Kraus Psychotherapy, LLC has consciously made the choice to be a private pay (out-of-network) practice, which means we do not accept insurance directly.
Although we do not work with insurance directly, some services may still be eligible for reimbursement.

What does that mean for you?
You are responsible to pay your rate at the time of service. While this can be challenging, it means we are able to invest more time into your treatment and stay up to date on the best practices for the challenges you are facing.

Although we do not accept insurance directly, we will happily provide you with the documentation (called a superbill) that you need to get reimbursed for therapy services - if you are eligible. You submit the documentation to your insurance company, and they reimburse you directly.

How do you know if you are eligible for reimbursement?
Depending on your plan, you may have “out of network” benefits. It may seem a little complicated at first, but many of our clients navigate this process with little difficulty.

We recommend calling your insurance company directly, and ask them the following question:

Do I have out-of-network benefits?

If no: Talk with your HR representative about how you can sign up for a plan with out-of-network benefits during your next open enrollment period.

If yes, ask the following questions:
-What is my out-of-pocket responsibility?
-What is my out-of-network deductible for outpatient mental health?
-How much of my deductible has been met this year?
-What is my reimbursement rate for (we most commonly use the service codes below)…?
90834 - Individual Therapy, 50 minutes
90847- Family Therapy With Client Present
90846 - Family Therapy without Client Present
-What is my reimbursement rate for telehealth services?
-Do I need a referral from an in-network provider to see someone out of network?
-Do I need any other prior authorization to receive these benefits?
-How do I submit claim forms for reimbursement?
-Is there a deadline for my reimbursement?
-Is there anything else I need to do?

**Executive Function Coaching and Autistic Coaching Services are NOT reimbursable.

Under the No Surprises Act, health care providers need to give clients who are not using insurance for either in- or out of- network coverage (self-pay) an estimate of the cost for non-emergency medical items and services called a “Good Faith Estimate” explaining how much their medical care will cost over the course of their treatment.

If this applies to you, we will be provided a Good Faith Estimate in writing to you at least 1 business day before your medical service or item. You can ask for a Good Faith Estimate before you schedule a service, or at any time during treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about Good Faith Estimates visit www.cms.gov/nosurprises.