INSURANCE VERIFICATION FAQS
Q: “But I have insurance and I should only owe a copay.”
A: When the claim is returned and if it is determined by your insurance provider that you only owe a copay, then all overcollections will be refunded.
Q: “I can’t afford the retainer rate; I was told I could use insurance and only pay my copay.”
A: If you can provide written verification from insurance provider that your insurance plan is active, that your policy includes mental health coverage, and that your patient responsibility rate is lower than the deposit rate, then we will honor and accept the lower rate.
Q: How can I provide written insurance verification from my insurance provider?
A: 1. Call your insurance provider.
Contact your insurance company using the 1-800 number listed on your insurance card. Let them know you are inquiring about outpatient mental health benefits. Often, health insurance companies have a separate company for mental health benefits.
2. Is your therapist in network?
Determine whether the preferred therapist is an in-network or out-of-network provider for your mental health benefits. For a list of insurance providers with whom we are affiliated, please click here.
3. Ask about your coverage & benefit details.
It is important to ask about the following when calling your insurance provider:
- Number of visits allowed in a calendar year or in the lifetime of the policy
- Authorization Number (if required before your first visit)
- Mental health claims address
- Payer ID for your insurance provider.
- Check each of these benefits for an in-network provider and an out-of-network provider.
4. Obtain written verification from your insurance provider of the coverage & Benefit details.
Be sure to request a written copy of the coverage & benefit details discussed with your insurance provider. We will only be able to honor the information you provide us with if we have written documentation of the benefits on file. You should also obtain a reference number for the call with your insurance provider in case insurance processes your claims differently from the information they provided you with during the call.
5. Schedule appointment with The Center.
EMAIL our billing department to inform us of your plan’s specific insurance coverage & benefit details, as discussed during the call with your insurance, and attach a copy of the written documentation from your insurance provider. This information will be uploaded to your file, and we will honor the information provided until otherwise stated by the insurance provider upon claims processing.
Q: Why can’t you provide me with my copay information?
A: Our automated system notifies us if your insurance is active, however it will not provide specific coverage & benefit detail information.