Alison C. Smith, Ph.D.
Licensed Clinical Psychologist
Insurance Information
Possibilities for making therapy more affordable include using:

  • Flexible Spending (FSA) or Health Savings Accounts (HSA)
  • Insurance


Flexible Spending Account or Health Savings Account:

Accounts such as these typically only require only the submission of a receipt from the service
provider. Such a receipt can be provided to you at the time of service.

Insurance:
The following information is provided to assist you in the process of determining the necessary
information to ensure that your insurance company will either cover my services (BCBS) or
reimburse you appropriately (out-of-network).Please download the appropriate form and complete
it prior to our first session.

1) BlueCross/BlueShield
2) Tricare
3) Out-of-Network Benefits

BC/BS:
Individuals with BC/BS pay the full maximum reimbursement fee (set by the insurance company)
each session until their deductible (if any) is met. Once this deductible is met, clients pay only the
co-pay each session. I will then bill the insurance company directly for the balance of the
reimbursement fee. Note that there may be a limit on how many sessions a plan may reimburse per
year. With your written permission, I will also provide information to the insurance company to
facilitate reimbursement should they request it (Form: Questions for BCBS).

In order to determine what your benefits are, please take the following steps:  

  • Call the customer service number on the back of your insurance card (for Mental Health).  

  • Tell them you will be seeing a licensed psychologist who participates in Anthem Blue
    Cross/Blue Shield.  

  • Ask them if you need pre-authorization for services. If yes, find out if you can get the pre-
    authorization as the client or if the provider must get the pre-authorization. This information
    is critical to making sure that the fees for services are covered appropriately by your
    insurance company.  

  • Ask if there a maximum number of visits allowed per year.  

  • Ask if you must meet an annual deductible before your benefits go into effect.  d

  • Find out what your copay is and whether it changes based on the number of sessions (e.g.,
    coverage of 80% for first 5 sessions and 50% thereafter).  

  • Record the name of the person you spoke with and the date of your telephone call.
                                       
Tricare:
To get information on coverage for mental health services, please go to the official Tricare web
site for mental health at http://www.tricare.mil/mentalhealth. After you enter the site, select
"Learn More" in the "Making Appointments" box. The page that follows will provide you with
information regarding your Regional Mental Health Contact phone number. There are specific
referral and prior authorization rules you must follow before getting care. These rules vary by
program type and your beneficiary category. Your regional contact will be able to provide you with
this information.

Out-of-Network Benefits:
I am licensed in Virginia as a Clinical Psychologist. As such, your insurance company may
reimburse you according to the guidelines they have established for out-of-network providers.

You will be provided with statements of service that can be submitted to your insurance company
for reimbursement. With your written permission, I will also provide information to the insurance
company to facilitate reimbursement should they request it (Form: Questions for Out-of-
Network Benefits).

In order to determine what your benefits are, please do the following:

  • Call the customer service number on the back of your insurance card (the Mental Health
    number).

  • Tell them you will be seeing a licensed psychologist that is an out-of-network provider.

  • Ask what the reimbursement rate is for individual/couple's therapy. This rate will vary
    between different companies and contracts.

  • Ask if you must meet an annual deductible before your benefits go into effect.

  • Ask if there is a maximum number of visits allowed per year.

  • Record the name of the person you spoke with and the date of your telephone call.
Forms & Downloads