INSURANCE ISSUES

If you are using insurance, please read all of this. We know it's complicated, but it's all part of the deal when you want your insurance company to pay for mental health services. This information probably does apply to your insurance company, but it may not. To verify this and more information, PLEASE CALL YOUR INSURANCE PROVIDER prior to scheduling an appointment. Here are some FAQ's. If these do not answer your questions, call us at (513) 831-9408

WHAT IS AN AUTHORIZATION AND DO I NEED ONE?

WHAT IS A DEDUCTIBLE?

WHAT IS A COPAY?

WHICH SERVICES DOESN'T INSURANCE COVER?

ARE THERE BENEFITS TO NOT USING MY INSURANCE?

WHAT INSURANCE SERVICES DO YOU TAKE?

WHAT INSURANCE DON'T YOU TAKE?


WHAT IS AN AUTHORIZATION AND DO I NEED ONE?
Insurance does cover most of the services our office provides and we provide insurance billing as a courtesy for our clients, but there are several issues you should be aware of when using your insurance. The first issue is that most insurance companies require an AUTHORIZATION before you can see a therapist. To find out if you need an authorization, call your insurance company. To make things more interesting, several insurance companies contract out (outsource) their mental health payors. If this is the case with your insurance there should be a separate number for mental health treatment on your insurance cards. Humana, Choice Care and Anthem contract outside payors for their mental health coverage.

WHAT IS A DEDUCTIBLE?
Some insurance plans have what's called a DEDUCTIBLE. What this means is that you have to pay a certain amount of money before your insurance plan will kick in. For example, if you have a $100 deductible, you'll have to pay your health care specialist the first $100 billed before your insurance will pay anything.

WHAT IS A COPAY?
Most insurance plans also have COPAYS. This is what your insurance will expect you to pay along with what they will pay. This can be anywhere from $5 to $50 depending on your plan.

WHICH SERVICES DOESN'T INSURANCE COVER?
Hypnotherapy for weight loss or smoking; Marital therapy; and in some cases psychological evaluations for the gastric bypass surgery. We do not bill insurance companies for HOME BASED THERAPY. This service is considered SELF PAY.

ARE THERE BENEFITS TO NOT USING MY INSURANCE?
If you are using insurance, your insurance company will have the right to know a diagnosis and a treatment plan. On rare occasions, insurance companies will conduct chart audits, meaning they will have access to the information within the chart.
These are some of the insurance policies whose plans we are a part of. (If you do not see your plan here, call them to ask).

If you intend to pay without using insurance, you will have some added confidentiality as there will be no other party that will have a right to the information within your chart without your written permission. Additionally, you do not have to worry about being diagnosed with a mental illness that your insurance company may or may not reimburse. In other words, you'll save yourself and us a lot of paperwork.

WHAT INSURANCE SERVICES DO YOU TAKE?
Insurance company names and plans are ever changing. To find out if we accept your insurance, please call us at 513-831-9408 or check with your insurance plan.

Remember to bring your insurance card with you for each appointment and please make us aware if your insurance situation changes.

We do not take any form of Medicaid and we DO NOT TAKE INSURANCE FOR ADHD EVALUATIONS.

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