The only insurance that we accept in-network is Humana. If you carry other insurance, you may be able to get reimbursement if you have “out-of-network” benefits. Call your insurance company, ask the following questions, and discuss their answers with me. We’ll figure it out together!
QUESTIONS FOR YOUR INSURANCE COMPANY:
(The phone # is on the back of your card.)
If you have Anthem BCBS, ask if you have the “traditional” plan; I am actually “In-network” with that plan.
If Not, ask-
-Do I have “out-of-network benefits” for “outpatient mental health in the Dr’s office?” If “yes”: YES ___________ NO_______________ (if “no”, stop here.)
DEDUCTIBLE-
-Do I have a deductible, and, if so, what is it? ______________________
-Does this deductible apply to only “out-of-network” services, or does it combine both in- and out-of-network services? ___________________________________
-Does the deductible combine medical and mental health or is the mental health deductible separate? ________________________________________________
-Is the deductible based on the full billed amount per session or on the “allowable” amount? _____________________________
-Does my deductible and my “plan year”begin on Jan. 1 or on another date? What date? _________________________________
COPAYMENT/COINSURANCE PER SESSION-
-What does the insurance co. pay per session for the following CPT codes:
90847 and 90837? (These refer to the first session and to subsequent therapy sessions…)
-They may describe this in terms of “co-insurance”…just write it down and let me know. ____________________________________________________________________________
BILLING-
-What is the billing address? ______________________________________________________
ARE AUTHORIZATIONS NEEDED? Y______ N______
DO NOT ATTEMPT TO TRY TO UNDERSTAND ANY OF THIS. Just write down the answers and call me so I can translate and explain.