Understanding Insurance.
Navigating insurance has become increasingly complex for both clients and providers. The administrative burden of submitting claims, responding to denials, obtaining authorizations, and meeting ever-changing documentation requirements has grown significantly. For our clinicians, who already dedicate substantial time to clinical care, test interpretation, and report writing, these administrative demands became unsustainable, especially amid ongoing staffing shortages in the mental health field.
To protect the quality of our care and ensure that our providers can focus on what matters most; our clients, we have transitioned off most insurance panels and now operate primarily as a private pay practice. This model allows us to spend more time with each client, offer faster scheduling, and maintain the highest standards of accuracy and personalized care.
Navigating insurance can be confusing, so here’s a quick guide to help you understand key terms and how they relate to BonPsy Wellness’s psychological testing services:
PPO vs. HMO Plans
PPO (Preferred Provider Organization) plans typically allow you to see out-of-network providers and may reimburse a portion of your costs when you submit a superbill.
HMO (Health Maintenance Organization) plans usually require you to see in-network providers only, meaning services from Clarity Psychological Testing would not be covered under an HMO plan.
Prior Authorization
Some insurance plans require prior authorization before they will reimburse for psychological testing. This means your insurance company must approve the service in advance. If prior authorization is not obtained before testing, they may deny reimbursement, even if you have out-of-network benefits.
Deductible
Your deductible is the amount you must pay out-of-pocket each year before your insurance begins to reimburse for services. For example, if your deductible is $2,000, your insurance won’t start reimbursing you until you’ve paid that amount toward eligible healthcare expenses.
Co-Insurance
Once your deductible is met, co-insurance is the percentage of the cost you share with your insurance company. For example, your plan might pay 80% while you pay 20%.
Co-Pay
A co-pay is a fixed amount (like $25 or $50) that you pay for certain services. Co-pays are set by your insurance company, not by our office, and may not apply to testing services.
Questions About Your Benefits?
For the most accurate and up-to-date information, please call the number on the back of your insurance card and ask about:
Out-of-network benefits for psychological testing (CPT codes 96130 and 96132)
Whether prior authorization is required
Your deductible, co-insurance, and co-pay amounts
Our team can also provide a superbill for you to submit to your insurance, or you can use services like Mentaya or Reimbursify to help with reimbursement.