The therapy center is part of the network, however the provider is not

Individual/Marketplace Insurance
1

I’m on the hunt for a therapist who specializes in OCD and exposure therapy, and I finally found one. I have a PPO with CareFirst.

The therapist’s office ran an insurance check and told me that I’m covered with a $40 copay. However, after calling my insurance and using their online “find a doctor” portal, I discovered that the agency is in-network, but the therapist herself is not.

So, I’m getting two conflicting pieces of information. My plan is to follow up with the therapist before scheduling any appointments, but my inclination is that I’m not covered. Is that correct?

2 Likes
2

The real answer is probably known by your insurance company rather than by the therapist or practice. Patients always have the duty to obtain this information; they are not held responsible if they are mistaken, as they frequently are!

1 Like
3

Is this a practice in groups? A group’s providers could not all be connected to the network.

1 Like