At Access to Coverage, we specialize in helping individuals secure coverage for therapy with their out-of-network providers. We understand how important therapy is for your well-being and the financial challenges that can come with using out-of-network therapists. Our goal is to work directly with your insurance company to negotiate a special contract that treats your therapist as in-network, reducing your out-of-pocket costs and ensuring you get the coverage you need.
We offer a range of services to assist individuals in securing coverage for out-of-network therapy. Here’s how we can help:
We negotiate directly with your insurance provider to establish a special agreement that treats your out-of-network therapist as in-network. This helps reduce your out-of-pocket expenses and makes therapy more affordable.
We handle all necessary paperwork, including the HIPAA Release Form, which allows us to communicate directly with your insurance company and advocate on your behalf.
We assist in gathering the required documentation from your therapist, such as NPI numbers, diagnosis codes, CPT billing codes, and session charges, to streamline the negotiation process.
We provide continuous support throughout the entire process. Our team will answer any questions you have and assist with any follow-up needed to ensure your coverage is confirmed and your therapy sessions are covered.
Every client is unique, and we tailor our approach to fit your specific needs. We work with you to understand your insurance plan and find the best way to negotiate coverage for your therapy.
As a therapist, your primary goal is to provide long-term, effective care to your clients. However, many clients face financial barriers when their insurance does not cover out-of-network therapy. Without proper coverage, they may be unable to continue their treatment, which can hinder their progress.
Free – During the initial consultation, we’ll review your situation, explain the process, and answer any questions you may have about how we can help you secure coverage.
$100 – A one-time, non-refundable application fee is required to initiate the process.
Varies – The fee for negotiating and securing coverage will depend on your insurance provider’s reimbursement rate and the terms of the agreement.
Subject to your insurance company’s approval of the reimbursement rate (excluding your copay amount), the following fees apply for coverage approvals:
Approval of up to $9,999 in coverage: $500
Approval of $10,000 or more in coverage: $1,000 (maximum fee)
Please note: Coverage approvals can take anywhere from 3 to 30 days, depending on your insurance provider.
If your case requires extra follow-up, paperwork, or negotiation, we charge $100 per hour for any additional services. We’ll always discuss these charges with you before proceeding.
Some clients prefer that we submit their therapist’s bills directly to their insurance company for processing. We offer this service for $100 per submission.
At Access to Coverage, we pride ourselves on transparency. You won’t encounter any hidden fees or surprise charges throughout the process. We ensure that you know exactly what to expect from the start.
If you’re ready to secure coverage for your out-of-network therapist, contact us today at 848-525-0066 or email [email protected]. Let us handle the details, so you can focus on your therapy and well-being.
At Access to Coverage, We are committed to helping individuals get the therapy they need by breaking down the barriers that insurance companies often put in place.