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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