Using Your Insurance to Offset the Cost of Psychiatric Care
Many patients with PPO plans receive significant reimbursement for visits with Dr. DePalma — a board-certified psychiatrist serving Phoenix and Scottsdale.
What Does "Out-of-Network" Mean?
Dr. DePalma is an out-of-network physician, meaning he does not contract directly with insurance plans. Rather than limiting patients to a narrow insurer-approved panel, this model allows him to spend more time with each patient and maintain independence in clinical decision-making.
Payment is due in full at the time of your appointment. Upon request, you will receive a detailed invoice (sometimes called a superbill) containing your diagnosis codes and CPT procedure codes, which you can submit directly to your insurance company for potential reimbursement.
Can I Still Get Appointments Covered?
Many patients have successfully received partial or full reimbursement from their insurance company as an out-of-network benefit. Whether you qualify depends on your specific plan — PPO plans more commonly include out-of-network psychiatry benefits than HMO plans.
Three Ways to Find Out What Your Plan Will Reimburse
-
1
Review Your Insurance Brochure or Member Portal
Look for a section titled "Out-of-Network Benefits" or "Non-Participating Provider Benefits." PPO plans are significantly more likely to include this coverage than HMO plans.
-
2
Call the Member Services Number on the Back of Your Insurance Card
This is the fastest way to get a precise answer before your appointment. Ask the following questions:
Questions to Ask Your Insurance Company
- QDoes my plan include any out-of-network coverage for psychiatry or mental health services?
- QIf so, what percentage of the allowed amount will be reimbursed after my deductible?
- QHow much of my out-of-network deductible has already been met this year?
- QWhat is the reimbursement amount for the following CPT codes?
CPT Code Service Typical Use 90792 Psychiatric Diagnostic Evaluation with Medical Services Initial consultation (new patient) 99214 Office Visit — Moderate Complexity 30-minute follow-up 99215 + 90838 High-Complexity Office Visit + Psychotherapy Add-On 60-minute follow-up with therapy -
3
Submit a Claim and Review Your Explanation of Benefits (EOB)
If you prefer not to call in advance, see Dr. DePalma, receive your superbill, and mail or upload your claim to the address or portal on the back of your insurance card. Your insurer will send an Explanation of Benefits (EOB) detailing what they will cover.
Insurers are legally required to respond to claims within 30 days.
Learn More About Out-of-Network Psychiatry
If you'd like to understand why Dr. DePalma operates outside of insurance networks, or explore third-party resources on out-of-network benefits, the links below may help.