(850) 692-9355
Contact

Out-Of-Network Benefits

Dr. Poulakos sees patients with other commercial insurance plans outside of Aetna as well (i.e. United, Cigna, BCBS, etc.) as an out-of-network provider. Patients with these plans are able to get a substantial portion of the visit covered by their insurance company via their out-of-network benefits. With the patient portal, Dr. Poulakos makes it easy for patients to submit out-of-network claims electronically and receive reimbursement in a timely manner. He will help guide patients through any questions they might have and encourage patients to use Reimbursify to assist them in this process. Reimbursify makes submitting out of network claims as transparent and simple as possible for patients.

As an out-of-network provider, clients pay their fee at the time of the session. Once the practice receives payment, the client will receive a copy of their superbill to them and submit to their insurance to receive about 60-80% back as reimbursement. You might be wondering what a superbill is. This is a type of invoice that includes the billing codes for your session as well as any diagnoses given. Insurance coverage is very broad, therefore it is always best to inquire with your insurance provider to receive specific details on their process. To aid you in this conversation here are some helpful questions for you to bring to that conversation:

  • Do I have mental health coverage?
  • What percentage of my session fee will I be reimbursed for an out-of-network provider?
  • Do I have a deductible for out-of-network mental health benefits? If so, what is it?
  • How many sessions should I expect to be covered in a given year?

Links to common insurance companies claim submitting directions:

At a Glance

Dr. Paul Poulakos

  • Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
  • Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
  • Past Clinical Assistant Professor of NYU Langone Medical Center
  • Learn more