I’m happy to give you a receipt at the time services are rendered and you can submit them for reimbursement. Make sure to follow the following verification steps:
To verify your mental health benefits:
- Consult your insurance card to find the number for “customer service,” “benefits,” “eligibility,” etc., or your card may be a specific number for “behavioral health” or “mental health” benefits.
- When you dial this number, be sure to inquire about “behavioral health” or “mental health” benefits, which may be different than your medical benefits.
- Inform the person verifying your benefits that you are NOT inquiring about inpatient or outpatient benefits (which is related to hospitalization for mental health issues); you are only inquiring about office visit benefits.
- And in the event that you have a future dispute with your insurance company, be sure to keep a record of the information that you gather, including
a. the name of the customer service representative, who is helping you, and
b. the date and time that you gathered the information.
If your insurance customer service representative identifies that you have applicable benefits, and you would like to learn more about how to use said benefits, you may ask the service representative the following questions:
- Is my mental health plan an HMO or a PPO?
- If it is a PPO, what are my benefits for an “out-of-network” provider?
- Do I have a deductible (the deductible may be different for “in-network” and “out-of-network” benefits)?
- Has my deductible been satisfied? –If you have called a “behavioral health” or “mental health” number on your card, he/she may tell you that you must phone the main insurance company number to obtain this information.
- Does this “deductible year” run from Jan.—Dec.? If not, where am I in the cycle?
- What will be my co-pay?
- How many visits am I allowed per calendar year?
- Is pre-authorization required before I see a therapist? If so, ask your customer service representative for this phone number, as you will need this to pursue authorization.
- Is there a “pre-existing” clause?
- What diagnoses qualifies for reimbursement?
- What types of licenses are accepted (Licensed Marriage & Family Therapist)?