What does “Out-of-Network” Mean?

One of the most asked questions we hear is “Do you take my insurance?”. We love it when the answer is a clear-cut “yes” or “no”. Unfortunately, we find ourselves frequently saying “it depends”. It depends not only on your insurance company, but on which of the dozens (or sometimes hundreds) of policy’s your insurance company offers that you might have. Just because you have XYZ insurance doesn’t mean we know which particular policy XYZ offers that you have.

For some policies we are “in-network”; for others we are “out-of network” but can still work with you and your insurance. For still others, we are out-of-network but cannot work with your insurance.

In-Network. This means that we have a contract with your insurance company. Our contract with the insurance company may spell out what we can charge, how many session we can provide, or how often we have to report back to the company on the progress being made in treatment. Some contracts are with Christian Family Institute as a group and others are with individual therapists. The therapist you originally requested may not be in-network but one of our other clinicians is; in other words, one of our therapists is likely to be able to work with you and your insurance.

The sad truth is that insurance companies are requiring more and more from therapists while paying less. Also, it appears that insurance companies have a preference for contracting with large hospital-based networks: they can do one-stop-shopping as they negotiate fees for surgery, oncology, pediatrics, etc. as well as mental health. This may mean that some companies prefer not to contract with individual providers or small groups. For these reasons we are constantly re-evaluating our insurance contracts.

Out-of-Network. This means that we are not contracted with your insurance company. Some policies will reimburse you for counseling services that are provided by a clinician who is not under contract with them. Usually you will be reimbursed at a somewhat lower rate than if you had seen someone in-network. Other policies (usually HMO’s) will not reimburse anything to you if you see an out-of-network clinician.

It is important to remember that out-of-network means we have NOTHING to do with your insurance, co-pays, or deductible. This is YOUR insurance: you are the one with a contract with the insurance company, not VSWI. We may, if you request it, offer to submit claims on your behalf. We do this as a courtesy and convenience for some of our clients. It does not mean that we are offering to act as if we were in-network; it is merely a free service we offer so your counseling experience will be as simple and hassle-free as possible.