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 have access to your personal records. either because they demand session notes and detailed treatment plans or because they encourage the use of electronic medical records. These records are hackable and easily accessible to the insurance companies and a number of other entities known in HIPAA as their "business associates."
Many savvy people, who don't want to wait months for an appointment with a provider who takes their insurance, come to see Dr. Spellman in order to get the care they deserve. Quickly, easily, and privately. They know that they actually save time and money in the long-run too.
Continue reading to find out how you can do things this way and get partial reimbursement from insurance - with minimal invasion of privacy.
All insurances require that you be given a mental health diagnosis if they are paying for your treatment. Many people do not realize that having a mental health diagnosis on their permanent record can come hurt them either now or in in the future.
What is more, when a provider bills your insurance, 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.
So even though you are paying for health insurance and feel you might as well use it, in some cases it would actually not be wise for you to use it for mental health. You can reserve your insurance for your general medical needs.
In short, Dr. Spellman does not take any insurances. That being said, The panels below explain how you can use your insurance in way that preserves some of your privacy.
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. You would still have to be given a mental health diagnosis (in a code number) but it would not be one that makes you seem worse than you are. Dr. Spellman does not like to "label" so is very discrete and would rather err on the side of caution.
Most high level professionals do not want any record of psychiatric care so do they not submit claim forms.
However, people who already have a permanent record of a mental health diagnosis from previous providers, 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 50 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 50-minute sessions will be an Evaluation and Management code and a Psychotherapy add-on code. Typically she will be combining 99213 (Evaluation and Management) with 90836 (Add-on Psychotherapy).
If you are seeking medication management without psychotherapy the procedure code would typically be 99214.
Are Dr. Spellman's fees affordable?
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.