We have provided details below for most questions we hear from Spark patients.
Please feel free to call or complete a contact form request if you have additional concerns.
Spark Providers & Services are considered “out of network” with all insurance companies EXCEPT Blue Cross / Blue Shield & CIGNA.
Most of our patients are able to get part or all of fees paid by insurance using typical “out of network” reimbursement options. Please verify with your insurance carrier if reimbursement is important to you prior to scheduling or paying for Spark Services.
Following each visit an invoice with appropriate diagnostic information will be provided, so patients may submit for reimbursement by sending service paid invoices directly to them.
HOW TO FIND OUT IF YOUR INSURANCE COMPANY WILL REIMBURSE AND IF SO, HOW MUCH:
Three different ways to find if, and how much your insurance company will reimburse:
1. Check your health insurance materials or website to review “out of network” coverage. This is more common with PPO plans than HMO plans.
2. Before an initial visit with Spark call your health insurance company (using the number on your insurance card) and ask:
Does my plan has include any “out of network coverage” for out of network Psychiatric Providers? And, if so, how much you will be reimbursed for the following CPT (Current Procedural Terminology) Codes?
90792 (Initial Evaluation Visit For New Patients )
99214+ (Standard Follow Up | Medication Management | 30 mins)
99215+90838 (Extended Follow Up Visit | 60 mins with Therapy)
Phone Call, Letter or Other Provider Requests are not covered by insurance.
3. If you are not sure what is covered in part or whole and do not want to call your insurance company you may decide to submit an invoice and see how much reimbursement you receive if any. Also read the EOB (Explanation of Benefits) that is sent back to you by your insurance company.
Health insurance companies are required by law either to pay the claim, or tell you why they are not going to pay, within 30 days.
Prior to the initial visit, a complete record and paperwork review will be performed.
Please complete all new patient paperwork fully and completely at least 2 days prior to your scheduled intake appointment.
Visit will usually occur via the internet or in person.
Visit will usually require between 30 and 60 minutes. Please be prepared to start on time as we will end on time. We strive to be punctual with all of our clients.
Visit may include a history taking session, paperwork, blood pressure and vital signs check, height and weight measures, and mental health screening forms. Also, collaboration with your other medical providers and past medical providers is sometimes necessary.
Labs- sometimes you will require lab work or even genetic testing to gain a greater understanding of medical needs and monitor medication levels.
Prescribing- Provider will discuss any past treatments, current medications, treatment recommendations, and often times medications may be prescribed or refilled at the first meeting.
Currently, Spark only accepts and direct bills for Blue Cross / Blue Shield & CIGNA insured patients.
Fact is, insurance companies continually require information from the Psychiatric Providers in order to determine if they will continue to cover treatment(s). This effort to limit patient benefits can create long delays before treatment decisions initially approved and often results in a temporary or permanent disruptive to existing treatment(s), which can be very disappointing (and sometime dangerous) to patients.
In the end, insurance most companies can limit coverage at any time, or for any type of treatments you can receive without warning or justification, so in order to provide the best care and outcomes possible, we are very selective of the insurance providers that we will contract with.
National Suicide Prevention Lifeline
Substance Abuse and Mental Health Services Administration National Helpline
National Institute of Mental Health
Appointment Attendance: Please arrive or log-in on time for scheduled appointments. We strive to be on time for all of our clients and each appointment will need to end on time to ensure punctuality for all. If you are more than 10 minutes late for scheduled appointment, you will likely be rescheduled and charged for the scheduled visit.
Cancellations: We require 24 hours’ notice to cancel appointments or fees will be forfeited.
Prescription Refills: It is vitally important that you attend appointments on a regular basis. Good adherence to follow up appointments and adequate treatment monitoring are vital factors in treatment outcomes. Refills are provided at each appointment when indicated, and will include sufficient refills until the next scheduled appointment.
This system of care generally works well, but on rare occasions, a client may need a refill due to unforeseen circumstances. In that case we will do our best to provide assistance to ensure there is no gap in treatment. However, we do require 3 days’ notice for refills and cannot offer same day services.
Minor Care: For clients age 15 and older, it may be helpful, but is not generally required, to have a parent or guardian present for evaluation and treatment. For clients age 14 and under, parental attendance and consent is required for each visit.
Contacting your Provider: Feel free to contact your Provider via email for the quickest response. Most emails will be returned within one business day. Do not use email for emergencies, but rather go to the nearest emergency room or call 911 for help.
In some circumstances it may be indicated to speak with your other Provider(s) by phone for medical or psychiatric advice, consultation, or changes. These will be scheduled on a case-by-case basis at a fee.
In some circumstances Clients may request letters be written by their Provider. These requests will be handled once weekly and there will be a small fee based on time required. Not all letter requests will be granted.