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Insurance FAQ

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We currently are only accepting the following insurance plans:

This means we are out of network with all other carriers. If we are out of network with your insurance company, we are able to provide you with a reimbursement invoice which you are able to submit toward your out-of-network benefits. 

Medical Billing FAQ: Costs, Codes, and Insurance Scenarios

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What CPT Service Codes do you use, I need them to verify my plan with my insurance company

Call the member service number located on the back of your card and tell them that you’re seeking behavioral health services and specify if it’s therapy or psychological testing. Below are the billable CPT service codes we use when billing for our services.

CPT Codes Used In Therapy: 90791, 90837, and Teletherapy

CPT Codes Used For Psychological Testing:

  • Intake Appt #1: 90791
  • Testing Appt #2: We bill a combination of the following – 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139
  • Feedback Appt #3: 90837

We completely understand, Insurance can be overwhelming! Not to worry you’ll only need to ask them 3 questions and please document the call with a reference number.

Main Questions To Ask Your Carrier When Conducting A Benefit Verification:

  1. Do I have a deductible that applies ? If so, how much and what dollar amount is currently met?
  2. Do I have a coinsurance portion that applies? If so, what is the coinsurance percentage?
  3. Am I missing any Coordination of Benefits information ? (If your insurance carrier is missing this information from you, they may deny all claims until you provide it to them. They simply need to know if you have another insurance policy that may cover your services. In this case, one policy will be considered primary and the other secondary. If we are out-of-network with your primary policy, you will need to pay out-of-pocket and submit a superbill invoice to them, which we can provide for you.)
The actual total cost can be influenced by various factors, including your specific insurance contract limitations. Since there are numerous insurance plans available, there isn’t a one-size-fits-all approach. If you have a deductible to meet, the cost may be subject to that deductible. If the deductible doesn’t apply, you may have a small coinsurance or copay portion.
 
Additionally, your insurance carrier may provide us with inaccurate benefit information, such as stating that a deductible applies when it doesn’t. In such cases, you may overpay, and we will promptly refund the credit balance to you. Conversely, if your carrier tells us that the deductible doesn’t apply when it actually does, you may have a balance owed.
 
As providers, we don’t control how your insurance company processes the claim, but we do our best to ensure accuracy. However, we must be transparent that the information provided by your insurance company is not guaranteed, and we want to make sure all our valued clients are aware of this.
 
Please don’t hesitate to reach out if you have any questions or need further assistance. We’re here to help you navigate the complexities of insurance and ensure you have the information you need.
Infographic about how insurance works

In insurance terminology, “covered” means that the service codes are eligible for billing and are subject to your plan’s contractual limitations, which is ultimately the member’s responsibility to understand.

This means that “covered” does not necessarily equate to “paid.” If the services you are receiving apply towards your deductible, coinsurance, or copay, then your claim will be processed accordingly.

Example 1: If the total cost of your service is less than your remaining deductible amount and the deductible applies, you will owe this amount to the provider. The service is still considered covered and subject to the plan’s contracted rate. It’s important to note that insurance contracted rates are typically lower and discounted compared to private pay rates.

Example 2: Similarly, if your deductible has already been met or does not apply to the service, you may be responsible for a coinsurance percentage, a copay, or the insurance carrier may make a full payment based on the contracted rate. Whether the insurance company pays in full or shares the cost with you, the service is still considered “covered.”


In short, the word “covered” means “accepted and not denied or rejected.” If the service is not “covered,” the service costs will be subject to our out-of-pocket rates.

We completely understand and would be happy to clarify! Feel free to email our billing department at billing@brightpinepsych.com

Front desk staff may not always have the appropriate clinical expertise to answer questions about your unique situation. That’s why we provide quick and efficient consultations with experienced clinicians.