Insurance & billing
How we handle the paperwork.
We work with most major commercial insurance plans, so most patients pay only their plan's copay or coinsurance for behavioral health care.
In-network plans
The list below reflects our typical commercial in-network roster. Network participation can vary by state and by plan tier — please verify your specific plan when scheduling.
- Beacon Health Options (Carelon Behavioral Health)
- Humana (commercial)
- Anthem Blue Cross Blue Shield (state plans)
- Aetna
- UnitedHealthcare / Optum Behavioral Health
- Cigna
- Blue Cross Blue Shield (regional plans)
- Magellan Health
This list is updated as plans are added or retired. Please confirm coverage when you schedule.
What you'll typically pay
- In-network visits: your plan's behavioral-health copay or coinsurance.
- Out-of-network: we can provide a superbill for self-submission for partial reimbursement (where your plan permits).
- Self-pay: flat fees published on request. Most patients with insurance pay less than self-pay.
No surprises
Under the federal No Surprises Act (2022), uninsured and self-pay patients are entitled to a Good Faith Estimate of expected charges before care begins. We provide one on request and at scheduling for any self-pay patient.
Billing questions
How much will my copay or coinsurance actually be for a psychiatric visit versus a therapy session?
Copay and coinsurance amounts vary by plan, benefit tier, and whether you have met your deductible for the year. Because psychiatric evaluation visits are typically billed at a higher complexity level than routine follow-ups, the cost per visit can shift across your treatment. We recommend calling the member services number on your insurance card and asking specifically about mental health outpatient benefits before your first appointment.
Does Great Lakes Clinical handle prior authorization for psychiatric medication or therapy, or is that the patient's responsibility?
Our billing and clinical staff work together to initiate prior authorization requests when a prescribed medication or treatment plan triggers that requirement. We will notify you if a request is pending or if a plan denial requires appeal, and we support the appeals process with clinical documentation. However, final authorization decisions rest with the insurer, and we cannot guarantee approval.
If I pay out of pocket, will I receive a superbill I can submit to my insurance for reimbursement?
Yes. Patients who pay out of pocket at the time of service receive an itemized superbill containing the procedure and diagnosis codes required for out-of-network reimbursement claims. Reimbursement rates and processes differ significantly by plan, so we encourage patients to verify their out-of-network mental health benefits directly with their insurer before assuming a specific reimbursement level.
Can I use my HSA or FSA account for appointments here?
Health savings account and flexible spending account funds are generally accepted for behavioral health services billed as medical care. We recommend confirming with your account administrator that mental health outpatient visits qualify under your specific plan's terms, as plan structures vary.
What happens to my billing if my insurance changes during an ongoing course of treatment?
Please notify us as soon as you know your coverage is changing. We will verify benefits under the new plan and discuss any changes to your cost-sharing before your next appointment. Depending on whether the new plan is one we participate with, your status may shift from in-network to out-of-network, which would affect your reimbursement rate and out-of-pocket cost.
What is the good-faith estimate, and when will I receive one?
Under the No Surprises Act, patients who are uninsured or who choose to pay out of pocket have the right to a good-faith estimate of expected charges before receiving services. Great Lakes Clinical provides this estimate upon request or prior to a first appointment for self-pay patients, covering anticipated visit costs based on your treatment needs at that time.
Coverage questions? We will check for you.
Tell us your plan when you reach out — we will verify benefits before your first visit.