Navigating insurance can be hard. We want to help make it simple.
Below we explain some common insurance terms, and how they may impact your care at Octave. To learn more about insurance and pricing specifically for Octave services, check out our Insurance page.
In-network means that we are part of an insurance company’s network of providers and have agreed upon a discounted price for our services. If you have in-network insurance, we can check your plan and provide you with more information on what you can expect to pay based on your coverage.
Out-of-network means that you will be responsible to pay for your session in full, up-front. Many insurance companies will provide reimbursement of 50% - 80% for psychological services, and we can help you through the process by providing superbills on a monthly basis which can be submitted to insurance for reimbursement.
A superbill has the required information your insurance provider needs when you submit a claim for reimbursement. The superbill will include your name, your provider's name, your provider’s employment identification number, your provider’s National Provider Identifier number, the code(s) for your diagnosis, the code(s) for any services, the date of your appointment (date of service), and the total amount of the bill.
A deductible is a set amount of money you are expected to pay before your insurance will start paying for your care. This amount is determined by your specific policy and is set in advance. Your deductible accumulates throughout the year, so once you meet it, you wouldn’t have to pay the deductible again.
Once your deductible has been met, you will still be responsible for paying a co-insurance amount. This is the percentage of the bill that you are responsible for with the remainder being paid by your insurance. For example, if you have a 20% co-insurance, you will pay 20% of each bill and your insurance company will cover the other 80%.
An out-of-pocket limit is the maximum amount of your own money you will have to pay for care during the year. Think of the out-of-pocket limit as your deductible + coinsurance + copayments (if your plan has them) up to a total dollar amount. After you spend the out-of-pocket limit, your insurance company pays 100% of the cost.
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If you or someone you know is experiencing an emergency or crisis and needs immediate help, call 911 or go to the nearest emergency room. Additional crisis resources can be found here.