Practice Manager & insurance specialist
Randi Needham
Randi is an essential part of the Lotura Psychology Practice team. She brings extensive expertise in client billing and insurance to ensure a smooth experience for our clients.
As the Practice Manager and Billing Specialist, she is highly knowledgeable about out-of-network benefits and is dedicated to helping clients navigate the reimbursement process with ease.
From verifying coverage to submitting claims and handling insurance communications, Randi manages the complexities of insurance so you can focus on your well-being. She is always happy to answer questions and provide guidance.
Alongside her work, Randi also has a deep interest in genealogy and history. In her free time, she assists individuals who have been touched by adoption to discover their heritage and learn more about their biological families. For some adult adoptees, knowing their roots and learning about their genetics can provide them with a great sense of closure and give clarity and purpose to their lives.
Insurance Information
Understanding Your Out-of-Network Benefits
Even though Randi can verify your coverage on your behalf, you may call your insurance to find out more about your mental health benefits.
Here are some helpful questions you can ask your insurance provider:
1. Do I have out-of-network benefits for mental health? If no, you are responsible for the full session fee. If yes, go on to ask the questions that follow.
2. What is my deductible for out-of-network mental health services?
3. How much of this amount have I met thus far for this year?
4. What is the percentage covered per therapy session? Is there an “allowed amount"?
Out-of-Network Benefits Example
Let’s say your insurance provider gives you the following information:
• Out-of-network deductible: $1,000
• Amount met so far: $200
• Reimbursement rate: 60% of the allowed amount
• Allowed amount per session: $150
• Therapist’s session fee: $300
How This Works:
1. Meeting Your Deductible:
• Before your insurance starts reimbursing you, you must first meet your $1,000 deductible.
• Since you’ve only met $200 so far, you would need to pay for sessions out-of-pocket until you reach the remaining $800.
2. Reimbursement After Meeting the Deductible:
• Once you’ve met your $1,000 deductible, your insurance will reimburse you 60% of the allowed amount (not necessarily the full session fee).
• In this example, the allowed amount is $150 per session, and 60% of that is $90.
• After meeting your deductible, your insurance would reimburse you $90 per session (60% of the allowed amount of $150).
• Your out-of-pocket cost would be the remaining $210 per session since your therapist’s full fee is $300.
This example highlights the importance of checking your insurance benefits so we can determine the cost of sessions in advance and plan accordingly. Randi is more than happy to assist you in this process!