll need to submit this superbill so that you can receive reimbursement from your insurance company. Here's how:

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Option 1: DIY Submission

What You'll Need:

• The superbill we provide after each session. We make sure it includes all the necessary information!
• Your insurance company's claim form, which is typically available on their website.
• Your insurance card and personal information

The Process:

1. Obtain the Claim Form
   
   • Find your insurance company's out-of-network claim form on their website
   • Many insurance companies now have online portals where you can submit claims electronically
   • If you can't find it, call the number on the back of your insurance card for guidance.
2. Complete the Form
   
   • Fill out all required personal information
   • Include your policy number and group number from your insurance card
   • Enter the service information from your superbill (date, CPT code, diagnosis code, amount paid)
3. Submit Your Claim
   
   • Attach your completed superbill to the claim form
   • Submit through your insurance company's preferred method, which may include an online portal submission, email, fax, or mail.
     
4. Keep Records
   
   • Make copies of everything you submit
   • Keep a log of when you submitted each claim
   • Save any confirmation numbers or receipts from your submission

What to Expect:

• Reimbursement typically takes 2-6 weeks
• You may receive an Explanation of Benefits (EOB) before you receive payment
• Your insurance company is the best resource for questions about claim status
• If a claim is denied, your insurance company can explain why and guide you through any appeal process

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Option 2: Let Someone Else Handle It

Services like Reimbursify and Thrizer can make the submission process nearly effortless.

How These Services Work:

1. You create an account with the service
2. Upload your superbill (often just by taking a photo with your phone)
3. The service submits the claim to your insurance company
4. They track the claim and notify you of reimbursement or issues
5. Some services will even deposit reimbursements directly to your account

Cost Considerations:

• Most services charge either a small fee per claim (typically $1-5) or a percentage of the reimbursed amount (typically 5-10%)
• Many clients find the time and hassle saved well worth the cost

We believe everyone deserves access to quality mental health care. Here are several strategies our clients use to make therapy more budget-friendly:

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Use HSA/FSA Accounts

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) allow you to pay for therapy with pre-tax dollars. This can provide significant savings depending on your tax bracket.

Key Information:

• Funds contributed to HSA/FSA accounts aren't subject to federal income tax
• Depending on your tax bracket, this could save you 20-30% on your therapy costs
• Most HSA/FSA accounts provide a debit card you can use to pay for sessions directly
• Keep your receipts and superbills for your tax records

Note: If you don't currently have an HSA or FSA but your employer offers one, consider enrolling during your next benefits period.

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Potential Tax Benefits

Even without an HSA/FSA, therapy expenses may qualify as tax-deductible medical expenses.

Key Information:

• Medical expenses (including therapy) that exceed 7.5% of your adjusted gross income may be tax-deductible
• You must itemize deductions on your tax return to claim this benefit
• Keep all therapy receipts and superbills throughout the year
• Consult with a tax professional to determine if this applies to your situation

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Our Doctoral Clinicians: Quality Care at Lower Rates

Working with one of our Doctoral Clinicians is like getting two therapists in one! They provide excellent care at reduced rates while receiving weekly supervision from our licensed psychologists.

Benefits Include:

• Sessions at $100-$130 (compared to $160-$255 for licensed psychologists)
• Treatment supervised by experienced licensed psychologists
• The same evidence-based approach and specialized expertise
• Regular case consultation to ensure quality care

Many clients find this is the perfect balance of quality and affordability.

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Sliding Scale Options

We believe in making therapy accessible. We offer a limited number of sliding scale spots according to need and availability.

How to Apply:

• Ask about and express your need for sliding scale availability when scheduling your first appointment
• Our Client Care Specialists will provide information about the application process
• Documentation of financial need may be required
• Sliding scale spots are limited and may have a waiting list

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Maximize Your Insurance Reimbursement

Being strategic about how you use your insurance can help maximize your reimbursement and overall out-of-pocket costs.

• Schedule multiple sessions in a month after meeting your deductible
• Submit claims promptly and regularly
• Appeal denied claims when appropriate
• Consider timing elective therapy based on your deductible cycle

While we don't directly work with insurance companies, we're committed to:

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Transparent Billing and Documentation

• Providing superbills promptly after each session
• Ensuring your superbills contain all the information insurance companies typically require
• Clear communication about our fees and payment policies
• Readily available receipts and payment records

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Affordability Options

• Multiple payment methods accepted (credit card, check, HSA/FSA)
• Doctoral Clinician options for reduced fees
• Limited sliding scale spots for those with financial need
• Flexible scheduling to align with your budget and insurance cycle

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Support Throughout the Process

• Clear guidance on using out-of-network benefits
• Resources for navigating the reimbursement process
• Responsive staff to answer your billing and insurance questions
• Focus on providing high-quality care that offers good value

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Ongoing Communication

• Regular updates about any changes to our policies
• Transparent discussions about recommended treatment length and frequency
• Open conversations about the financial aspects of therapy
• Timely responses to any billing or insurance questions

Fees vary based on the specific provider and session length. We believe in transparent pricing. Here's what you can expect:

Licensed Psychologists

• Initial Evaluations (60m): $330
• Follow-up Sessions: $255 per therapeutic hour (45 minutes)
• Check-In Sessions (30m): $170

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Licensed Professional Counselors

• Initial Evaluations (60m): $250
• Follow-up Sessions: $190 per therapeutic hour (45 minutes)
• Check In Sessions (30m): $130

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Licensed Professional Counselor - Associates

• Initial Evaluations (60m): $215
• Follow-up Sessions: $160 per therapeutic hour (45 minutes)
• Check In Sessions (30m): $107.50
• Supervised by Licensed Professional Counselor - Supervisors

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Doctoral Clinicians and Counseling Interns

• All Sessions (45m follow up and 60 minute intake): Start at $130, unless otherwise agreed upon based on financial need ($50-$75/session)
• Supervised by Licensed Psychologists
• Excellent care at reduced rates