Out of Network, Fee for Service, Insurance Reimbursement, Payment Policies

Sunsphere Psychiatry is not in network with private insurance companies at this time. Sunsphere Psychiatry is unable to see patients with TennCare (Medicaid).

Full payment is expected at the time of service. All patients must keep an active credit card on file to schedule appointments. Patients may choose to pay via another method such as debit card, cash, HSA (health saving account) card on the day of their appointment.

Superbills (receipts with billing codes for medical services) are available upon request for patients to submit to their private insurance company to request out of network reimbursement.

Potential patients are encouraged to call their insurance company and clarify their policy’s out of network benefits as well as the process to submit a claim to the insurance company for reimbursement to the patient (themselves) directly. Some insurance policies have a yearly deductible that must be met before patients are reimbursed for out of network services. Some insurance policies require pre-authorization to see an out of network physician before patients can file a Superbill to request reimbursement.

Medical Service Codes Frequently Used at Sunsphere Psychiatry:

Initial Psychiatric Consultation: 90792, 99205

Follow-Up Psychiatric Appointments: 99213, 99214, 99215

Add on codes: 90833, 90836 (medication management with therapy), 99417 (prolonged evaluation and management services)