Insurance

New clients need to know a few things before beginning counseling. Intake documents and telephone calls are a part of the preparation. The client must call their insurance company before the first appointment (see “How To Check Your Benefits”). This telephone call will inform the client of their financial responsibility, but it is also becoming a requirement for the insurance companies. Insurance Companies and Employee Assistance Programs are requiring that authorizations be obtained before seeing a counselor. Otherwise, the insurance company or EAP are refusing to pay. Which means you pay for the session.

Clinicians Accept the Following:

Call your insurance company using the 1-800 number listed on your insurance card. Let them know you are inquiring about “outpatient mental health benefits via telehealth or in an office setting.” Often health insurance companies have a separate department, division, or company for mental health (a.k.a. behavioral health or psychotherapy) coverage versus medical health coverage, so be sure to ask about outpatient mental health benefits.
  • Does your policy require pre-authorization to use mental health benefits?
  • Is there a deductible amount to be met on your policy?
  • If yes, how much per individual/family?
  • Is there a limit on the number of sessions?
  • Are there any CPT codes excluded from your policy?

If we are not on your particular plan, we will be an out-of-network provider. To determine what this means for you, the first thing you should do is check with your insurance carrier.

Once you contact a representative, ask the following questions:

  • Do I have out-of-network mental health benefits?
  • How much does my insurance company pay for an out-of-network provider?
  • What is the coverage amount per session?