The Hollywood Therapy Insurance Explainer
We know it's confusing. Here's help!
What is an HMO or PPO?
An HMO plan covers a specific group of doctors only.
A PPO plan allows you to choose any doctor or provider--both in and out of network providers are covered. Hollywood Therapy is an in-network provider for the following insurance companies: Aetna, Anthem Blue Cross, Blue Shield, Magellan, and MHN.
Hollywood Therapy takes most PPO insurance plans. You pay only a portion of the cost, and we collect the rest from your insurance company. For out of network benefits, your co-pay may be higher than when working with an in-network provider. Please call us if you have any questions, we are happy to help you.
What is a deductible?
A deductible is the amount of money you must spend on all medical services before your coverage begins. Once the deductible is met, you will have a co-pay. If you have a high deductible, you may still have coverage. If you have an HSA or an FSA, which is a set amount of money, your plan provides to help with high deductibles.
With in-network providers, you have a set co-pay. With out of network providers, your co-pay is based on the percentage your plan pays for therapy. Our staff will check your deductible and rates of reimbursement to let you know what your co-pay will be. We will file claims and get paid by your insurance company.
Why choose out of network providers?
* Quality: Many highly trained, seasoned therapists choose to remain out of network
*Choice: With PPO plans, you have the right to see out -of- network providers.
*Specialization: You can choose the best therapist for your needs—couples therapy, sexual concerns, or modern technology-based therapies like EMDR, neurofeedback, and sensorimotor therapy is offered by out of network therapists.
*Access: No waitlists. Get seen quickly.
*No gatekeepers: No referrals needed from your primary care doctor—book an appointment, and our staff will take care of the necessary paperwork to process your insurance claims.
Understanding In and Out Network:
If you have a PPO plan, you have a right to see an out of network provider. We collect a co-pay from you, and they pay us the rest. Hollywood Therapy is in-network with Aetna, Anthem Blue Cross, Blue Shield, Magellan, and MHN.
Insurance companies pay a portion of our fee (depending on your plan, typically ranges from 50-80%).
As a courtesy to our clients, staff therapists will call and check your specific benefit plan and inform you about your coverage for therapy. Bring your insurance card to your first visit or give us this information during the first phone contact, and we can help you understand your insurance benefits. You are responsible for the first session fee of $200 (unless you have insurance coverage).
Why is my copay higher with out of network providers?
Many insurance plans provide a lower reimbursement rate for out- of- network providers. For plans we are out of network with, we will work with you to help you understand these benefits before setting up your first appointment.
Hollywood Therapy will file claims with your insurance company. We collect a co-pay from you, and they pay us the rest.
Regardless of network status, the deductible must be met first before your coverage begins. Your out-of-network deductible may be higher than your in-network deductible. Our team will check your deductible for you.
Some plans provide an FSA or HSA card that covers costs until the deductible is met. You may want to check to see if you have one.