Insurance
Insurance Information
We work with several insurance plans to help make treatment more accessible. At this time, insurance only covers office visits (including both intake and follow-up appointments) and Spravato treatment, once specific medical criteria are met.
It is your responsibility to confirm that Solaris Integrative Psychiatry is in-network with your specific insurance plan. If we are not in-network, you will be responsible for the full cost of your appointments.
Please note that insurance does not cover ketamine injections, and we are unable to bill insurance for these treatments.
Out-of-pocket costs will vary based on your insurance coverage, including your deductible, copay, and coinsurance.
While we do not bill out-of-network insurance plans directly, we are happy to provide you with a superbill that you can submit to your insurance for potential reimbursement.
Accepted
Insurance Plans
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Please note the following important information regarding insurance
We are unable to accept Medicare insurance plans, including managed Medicare.
We are unable to bill insurance for ketamine injections.
Any fees not covered by insurance will be billed directly to the patient.
Nondisclosure of changes to insurance coverage in a timely manner will result in a balance owed by the patient.
Out of Network Information
Insurance plans that are not listed above are considered "out of network" (OON).
As out of network providers, we do not bill directly to your plan, meaning that you are responsible for all out of pocket costs. However, many insurance plans allow for OON reimbursement. As an OON provider, Solaris can provide you with a superbill, which is an itemized medical receipt that can be submitted to your insurance carrier for reimbursement for your out of pocket costs.
There are several factors to consider when selecting an OON provider, and we recommend contacting your insurance carrier prior to scheduling an appointment with Solaris. See "questions to ask your insurance carrier" below
Questions to ask your insurance carrier for out of network services
Do I have out-of-network outpatient medical benefits? If they ask for more details, say it’s for Spravato (esketamine) treatment and intake/follow up visits.
Is Spravato (esketamine) a medical benefit or a pharmacy benefit?
Are there certain requirements to use out-of-network benefits?
Is a referral required from my PCP?
Do I have an out-of-network deductible? If yes, what is my out-of-network deductible and how much of my out-of- network deductible has been met so far?
What is the start date my out-of-network policy is based on?
Does my policy cover the following CPT codes: 99205, 99214, 99215, 99417, G2082, G2083? How much is the insurance company’s “usual and customary fee” and what percentage of these services do they cover?
Is prior authorization required?
What is the claims mailing address (often different than what is on your card) or is there a way to submit claims online?
At the end, make sure to get the name of the person with whom you spoke, date of phone call, and reference number for call.
