I am paneled on select insurance panels (ex Aetna, Cigna, Moda, PacificSource, Lifewise, Regence/BXBS). Please reach out to inquire if yours is accepted.
It is YOUR responsibility to contact your insurance company to ask about deductible, co-pay, co-insurance, etc.
Mental health services may or may not be covered by your health insurance or benefit plan. You may use FSA/HSA for this service if it not covered on your plan.
Currently, telehealth IS covered but as the pandemic subsides, insurance companies are starting to announce a stop-date for telehealth coverage. I encourage you to contact your insurance to confirm coverage.
Medical necessity is required in order for any claim to be paid by your insurance - there are no exceptions to any therapist, patient, or insurance carrier. Meaning, in order for your insurance to cover services, a mental health diagnosis will be determined, and assigned to you and will remain part of your medical record. Please consider this when making the decision to use your insurance benefit - feel free to ask about possible/potential implications.
If you are interested in couples therapy, please check with your insurance company to ask whether or not it is covered. If not, ask what type of coverage you may have for 'non-covered' services. If you prefer to pay out of pocket. I can provide an invoice to you, for you to submit to your insurance carrier for reimbursement of my fee.
If you are insured and prefer to forego using insurance for our services, I will provide an 'estimate of service cost' for transparency and to meet the guidelines of the No Surprise Act. If you have an HSA/FSA account, it is possible those funds may cover our services please confirm with your insurance company.
INSURANCE:
If using insurance, I will ask for you insurance information as well as a release-of-information, to provide authorization from you so that I can submit the claim on your behalf.
Deductibles, copayments and coinsurance are common with insurance. Please reach out to your insurance company to learn what your plan offers.
Possible questions to ask:...Do I have mental health coverage? If so, what is covered? In my experience, couples/marital/partner counseling is most often not covered, unless there is a medically-necessary diagnosis for one or both parties....Is Dr Shannon Lilja an in-network or preferred provider?...If Dr Shannon Lilja is not in-network or preferred, do I have out-of-network coverage to see her?...Do I have a deductible to satisfy?...What is my copay or coinsurance?...Is a pre-authorization required before services can begin?...Is there a limit on the number of appointments?
