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Information
about Insurance Companies and benefits:
Please
note: There are hundreds of plans offered by the major
insurance companies and their mental health benefits vary. In order to
obtain the most accurate information, call the telephone number listed
on the back of your insurance card for “Mental Health
Benefits”. Most managed care plans suggest that you receive
your care from a list of pre-approved providers and they offer the best
coverage for these.
Many also
offer options for “out-of –network” benefits that you may
utilize. This information can be provided to you when you
call customer service.
Some of the
questions you might want to ask:
Is
pre-authorization or pre-certification required? (sometimes the first
session does not require pre-authorization, but is required
for ongoing care to be approved.)
Is there a
limit to the # of sessions covered per year. (do they use the calendar
year or from the date of first service)
Are there
out-of-network benefits ?
§ Is there a
deductible to be met?
§ What is the
coverage after the deductible? Is there a co-pay or
co-insurance ?
If you choose
to use “out-of- network” benefits you will pay the therapist out of
pocket and receive a bill/receipt for the services rendered.
This bill is sent by you to the insurance company and they send the
payment for reimbursement directly to you. If you are
choosing this option, be sure to get the address where you are to send
the bill/receipt.
I
am currently a provider for Medicare, 1199 National Benefit Fund,
Health Care
Payer Coalations of New Jersey, MHN, TriCare,
Horizon Blue Cross/Blue Shield of
New Jersey(Not including
managed care plans).
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