Which insurances does Dr. Spellman participate with?
Dr. Spellman has opted out of all insurance networks because to "participate" with an insurance means that the provider has to allow the insurance to dictate the treatment and to have access to all of your personal records. because most insurances require/encourage the use of electronic medical records. These records are easily accessible to the insurance companies and a number of other entities known in HIPAA as their "business associates." Many people do not realize that having all this personal information "out there" can come back to haunt them in the future.
What is more, in order for the provider to get paid directly by the insurance the provider must give insurance (and their unknown business associates) a lot of your personal information. The more detailed your history, the more symptoms are recorded, and the worse you are said to be doing, the more the provider can bill. Plus these psychiatric records could really hinder your future career if you are in one of the professions.
Dr. Spellman refuses to be part of this diabolical system.
How do payments get handled?
Patients pay Dr. Spellman privately and directly and she offers them a paper insurance claim form to submit to their insurance for reimbursement - if they have "Out of Network Benefits." See more about what to ask your insurance company in the next panel.
A major difference in privacy is that the insurance cannot get access to your records or to your private information because Dr. Spellman uses paper only (not electronic) records. The only thing she puts on the insurance claim form are code numbers and dates. No details.
No data breaches.
Most high level professionals do not want any record of psychiatric care so do they not submit claim forms.
Many people, however, do submit claim forms and the most popular insurance plan for state employees pays 80% reimbursement after the deductible is met.
What do I tell my insurance if I call to find out how much they would reimburse me?
If you call your insurance, tell them Dr. Spellman is an Out of Network MD-psychiatrist and that she will be spending 55 minutes with you each session. The "procedure code" for the first session is always 90792. Subsequent sessions are coded differently. The two "procedures" Dr. Spellman will typically combine during those subsequent 55-minute sessions will be an Evaluation and Management code and a Psychotherapy add-on code. Typically she will be combining 99214 with 90833 OR 99213 with 90836
Are Dr. Spellman's fees affordable?
They are very affordable and many people, after deductible and reimbursement, end up with an out-of-pocket expense equal to a typical co-pay.
Dr. Spellman offers two different highly discounted 4- session packages since most people need at least 4 sessions to get back on track. Call or text her for details. She will want to speak with you briefly and learn what your needs are to see if she thinks she can help you - before she makes an appointment with you.