Do you have employer-provided benefit coverage for mental health services? Amazing … now what?
Every insurance plan is different, even within the same insurance company, so it is important to fully understand your coverage before committing to services including the eligible professions (Social Work, Speech Language Pathology, etc.), the type of services (individual, group, supervised, etc.), and the amounts covered per person/family/session.
We strongly recommend you call your insurance provider and check your coverage parameters before beginning a course of therapy or a group program. Where possible and therapeutically appropriate, we can help plan your services around the coverage you have, when we know ahead of time.
Ultimately, it is your responsibility to know your insurance coverage and to communicate your preferences to us in advance.
Here are the answers to some frequently asked questions:
Does NowWhat have a Psychologist on staff?
No, we do not currently have a Psychologist on staff and therefore cannot issue receipts under that profession. We do have several Registered Psychotherapists on the team, but this is a different professional designation. Take care not to mix them up!
Does NowWhat direct bill my insurance company?
No, not at this time. Clients pay for services upfront via credit card or e-transfer and may claim their receipts for reimbursement from their providers after each session has occurred.
What type of professional services are available at NowWhat?
NowWhat? offers services under Master’s of Social Work (MSW) or Registered Social Work (RSW), Registered Psychotherapist (RP), Occupational Therapy (OT), and Speech Pathology (SLP).
How do I make a claim through my insurance?
Most insurance companies have online portals where you can submit your claims. Some will have you enter the session information without a receipt (but hang onto them in case you are audited!) and some will have you upload a pdf of your receipt along with your claim. Services may be ‘hidden’ and found listed under a broader category name such as ‘Professional Services’ or ‘Counselling and Mental Health’. Your service provider’s name, designation and and license number will be in the top right corner of your receipt under our name, address, and phone number.
Why can’t I claim the amount I’ve pre-paid for a Group Program?
Pre-paid receipts for group programs are sent for record-keeping purposes only, and can not be submitted for reimbursement – they do not have service name, date, provider, duration, cost or attendance information on them. Insurance providers (and funding programs such as OAP or NIHB) will not reimburse/accept claims before a session has been attended. This is to avoid fraudulent claims. You will be emailed official receipts after each session of the group program occurs as we apply your account credit, and you will be able to claim back your payment in weekly installments over the duration of the program.
My insurance only covers $100 for each session. Is there any way around paying the remainder of each session out of pocket?
For individual sessions, unfortunately, no. You must pay the remainder of the session that is not covered out of pocket (unless you also have a Health Care Spending Account as part of your benefit package, in which case you may be able to submit the remainder for coverage that way). However, under family billing, where more than one family member is attending a session, we can split bill the session, which will extend your coverage to cover sessions more fully. Please bring this request to our attention at least 2 days ahead of the session, so we can enter the session under each family member’s clinical file and ensure that the therapist has planned for more than one attendee. It may not be therapeutically appropriate to use a family approach depending on the situation, so your therapist may not agree to family sessions. Conversely, family sessions may be the recommendation of the therapist, depending on individual circumstances. This is a clinical decision and is completely at the discretion of your therapist. We get it – life (and therapy!) is expensive. It’s in your best interests to ensure your claims are solidly within your insurance company’s eligibility requirements to protect your coverage long-term. Thanks for respecting our clinicians’ commitment to their professional college standards and to therapeutic best practices.
Why is there a ‘Supervisor’ listed on some receipts?
Whenever your clinician has a billable designation themselves (MSW, RP, SLP, OT), you will only see their name on your receipt (top right, under our address). However, if you are seeing a therapist who works under the supervision of a different clinician (such as a Child and Youth Counsellor or Social Service Worker working collaboratively under the supervision of an MSW), you will see the supervising clinician’s name with the label ‘Supervisor:’ at the top right and the name of the therapist delivering the service in the note. Supervised practice is generally covered by most insurance companies; please check your specific coverage to confirm. This model of supervised therapeutic practice is standard across the industry and allows us to match you or your child with a therapeutic coach who is highly specialized, giving us a broader range of personalized options for therapeutic support taking into account the needs, special interests, ability to provide in-home visits, etc.
