Lisa Wessan, LICSW on Insurance and Fees

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🌀 How to use your Out of Network Benefit (“OON”) for Therapy with me
(and for your other licensed and board certified providers) 🌀

🌀 It is your responsibility to contact your insurance company and discover how your OON benefit will reimburse you.

If your plan has an OON benefit, you can be reimbursed for treatment from licensed and board certified clinical providers that are not "In Network" with your insurance company.

Unfortunately, most HMOs and any version of the Commonwealth's MassHealth do not offer OON benefits.

OUT OF NETWORK INSURANCE BENEFITS: HOW IT WORKS

Clients submit fees to me at the time of service with checks, PayPal and other sources of payment. Once you have contacted your insurance carrier and know if you have the OON benefit, you will be reimbursed either 80, 70 or 60 percent of your expenses based on your plan.

Insurance statements from me are usually delivered the first week of each month to reflect fees from the previous month.

These statements include specific diagnostic information your insurance company will need to fulfill your OON benefit.

You then submit my statement (along with your insurance company's OON form if there is one) and either mail it in or submit it on their web site.

🌀 In order for me to prepare an OON statement, please send me:

1. Name of Subscriber.

2. Your date of birth.

3. Your full address.

4. Insurance carrier name and your account number.

5. Group # or name of company.

Once I have this data I can complete the statement for your OON reimbursement.

🌀 PRO TIP:

If you do not submit your statements digitally, please mail your OON packet via CERTIFIED MAIL. This is essential, for the insurance companies are notorious for saying "We did not receive your claim." You will then receive reimbursement from your insurance company, usually within 30 business days.

Keep in mind you usually have 90 days to file from the date of service in order to be reimbursed. Some plans allow up to a year. Please submit your claims in a timely manner to avoid denial of payment after 90 days has passed.

If your insurance carrier requires the provider to fill out forms, please send to me. I will complete the necessary paperwork as needed.

🌀 Sessions are paid for at or before the time of our session. It is not possible for us to work on a credit system, so there are no “Net 30” or “Net 60” terms.

If you have any questions, please contact your insurance carrier and they can clarify what is possible for you concerning your OON benefit.

You and I will discuss payment options on the phone once you have decided you would like to work with me.

Onward and Upward,

Lisa Wessan

PS – You can watch me share about OON Tips in this short video HERE.

CONSULTING FEES

DESCRIPTION	FEE
Initial Individual Consultation	$235.00
Ongoing Individual Therapy sessions (45-50 Minutes)	$175.00
🌀 🌀 🌀
Initial Couples’ or Family Consultation	$260.00
Ongoing Couples’ or Family/Group Consultation (60 minutes)	$200.00
🌀 🌀 🌀
Dialectical Behavior Therapy Skills (DBT)
Ongoing Individual weekly DBT Sessions (45-60 Minutes). If the DBT curriculum cannot be incorporated into a standard 45 minute session, we will need the extra time to learn the skills. Each person is different – some can process their feelings and learn DBT in a shorter session, some need more time. It usually becomes clear after a few sessions if we can’t end at the 45 minute marker and/or go over 60 minutes trying to complete the work. You will always have the option to end at 45 minutes or continue for 60 minutes.	$175-200
DBT Skills Groups (90 Minutes) 14-week semester.	$70.00/week ($980 per semester)