Insurance Coverage

Because health insurance plans vary greatly, Wellspring cannot guarantee that any portion of the fee will be reimbursed by health insurance providers. However, many Wellspring guests successfully receive health insurance reimbursement for a significant portion of their tuition fees because individual and group Cognitive-behavioral Therapy sessions are central to the Wellspring program.

The clinical component of Wellspring includes a psychological assessment and Cognitive-behavioral counseling sessions.

These services can be categorized as either “mental health” or “health” (“medical”) treatments and reimbursement will vary depending upon provider, plan, and benefits.

Typically, guests with PPO plans are more likely to receive reimbursement for a portion of the clinical component of the program.

At the end of the Retreat, Wellspring produces and submits a statement to your health insurance. The statement won’t come from Wellspring. It will come from the therapist.
Wellspring uses a private billing agency to bill insurance companies directly for reimbursement.  If preauthorization is required, Wellspring will determine this and, where possible, ensure that treatment is preauthorized.

Treatment at Wellspring is not considered inpatient care despite the fact that guests are in residence, nor should our services ever be represented as such.

Questions to Consider in Determining Likely Reimbursement from Health Insurance:

Question

Understanding the Answer

Question #1: 
Does my health insurance plan reimburse for out-of-network behavioral therapy?

If yes, go to Question #2.
If no, then you are very unlikely to receive any reimbursement of the Wellspring fee.

Question #2:  
Is there a deductible required for out-of-network behavioral therapy?

If no, go to Question #3.
If yes, ask the amount, and whether you may have already satisfied all or part of it for this year.

Question #3: 
At what rate will I be reimbursed?

  1. Individual cognitive-behavioral therapy sessions (CPT codes 90806 and 90804)
  2. Group cognitive behavioral therapy sessions (CPT code 90853)
  3. Psychological assessments (CPT code 90801)

Please note:

  1. Individual sessions are billed at a rate of $96 to $144, depending on length
  2. Group sessions are billed at a rate of $72 per (typically a group session each day)
  3. The assessment is billed at a rate of $500 (typically one assessment)

Please note that the reimbursement will be sent to Wellspring, and Wellspring will immediately process a check for you for the amount of the reimbursement received, less a 6% administrative fee paid by Wellspring to the insurance billing service.