Access to Coverage provides administrative advocacy and billing coordination services that help clients and therapists navigate insurance processes related to out-of-network therapy.
Our role is to organize documentation, coordinate communication, and assist with administrative submissions when permitted under a health plan. Insurance companies make all coverage and payment decisions.
Access to Coverage is an administrative advocacy and coordination service. We assist clients and therapists with the administrative steps involved in requesting insurance coverage consideration or submitting claims when allowed under a health plan.
We focus on reducing confusion around documentation, insurer requirements, and communication processes.
No.
Access to Coverage is not an insurance company, healthcare provider, or law firm. We do not provide medical or legal advice and do not make insurance decisions.
No.
All determinations are made solely by the insurance carrier according to plan rules and medical-necessity review. Outcomes cannot be guaranteed.
Many clients and therapists find insurance processes confusing and time-consuming. Access to Coverage helps by:
Our goal is clarity and coordination — not control over insurance outcomes.
We work with many commercial insurance plans, employer-sponsored plans, Medicare Advantage plans, and certain managed care plans when permitted.
Each plan has different rules, and eligibility varies.
Managed Medicaid plans operate under strict state and federal regulations regarding member charges and administrative services.
Access to Coverage provides optional administrative advocacy and insurance coordination services. We do not charge Medicaid members for clinical care, therapy services, or insurance benefits.
When permitted under applicable plan rules, Access to Coverage may charge a fee for administrative advocacy services related to case coordination, documentation preparation, and insurance communication. If a Medicaid plan prohibits member-paid administrative assistance, services may instead be structured through provider-supported arrangements, or Access to Coverage may decline services to ensure full regulatory compliance.
Our goal is to provide ethical, transparent advocacy while fully adhering to Medicaid program requirements.
Access to Coverage is an independent administrative advocacy service and is not a healthcare provider, insurance company, or government program.
These plans have plan-specific requirements. During intake, we review the plan type and explain what administrative services may be available.
Complete the online intake form. We review your information, confirm plan type, and explain next administrative steps.
Typically:
When applicable:
Timelines vary widely depending on the insurance carrier and plan requirements. Some determinations occur quickly, while others require extended review periods.
If allowed under the plan, we may assist with administrative appeal coordination by helping organize and submit required documentation. Appeal decisions are made solely by the insurer.
Some plans allow submission for prior dates of service. If eligible, we can assist with administrative coordination of claim submissions. Reimbursement is not guaranteed.
Fees compensate administrative services only and are not payments to any insurance company.
If Medicaid rules prohibit member-paid administrative fees, we do not charge the member. Services may instead be therapist-paid or not offered depending on compliance requirements.
Billing submission is an optional administrative service where Access to Coverage submits claims electronically as an authorized billing agent using therapist-provided billing information.
Yes. Claims are submitted under the therapist’s NPI and billing credentials with authorization. The therapist remains responsible for coding accuracy and payer compliance.
Yes. Claims are never submitted without therapist authorization and required verification steps.
No.
Access to Coverage does not receive, hold, or distribute insurance reimbursements. Payments go directly to the client or therapist according to plan rules.
$50 per claim submission.
One submission may include multiple sessions listed on a single superbill or invoice.
No. Access to Coverage does not require assignment of benefits to itself. Insurance payments are directed according to the insurance plan.
Yes. You may stop services at any time. Fees already paid may remain non-refundable as outlined in the service agreement.
We use secure systems and only use information for the administrative services you authorize. Information is shared only when necessary with your therapist, insurer, or billing platform.
732-475-2111
cs@accesstocoverage.com
billing@accesstocoverage.com
Access to Coverage provides administrative advocacy and coordination services only.
We are not an insurance company, healthcare provider, or law firm.
Insurance coverage determinations are made solely by the insurance carrier. Coverage, reimbursement, and payment outcomes are not guaranteed.
Access to Coverage provides administrative advocacy and coordination services only. Insurance coverage determinations are made solely by the insurance carrier. Coverage, reimbursement, and payment are not guaranteed.
Access to Coverage is an independent administrative advocacy service and is not affiliated with any insurance carrier. We do not provide medical or legal advice.
732-475-2111
cs@accesstocoverage.com