Explaining Your Out-of-Network Benefits

You’ve begun your search for a therapist and found out just how many factors you have to consider. You are looking for someone who specializes in what you’re looking for, who seems to mesh well with you, and whose location and availability match yours. But insurance coverage? You hadn’t even thought about that!

Out-of-...What?

Out-of-network coverage is our primary way of accepting insurance here at Hudson LCSW Group. Many people understand their in-network coverage pretty well, but have no clue what out-of-network even means. Keep reading to understand your out of network benefits!

Our practice

Out-of-network primarily means that our clinicians are not contracted in-network with insurance companies

We are out-of-network for the following reasons:

• We don’t have to restrict our number of sessions

• We are able to work with what you want to work on

• We are able to keep our focus on the most important part…YOU!

What coverage means

We know that insurance can be a big headache. So don’t worry, we are able to verify and explain your out-of-network coverage for you!

When you reach out to us and provide us with your insurance benefit information, we are able to contact your insurance company to verify whether you have out-of-network coverage.

If you do have out of network insurance coverage, the two primary bits of information for you are:

1. Your deductible

If you have out-of-network coverage, you will have a set deductible, which is dependent on your insurance plan. As you come in for sessions, we submit the claims for you, and that money adds to your deductible.

2. Your co-insurance rate

Once your deductible is met, you will start to receive reimbursement checks from your insurance company at a set percentage of your insurance company’s usual and customary rate (UCR). Your co-insurance rate is that percentage that you will receive back.

What in the world is a UCR?

Your UCR, or usual and customary rate, is the rate that your insurance company is willing to cover for the cost of a session. The bad news, we are typically unfortunately not able to provide you with this specific amount. The good news, in most cases, the cost per session is covered in full. You can always refer back to your insurance plan or contact your insurance company’s customer services department in order to check your UCR!

This is a basic overview of what out-of-network coverage means! To verify your out-of-network benefits with us, please click here and feel free to reach out to us with any questions or concerns you may have.