Insurance FAQs and Assistance Request Form

GI Psychology does not accept health insurance or process health insurance claims and is thus an out of network provider. 

We accept credit cards such as Visa, Mastercard, American Express, Discover, and HSA cards.

All of this information is always available through the patient portal. Once you log into your portal, go to “Billing” and you will find all of this information. 

The invoice serves as a receipt for GI Psychology charging your payment method and shows the service for which you were charges. These are available the day after your appointment and after the your payment is collected.

The Superbill is the “Statement for Insurance Reimbursement” and has additional information for your insurance provider, in order for them to reimburse your claim. Specifically, it contains the diagnosis code and additional information about the practice (our Tax ID number). 

If you submit an invoice to your insurance for reimbursement, it will likely be denied, as it does not contain the needed information. 

Your insurance card will have a phone number on the back of the card for “Behavioral Health” or “Member Services”. You can use this number to contact your insurance company.

Many patients are able to get our services covered at a higher rate than typical out-of-network mental health, as if we are in-network, by receiving a gap exception/single case agreement.

See this handout for more details.

GI Psychology has created a comprehensive packet of information for the Single Case Agreement/Gap Exception Process that will answer any question you have for the process! You can find it here!

Please note, we will complete the form for you and submit it directly to your insurance provider. 

Practice Name: GI Psychology

Email: admin@gipsychology.com

Phone Number: 703-910-2577 

Fax Number: 703-661-9463

Mailing Address: PO Box 154, Fairfax Station, VA 22039

Tax ID: 85-4190300

GI Psychology NPI: 1336737543

Primary CPT Codes(these may differ for each case):

• Some insurances only want the last 5 numbers, in that case, just drop the 95- (which denotes telepsych)
• 95-90791 Telehealth: Intake/Psychiatric Diagnostic Evaluation (for first appointment)
• 95-90834 Telehealth: Psychotherapy 45-50 minutes (for subsequent appointments)

Please note, that you should not be identifying a specific provider or using a specific provider’s NPI information for insurance purposes until you have (a) received direction from a member of the admin team or (b) have a scheduled intake appointment confirmed with that clinician.

Sharon Arvelo, PsyD: 1316331036

Ray Bradni, PhD: 1609479781

Janet Eig, PsyD: 1194084962

Ellen Joseph, PhD:  1275088155

Tina Kavarligos, LPC: 1225585334

Megan Losik,  LCSW: 1457846636

Jennifer Scmaus, PhD: 1689359366

Samatha Silverberg, LPC: 1568807097

Kimberly Wesley, PsyD: 1174997712

Providers must meet with you or your child for 1 to 2 sessions in order to provide a diagnosis code. A provider cannot give without meeting with you and GI Psychology will not use a diagnosis code given by another provider. 

If you are concerned this will impact your Single Case Agreement application, the application will also typically require a “Date of First Service”. This would be your intake date and be the start date of your request, if approved. Submitting your application after the intake date will not impact the approval or denial of your application. 

If your claim was denied, the first thing you should do is contact the number on the denial notification. Gather addtional information:

• Reason for denial
• Information needed for an appeal
• Steps in the appeal process

If the reason for denial is due to a diagnosis code being incorrect, gather as much information regarding what diagnosis they would be looking for and how we can correct it. 

Once you have this information, contact the admin team and we will further assist you with appealing the denial. 

If your claim was denied, the first thing you should do is contact the number on the denial notification. Gather addtional information:

• Reason for denial
• What providers they are referring you to as an alternative
• Appeal process

Once you have the alternative providers they are recommending, investigate to inquire if they are able to provide a similar or the same service. If not, submit an insurance request above with all of the information (including the provider’s names and if they provide similar services) that you gathered; which might include the appeal process, directions for a necessity letter, where to send the appeal, and a copy of the appeal letter. 

You have the right to receive a “Good Faith Estimate of Expected Charges” explaining how much your medical care will cost under the No Surprises Act. See this handout for more details.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes  related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your health care provider, and any other provider you choose,     for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.