Out of Network Benefits Inquiry

The representative of your insurance carrier may ask for my information and information about my practice. 

Brandice Schnabel, LISW-S
Sky Witness Healing Arts, LLC
National Provider ID (NPI): 175740049
TAX ID: 81-2009334
Office address: 452 N Main St, North Canton, Ohio 44720
Mailing address: PO Box 3051, North Canton, Ohio 44720

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Questions to ask:

  • Does my plan include “out-of-network” coverage for outpatient mental health?
  • Is there an annual deductible for out-of-network mental health benefits?
    • If so, how much?
  • Is there a limit on the number of sessions my plan covers per year?
    • If there is, what is the limit?
  • Is there a limit on out-of-pocket expenses per year?
    • If so, what is the limit?
  • What is my co-pay or co-insurance percentage for out-of-network mental health services?
  • What is the policy year (i.e. Jan 1 – Dec 31, or based on hire date) for my plan?
  • Does my plan require a referral for psychotherapy?
  • Does my plan require pre-authorization for psychotherapy?
  • What is the reasonable and customary fee for my area/Stark County, Ohio?

(Reasonable and customary fee the amount that your plan determines is the normal range of payment within a given geographic area)

In order to find out the reasonable and customary fee, the representative may ask for a Clinical Procedure Terminology (CPT) code for the service you plan to receive. These are the CPT codes that I use:

  • 90791 Initial Assessment
  • 90837 Psychotherapy session

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