Welcome to AustinOCD

Will my health insurance cover Dr Mansbridge's fees?

It depends. I recommend that you call your insurance company to check your benefits before coming for assessment or treatment from me. The answer you get, however, may depend on how you ask your question. Insurance companies are required to honor their contract with you, but how they interpret that contract may be different from how you understand it.

In-network vs. out-of-network

Don't be put off if your company says that I'm not in their network of providers. I'm not in any insurance networks or panels, so you won't find me on their list of "preferred" providers. If you have "out-of-network" benefits, however, which you are very likely to have, you are entitled to receive treatment from any licensed provider you choose, including me; they will reimburse you at a lower rate (in other words, your co-pay will be higher) whenever you go "out of network," but they are required to reimburse at least some portion of my fees. If you're not sure how much they will reimburse, call them and ask what they reimburse for "outpatient mental health treatment going outside the network." I've seen people get reimbursed anywhere from zero up to 85% going outside the network.

Caution:   If they say they reimburse, for example, "50% if you go out of network," ask them if that means they reimburse 50% of what the doctor charges, or of what they consider to be "usual and customary" fees. It's not uncommon for insurance companies to say that they consider the "usual and customary" fee for psychotherapy to be much lower than is actually typical for that area. The amount should vary by zip code and by the type of provider (e.g., psychologist, social worker, licensed professional counselor). In some parts of the country, the real usual rate may be under $100 per session, and in other areas it may be over $200. My zip code is 78731.

You may be entitled to get reimbursed for my treatment at the in-network rate (lower co-payment) if there is no one on their provider list who knows how to properly treat your condition. (See also Dr Fred Penzel's excellent article, Fight for Your Health Insurance Rights.)

In-home treatment or extended sessions

OCD can be often be treated successfully via standard weekly 45- to 50-minute outpatient office visits if the patient is able to perform the recommended behavioral exercises between sessions, either on his or her own or with the help of friends or family members. Just as if you were learning to play the piano, a weekly lesson with your piano teacher would be helpful, but only if you practiced daily between lessons. It can sometimes be especially effective to have longer treatment sessions, though, perhaps 90 minutes or up to 3 or 4 hours. Some OCD concerns occur primarily in the patient's home or in some other location, so it can be especially helpful for the treatment to take place there. If you think any of these might be helpful for your OCD, you can ask your insurance company what they reimburse for extended sessions or for "in-home behavior therapy."  Mileage costs and travel time from my office to your home are rarely reimbursed, so you might need to cover those fees yourself while your insurance company covers the face-to-face treatment.