Questions to ask your insurance provider regarding your Out-of-Network Benefits.
1.Does my plan cover mental health outpatient visits? 2.Does my plan cover out-of-network providers? 3.How many sessions can I be seen for in one year? 4.How much will my reimbursement be if the therapy session (CPT 90837) is $145? 5.Do I have a deductible I have to satisfy? 6.Do I have to fill out any paperwork or have pre-certification prior to seeing a provider?
Glossary 1.Deductible: Money you pay out-of-pocket before you insurance covers your expenses. 2.Out-of Network: A provider who has no contract agreement with your insurance company. 3.Pre-Certification: A process of pre-approval from your insurance company to activate your mental health benefits. This can be done online at your insurance company’s website or by calling them; this is a yearly process. Your insurance company will send you a letter confirming pre-approval or you may be able to print it from the website immediately. Often times if your company requires pre-certification for mental health services but you do not request pre-certification before your first appointment, you could be responsible for appointment fees. When you make your first appointment to see a provider, the person scheduling the appointment may ask you for your pre-certification number before you meet with the provider.
If you are in crisis, please call the Crisis Connections line at 866-427-4747. If this is a medical emergency call 911 immediately or go to the nearest hospital Emergency Room.