Insurance

Malka Shaw LCSW

Insurance & Payment

Insurance Reimbursement

Many insurance plans will provide significant reimbursement for out-of-network mental health services. In order to insure full confidentiality and have ability to practice in an individualized fashion, I work as an out-of-network provider with most insurance companies.

The majority of the plans will allow me to provide electronic billing directly to your insurance provider. This will make it easier and faster for you to receive your reimbursement. When applicable, I can accept what is called “assignment of benefits.” This means that even as an out-of-network provider, your plan will reimburse me directly, and you will only responsible for the co-insurance or co-payment.

If you participate Flexible Spending Accounts or Medical Savings Plans through your employer it is likely that you can be reimbursed for any amount paid towards your mental health services. Please check with your Human Resource Department for more details.

Navigating through insurance benefits can often be confusing, deterring members from using the plan to its fullest benefits. You will find that the cost of my services is often similar or even less than to those of in-network providers.

I have prepared a list of questions to ask. Please call your insurance carrier or speak with the benefits manager at your place of employment.

  • Does your plan allow for out of network mental health benefits?
  • Do you have an annual deductible, and has it been met?
  • What is your percent of reimbursement per session, after deductible is met?
  • The insurance providers will reimburse you based on what is called the usual and customary rate or sometimes referred to as coverage amount per psychotherapy session, they will reimburse a percentage of this amount. Please note that amount may differ for individual, marriage or groups.
  • Does your plan require prior authorization? If so, can the member request the authorization or is the practitioner required to call?
  • Does your plan allow for “assignment of benefits”?
  • Does your plan have an “out of pocket maximum” of which when met you will be reimbursed at 100%?
  • Only if applicable, I would ask if you are covered for family and or group therapy sessions as well.

Payment

Please call me to discuss the rates for the different services. For your convenience, I accept credit card, debit cards, checks or cash. Please note that you are responsible for full payment at the time of the session, unless we have a signed agreement for me to accept assignment of benefits.