What are insurance credits?
Many clients receive insurance coverage through their employer. Some employer-sponsored insurance plans include additional benefits, such as access to a chiropractor or nutrition counseling. Covered therapy sessions may also be included as a benefit on some plans.
When therapy is offered as a benefit through employer-sponsored insurance plans, we call these sessions "insurance credits sessions."
What makes these sessions different?
- Previously, EAP clients were only accessible through Tava Referrals. Now, clients may choose to use their insurance credit benefits when they first sign up with Tava, or for any future sessions.
- They are billed with a specific CPT code: 99404, which is paid at your 38-52 minute session length rate, even if the session goes beyond 52 minutes.
- Once a client uses up all their insurance credit sessions, future sessions are billed at your standard referral rate (if originally a Tava client) or insurance rate (if originally your client). That means you can get paid more for ongoing 53+ minute sessions with these clients.
Best practices with insurance credits:
- Keep sessions to 38-52 minutes for insurance credit sessions. Sessions less than 38 minutes long will be denied, and sessions longer than 52 minutes are unfortunately not eligible for higher pay rates.
- After a client has exhausted all their sessions, encourage continuation through their insurance.
- For ongoing insurance-covered sessions, hold 53+ minute sessions for the highest payout rate.
How to identify insurance EAP sessions
Navigate to a client's profile. Under the "Coverage" session, you will see "EAP, [Insurance Name]," with the number of sessions the client is allotted.
Click on the EAP card for more details.
Insurance credits on the calendar
Navigate to your calendar. Insurance sessions will have a "shield" icon.
Click the session for more details.
Insurance credits at booking
If you are scheduling a session with a new insurance credit client, you will be notified before scheduling. We recommend adjusting the session duration to be 45-minutes.
Insurance EAP sessions
When joining an insurance credit session, you will be notified that sessions are paid at a set rate even if the session runs longer than 52 minutes.
FAQs
Can I add an insurance credit client on my own?
Yes! Providers can add insurance credit benefit info when adding a new client.
What insurance payers offer benefits with Tava?
Right now, Cigna is the only insurance plan that offers benefits with Tava. But we are working to add more!
What is the client experience?
You can learn more here.
Can I opt out?
No. Insurance credit sessions depend on the client's preferred coverage method. However, you can choose not to work with a client on a case by case basis if the fit is not right.
Can insurance credits cover couple or family therapy sessions?
Yes. Couple and/or family therapy sessions can be covered by insurance credits.
A session was just booked, and the insurance credit details say "pending." What does that mean?
If you see "pending verification," the sessions have not yet been confirmed by the payer. You may still hold the session. If the benefit is not confirmed, the client's insurance will be used to cover the session.