INSURANCE & BILLING GUIDE

Navigating health insurance benefits can feel complicated, especially when managing the internal strain of a demanding schedule. This guide is designed to give you complete operational clarity and control over your billing process. Because this practice operates on a direct, solo electronic billing framework, taking a few structured steps before your first session will ensure your coverage aligns perfectly with your care, preventing unexpected out-of-pocket costs.

How Insurance Works in This Practice

This practice is an in-network provider with select commercial insurance plans in Pennsylvania. When you utilize your health benefits, the practice will handle the direct, electronic submission of all clinical insurance claims on your behalf. However, because health insurance is a contract strictly between you and your carrier, final financial responsibility for all services delivered rests entirely with you. All client-responsibility balances, such as copayments or deductibles, are processed automatically following claim adjudication.

Before Beginning Therapy: Verify Your Benefits

To ensure complete financial predictability, you must verify your specific outpatient mental health benefits directly with your insurance company before your first scheduled appointment. You can complete this verification by calling the member services phone number printed on the back of your insurance card. This proactive step allows you to confirm your active network status, identify your exact financial obligations, and establish your coverage rules before care begins.

Information to Provide Your Insurance Company

When speaking with your insurance customer service representative, you will need to provide them with the following official provider credentials to ensure they pull up the correct contract files for this practice:

• Provider Name: Rebecca S. de Vries, Ph.D.
  
• Practice Entity: Rebecca S. de Vries, Ph.D., LLC
  
• National Provider Identifier (NPI): 1588983894
  
• Practice Location: Harmony, Pennsylvania (100% Virtual Telehealth Practice)

Questions to Ask Your Insurance Company

To get an accurate breakdown of your out-of-pocket costs, read the following questions directly to the representative:

Provider Participation

​Is Rebecca S. de Vries, Ph.D., LLC an active, in-network provider for my specific behavioral health plan tier?

Telehealth Coverage

Does my plan explicitly cover outpatient psychotherapy delivered via live, synchronous video telehealth? Is the benefit coverage identical to an in-person office visit?

Behavioral Health Benefits

Services and Billing Codes

​Are there specific standard procedure codes covered under my plan? Please verify my coverage for a 60-minute initial intake evaluation (CPT Code 90791) and a standard 53+ minute individual psychotherapy session (CPT Code 90837).

Deductible Tracking

Does my annual plan deductible apply to outpatient mental health or telehealth services? If yes, what is my total deductible amount, and how much has been met so far this calendar year?

Sending Insurance Information Securely

​To initiate your preliminary electronic verification, you must upload your insurance details directly through your secure TherapyPortal account. Please upload clear, high-resolution photographs or scans of both the front and back of your physical insurance card, along with a valid government-issued photo ID. Never send your insurance identifiers or personal health data via standard email or unencrypted text messages, as those channels do not meet HIPAA security standards.

Understanding Your Financial Responsibility

​Your total session cost is determined strictly by your insurance network's contracted allowed amount. If your plan includes a copayment, that fixed fee is due at the time of your session. If your plan carries a deductible that applies to mental health services, you will be responsible for paying the full contracted allowed rate for each session until your deductible is completely met. Once met, your plan's standard copayment or coinsurance rules activate automatically.

How Payment and Claims Work

Following each completed appointment, an electronic claim is transmitted directly to your insurance company. Your carrier typically processes the document within two to four weeks and issues an Explanation of Benefits (EOB). This document outlines the network's final adjustment decisions and clearly details the exact portion of the fee assigned to you. Any balance designated by your insurance company as client responsibility is automatically processed using your payment method on file in the portal.

Understanding Common Insurance Terms

To assist you in reviewing your insurance paperwork, here are the standardized definitions of common billing terms:

• Allowed Amount: The maximum dollar fee your insurance network permits a provider to charge for a specific covered service code.
• Copayment: A fixed, set dollar amount you pay out-of-pocket for a specific medical or behavioral health visit.
• Coinsurance: A specific percentage of the allowed amount that you are responsible for paying after your deductible has been fully met.
• Deductible: The total amount you must pay out-of-pocket for covered healthcare services before your insurance company begins to pay.
• Explanation of Benefits (EOB): A non-bill statement sent by your insurer showing how a claim was processed and detailing your remaining financial responsibility.

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