Insurance

I am committed to making your mental wellness journey as easy as possible. Navigating insurance and mental health services can be overwhelming. I am happy to be a resource for you with the guidance on this page.

Accepted Payments

I accept cash, Zelle, Venmo, or check for payment at the time of service as I am currently out-of-network with all insurance panels. However, please do not be discouraged as your insurance provider may offer out-of-network benefits for mental health services. Therefore, I have created this guideline to assist you with pursuing these benefits if it is an option with your plan.

Insurance Information

I am happy to provide you with a detailed receipt for each session for out-of-network claims.  You can then submit this receipt to your insurance company to seek reimbursement for any out-of-network mental health benefits you may have.

Information that will be provided on your requested receipt of payment:
Provider’s name
Provider’s NPI
Provider’s license number
Federal Tax ID number
DSM-5 and ICD-10 diagnosis codes
CPT or Procedure codes
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How to check your out-of-network coverage & out-of-network benefits:

The following is a general flow of conversation one would have when speaking with their insurance provider to determine if out-of-network coverage for mental health services is available with The Montclair Therapist.

Although I do not accept Medicare, I will print a receipt of service which you can submit for reimbursement. Here is a link to instructions and the Medicare Part B Claim Form: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1490S-ENGLISH-Instructions-PartB.pdf

This guide is provided to assist you with calling your insurance company to check on your out-of-network benefits. Dr. Amanda Aster, Psy.D. is not responsible for the information obtained using this guide.

Before your call:

Plan for 15-30 minutes of your time available to call your insurance company.

Make sure to have this information ready:

- Insurance card

- Name, date of birth, address, phone number, or possibly social security number of the cardholder or person for whom the services are for

- Pen and paper/notepad

- CPT Code for Individual Therapy: 50 minutes, 90837

Questions to Ask:

1. Are there out-of-network benefits for this policy?

2. Do I have a mental or behavioral health policy with out-of-network benefits?

3. What are the requirements to use out-of-network benefits?

4. Is prior authorization required?

5. Is a referral required from my primary care physician?

6. Do I have an out-of-network deductible?

If "Yes" to all the above, ask these questions:

1. What is my out-of-network deductible?

2. How much of my out-of-network deductible has been met?

3. What is the start date of the calendar year my out-of-network policy is based on?

4. In addition, ask the representative if your policy covers these services (use the CPT codes provided above). How much is the insurance company’s “usual and customary fee” and what percentage do they cover?

Other questions to ask:

Is there a session limit?

If yes:

What is the session limit?

How many sessions do I have left?

What percentage of services is covered/what is my co-insurance?

At the End of Your Call:

Make sure you have a record of the following:

- Date/time you called

- Representative’s name

- Reference number for the call