Payments > Patient Billing

which insurance to sign up for at new job - specific out of network provider


I have started a new job with the federal government and need to choose a health care plan. I see a therapist that is not in network for any offered plans and so, I am trying to figure out what the allowable amount that the different insurance companies would cover out of network, which would allow me to calculate the total cost I would be paying. So far, I have called GEHA and found out the Usual and Customary rate they use for CPT code 90834 is $140 (though they would not tell me a precise allowable amount). I also called Blue Cross Blue Shield in regards to their standard plan and they would not even budge on giving an estimate of what the allowable amount would be (or provide a Usual and Customary rate). Does a way exist to find out what the allowable amounts would be?? thx

Unfortunately most insurance carriers will not disclose this information so it makes it difficult to determine the best plan.  The most you can do is compare the out of network benefits to see which one will cover the services best, which without UNC amounts that can be difficult.   :(


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