
Requesting
Out-of-Network
Faith-based Psychotherapy Approval

Have an HMO?
Writing to your HMO (Health Maintenance Organization) to request permission to see an out-of-network provider like Embrace New Life involves a clear and formal email explaining why you need this specific service. Below is a step-by-step process and a sample email template to help you craft your request.
Process:
- Check Your Policy: Review your insurance policy before writing to understand the out-of-network care provisions. This will help you frame your request according to the terms covered by your HMO.
- Gather Information: Collect all necessary information about Embrace New Life, such as the services they offer, their credentials, and why they are a preferable choice for your needs.
- Medical Justification: If applicable, include a statement or letter from your current doctor or from your pastor, rabbi, imam, or sheikh recommending Embrace New Life for your specific health needs.
- Draft Your Email: Use a formal tone and include all necessary details to make a strong case for your request.
- Follow Up: After sending the email, be prepared to follow up with a phone call or additional documentation if required.
Sample Email Template:
Subject: Request for Authorization to Receive Out-of-Network Care
Dear [Insurance Company] Customer Support,
I hope this message finds you well. I am writing to request authorization to receive mental health services from Embrace New Life / Counseling & Wellness, an out-of-network provider specializing in faith-based mental health care.
My policy number is [Your Policy Number], and I have been a member of [Your HMO Name] since [Date].
Embrace New Life offers a unique service that is integral to my mental health needsโproviding specialized support for the three Abrahamic faiths: Islam, Judaism, and Christianity. This center serves as a sanctuary where spiritual beliefs and faith-based behavioral norms are respected and integrated into therapeutic practices. The clinicians at Embrace New Life are not only mental health experts but also have a deep understanding of theological aspects pertinent to these faiths, which is crucial for addressing my specific mental health and relationship concerns in a manner that aligns with my spiritual values.
My current healthcare provider supports the need for faith-sensitive mental health services and has emphasized the importance of a therapy approach that incorporates my religious beliefs for effective treatment outcomes. Attached is a letter from my provider outlining the medical and spiritual necessity for this specialized care. I kindly ask for your prompt review and approval of this request to begin receiving the care that best supports my mental and spiritual well-being.
Thank you for considering my request. I look forward to your positive response and am available for any further information or discussion to facilitate this process.
Warm regards,
[Your Name] [Your Contact Information]
NOTE: Therapy Services offered at EMBRACE by licensed professionals may be covered by insurance.
Services offered by Life Counselors, Grief Specialist & Biblical Counselors are usually not covered or reimbursed by insurance companies.
