“Our relationship with money and time reflects how we value ourselves and others”

Questions to ask Your Insurance

Thank you for choosing Restoration Counseling LLC as your mental health provider. While your wellness is my priority, I still must cover this often-uncomfortable topic about payments & missed appointments. I hope that these “Questions to Ask Your Insurance” will help you with obtaining pertinent information regarding eligibility and benefits payments and insurance responsibility for services rendered.

Insurance. I participate with most insurance plans. If you are not insured by a plan, I do business with, payment in full is expected at each visit. If you are insured by a plan, I do business with but don’t have an up-to-date insurance card, payment in full for each visit is required until I can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

IN-NETWORK BENEFITS |The representative of your insurance carrier may ask for Restoration Counseling information

Restoration Counseling LLC • National Provider ID: 1922574300

Jessica Pottorff • National Provider ID: 1922574300                  

TAX ID: 99-3597822

Add: 8450 Hickman Rd, Suite 10, Clive IA 50325

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• What’s my deductible for in-network mental health benefits?

• Is there a limit on sessions your plan will cover per year?

• If Yes, how many?

• Does my policy cover 60-minute sessions?

• If yes, how many?

• How much is your co-payment for mental health services?

• What is the policy year (i.e. Jan 1 – Dec 31)?

• Does your plan require pre-authorization for psychotherapy?

• Do I have out-of-network mental health benefits?

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In order to find out the reasonable and customary fee, the representative may ask for a Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows:


• 90791 Initial Assessment:

• 90834 Ongoing psychotherapy:

• 90837 Psychotherapy:

• 90847 Couples/family psychotherapy:

• 90853 Group psychotherapy:

• 90785 Interactive psychotherapy:

OUT-Of-NETWORK BENEFITS|The representative of your insurance carrier may ask for Restoration Counseling information              

Your insurance carrier may ask you some questions pertaining to this group practice. Kindly provide them with these information

Restoration Counseling LLC • National Provider ID: 1922574300

Jessica Pottorff • National Provider ID: 1922574300                  

TAX ID: 99-3597822

Add: 8450 Hickman Rd, Suite 10, Clive IA 50325

________________________________________

• Does your plan include “out-of-network” coverage for mental health?

• Is there an annual deductible for out-of-network mental health benefits?

• If so, how much?

• Is there a limit on the number of sessions your plan will cover per year?

• If Yes, how many?

• Is there a limit on out-of-pocket expenses per year?

• What is your co-insurance percentage for mental health services?

• Does your plan require pre-authorization for psychotherapy?

• What is the policy year (i.e. Jan 1 – Dec 31)?

• Does your plan require a referral for psychotherapy?

• What is the reasonable and customary fee for Polk County?

(Reasonable and customary fee the amount that your plan determines is the normal range of payment within a given geographic area)

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In order to find out the reasonable and customary fee, the representative may ask for a Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows:


• 90791 Initial Assessment:

• 90834 Ongoing psychotherapy:

• 90837 Psychotherapy:

• 90847 Couples/family psychotherapy:

• 90853 Group psychotherapy:

• 90785 Interactive psychotherapy:

What is a superbill and how does it work?

A superbill is a detailed document that allows you to bill your insurance company directly. It includes information similar to an insurance claim form, such as the date of the service provided, procedure codes, diagnosis code, and a total balance due.

Payment for the session is due at the time of service. You can then use the superbill to try to get reimbursed for the session by your insurance company if your plan offers out-of-network benefits for the services you’ve received. If you do have out-of-network coverage, the amount you paid for your services may either get applied to your deductible or reimbursed and sent to you by check. Whether or not you get reimbursed depends on the type of coverage you have.