If you’ve ever hesitated to start therapy because of insurance, you’re not alone. It’s one of the most common questions we hear: “Do you take my insurance?” The honest answer is that Evolve Psychological Services is an out-of-network practice, but that doesn’t mean your insurance can’t help cover the cost of your care. In fact, for many of our clients, it already does.

To make that process as simple as possible, we’ve partnered with Thrizer, a billing service that automatically submits your out-of-network insurance claims for you — no paperwork, no phone calls, no waiting around.

Wait, what does “out-of-network” actually mean?

Being out-of-network simply means we don’t bill your insurance company directly the way an in-network provider would. We’re not part of any insurance panel, and we don’t negotiate rates with insurers.

But here’s the part that surprises a lot of people: most PPO plans and many employer-sponsored health plans include out-of-network (OON) benefits for mental health care. That means your insurance may still reimburse a significant portion of what you pay us — you just have to know how to access it.

That’s exactly the gap Thrizer fills.

How do I know if I have these benefits?

The easiest way to find out is to check. We’ve added a free benefits calculator to our website that takes about two minutes. Just enter your insurance carrier, member ID, and date of birth, and you’ll instantly see:

•     Whether you have out-of-network mental health benefits
•     Your deductible status
•     An estimate of what your sessions might cost you out of pocket

No phone call required, and nothing is shared with us unless you choose to move forward.

If your plan is an HMO, Medicaid, or Medicare, unfortunately these typically don’t include out-of-network benefits, and Thrizer won’t apply. In that case, you’d continue paying our session fee directly, and we’re happy to provide a superbill if you’d like to attempt reimbursement on your own.

So what are my options?

You’ll have three ways to handle your sessions going forward, and you can pick whichever fits your life best.

Option 1: Self-Submit. 

You pay our full session fee and, if you’d like, we provide a superbill for you to submit to your insurance yourself. This is the same process many of our clients have used for years, and it isn’t going anywhere.

Option 2: Let Thrizer handle the claim for you. 

You still pay our full fee at each session, but instead of dealing with superbills and insurance portals yourself, Thrizer submits the claim automatically. Once it’s processed, your reimbursement goes straight to your bank account. While you’re working toward your deductible, this costs you nothing. After your deductible is met, Thrizer charges a small 1% fee — and only if your claim is successfully reimbursed.

Option 3: Pay only your reduced responsibility. 

This is the option that tends to make the biggest difference for people. Once your deductible has been met, instead of paying our full fee and waiting weeks for reimbursement, you pay only your reduced responsibility — essentially what you’d owe after insurance — right at the time of your session. Thrizer your claim behind the scenes. If a claim is ever denied, you’re never billed for the difference. This option carries a 5% Thrizer fee once your deductible is met, and nothing while you’re still working toward it.

Why we did this

We started Evolve because we wanted to offer thoughtful, individualized care without the constraints that can come with being tied to insurance networks, constraints like limited session lengths, restricted treatment approaches, or being told how many sessions someone “should” need. Staying out-of-network lets our clinicians focus on what’s clinically right for each client, not what an insurance company will approve.

But we also recognize that cost is real, and we don’t want it to be the reason someone delays getting support. Partnering with Thrizer felt like the right way to bridge that gap, keeping the clinical independence that makes good therapy possible, while making the financial side feel less like an obstacle.

What should I do next?

If you’re considering starting therapy with us, this might be a good moment to check your benefits before reaching out. It only takes a couple of minutes, and it can completely change how you think about what’s possible. You can check your beneifts on our website:

https://nicolegarciaphd.com/fees-insurance/

Insurance shouldn’t be the reason someone puts off getting support. We hope this makes that a little easier.

Have questions about your specific plan or which option might work best for you? Reach out to us at (973) 891-0793 or info@evolve-ps.com, we’re happy to talk it through.