How do I know if I’m eligible for In-Network Insurance (INI) Subscription Plan?
When you sign up for services or update/add your insurance information in your account, you will go through a real time eligibility check and our system will determine whether you’re eligible for an INI subscription. Confirmation of your in-network subscription can be found in your Cerebral Dashboard under “Insurance Information. Our system will check for coverage status, coverage for outpatient mental health services, and provider capacity. If you're not eligible for an INI subscription, you will continue on an out-of-network subscription:
- Please note that if you are placed on an out-of-network subscription but we become in-network with your plan or have capacity, please follow these steps.
- If you are placed on an INI subscription, you’ll have the option to accept the INI subscription and it is possible that you’ll be reassigned to a new provider who accepts your insurance plan.
Why was I reassigned away from my provider and/or Care Counselor when I converted to an insurance plan?
When you convert to an In-Network Insurance Subscription (INI Subscription) with Cerebral, our goal is for you to receive services with providers who are not just a clinical and personal fit, but also contracted with your insurance plan in order to provide the most affordable services. Unfortunately, Care Counseling is not a billable service to most insurance plans and so care counseling services are not eligible for our in-network subscription.
Can I stay with my out-of-network provider and remain on an insurance subscription?
It is possible for you to remain on an in-network subscription while seeing an out-of-network provider. You will be charged $124 per visit if you decide to continue to meet with a provider who is not in-network with your insurance plan. It’s also possible to incur one-time visit fees for any of the following scenarios:
- Inactive Insurance
- No Mental Health Benefits
- PCP Referral Required and not obtained
- Prior Auth Required
- Secondary Insurance
- Prescriber Out of Network
- Therapist Out of Network
- Sub-Plan Type Out of Network
We will ALWAYS communicate with you prior to any attended visit if any of the above scenarios apply to you, so that you can make an informed decision on attending your appointment with your provider.
Why am I paying a $30 subscription fee?
This recurring fee allows Cerebral to offer concierge value-added services to you, including 24/7 coordinator support, 24/7 emergency response line, online appointment booking, online prescription support, and a library of CBT exercises available via our mobile app. The subscription fee is separate from any applicable cost share or one-time visit fee.
What is a cost-share, and how much can I expect to pay?
Insurance-determined cost shares typically range from $0-$173, and they make up any applicable copays, coinsurances, and/or deductibles:
- Copay: A fixed dollar amount cost-sharing arrangement applied after a claim has been finalized. The balance is covered by your health plan.
- Coinsurance: The percentage amount applied after your deductible is satisfied.
- Deductible: A cost-sharing arrangement where your health insurance plan requires you to pay a set amount up to a predefined limit before the insurance plan will contribute towards your claims
Cerebral’s Billing Team will typically submit your claims to insurance plans within 90 days from the date of service. We aim to follow up on the claim within 45 days once the claim is submitted, and you can expect to receive an invoice within 7 business days after we’ve followed up on your claim.
Please note that Cerebral is contractually obligated to collect insurance-determined cost shares. These cost shares are non-refundable if the visit has occurred.
Cerebral’s Billing Team will communicate cost shares to you via email, and we aim to provide you at least 3 business days notice before your bill is due. We encourage you to contact your health plan with any questions regarding the processing of your claim(s), questions about your outpatient mental health benefits, or cost share information
How can I receive an invoice for my cost share or one-time visit fee?
Please submit an email to Insurance-Support@cerebral.com, and we will email your invoice within 3 business days.
I attempted to meet with my provider while I was on vacation, but was unable to do so. Why did this happen?
Due to state licensing requirements, Cerebral cannot move forward with completing your session if you are not receiving services in the state to which you indicated at sign up. We’re deeply sorry for the inconvenience, and we’re happy to reschedule your session as soon as you’re back in your state of residence!
How can I get in touch with a member of Cerebral’s Insurance Team?
Please submit an email to Insurance-Support@cerebral.com and we’ll follow up within 3 business days for non-urgent requests, and one business day for requests that require immediate response. We look forward to hearing from you!