Payment & Insurance
Payment
In-Network:
Illumine Counseling is in-network with Northwell Direct. Before beginning therapy, we’ll verify your insurance to confirm your eligibility, deductible, and copay/coinsurance. Once your deductible is met, you’ll only be responsible for your copay (or coinsurance, if applicable). Our office bills Northwell Direct directly, so you won’t need to submit claims yourself.
Out-of-Network / Private-Pay:
Illumine Counseling also works with clients who have out-of-network insurance or who prefer to pay privately. Many plans include out-of-network benefits, which may reimburse a portion of your session cost after you submit documentation (e.g., a superbill). We’re happy to provide superbills upon request.
Optional: Thrizer
Some clients use a company called Thrizer to streamline reimbursement. Thrizer can verify your out-of-network benefits, submit superbills directly to your insurer, and send reimbursements via direct deposit. For more information and/or to create an account, please visit their website (www.thrizer.com).
Insurance Questions for Out-of-Network Coverage
If your plan covers services with “out of network” providers, we can provide you with a monthly invoice, or superbill, to submit for reimbursement in accordance with your insurance company policies.
To help you explore this further, we have included some suggested questions you can ask your insurance provider:
What is your coverage for “out of network” mental health services?
Is there any limitation on teletherapy visits?
What is your deductible? How much of the deductible have you already met?
What is the coverage amount or percentage of cost per therapy session for services provided by a licensed clinical social worker in your state?
What is the cap on the number of sessions per year?
Does your policy cover individual psychotherapy (CPT Code: 90834-95) or couples/family psychotherapy (CPT Code: 90847-95)? If yes, how many, and what is the reimbursement?
Is there a co-insurance, copay or other cost you must meet for out-of-network coverage?
What is the policy year (i.e. Jan 1 – Dec 31)?
Does your plan require pre-authorization for psychotherapy?
How do you submit for reimbursement and what is the grace period for submitting bills?
