Frequently Asked Questions
How do I book a visit with Dr. Suzanna Freerksen?
What are the fees for services?
What are Out of Network (OON) Benefits?
Out of Network Benefits are available on most PPO private health plans and some EPO and POS plans. Many psychiatrists and therapists do not participate with insurance, because insurance companies have often been fined for not reimbursing mental health providers fairly, which is illegal under the several laws that are meant to ensure mental health parity. Your insurer reimburses you for Out of Network services at a rate that is a certain percentage (anywhere from 100% to 20%) of what you paid the OON physician for the service. Sometimes insurances have a separate deductible for out-of-network benefits, as opposed to in-network expenses.
Reclaim Joy Medical can help you obtain reimbursement from your insurance company for your OON benefits by submitting your OON claims on your behalf.
Why does Reclaim Joy Medical not accept insurance?
Your insurance has physicians who are contracted with the insurance plan, and therefore “in network”. Reclaim Joy Medical is Out of Network, so payment comes directly from the patient, and there is no pressure to comply with any medical record audits from the insurance company or third-party risk assessment record demands. OON physician records are audited rarely, and if such a request is received from your insurance company (has happened less than a handful of times), then we contact you for instructions on how to proceed and signed written permission to release your records to insurance, if that is what you desire. In network physicians receive most of their payment directly from the insurance company, and are required to automatically give the insurance company all medical records in case of any audit (which happen frequently). Private insurance companies are for-profit companies, so a significant amount of your insurance premiums go to shareholders in the company, corporate profits, and staff that is paid to second-guess your healthcare team. Several large national insurers have paid fines in court cases in which it was alleged that they violated the mental health parity law (were paying psychiatrists less than other physicians) or in other ways were allegedly breaking laws meant to protect their customers. Usually, these lawsuits are settled in such a manner that the insurance company does not admit wrongdoing or fault.