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How To Verify That Your Sessions Will Be Covered By Your Insurance
Things you need to know when verifying your mental health benefits:
- Be sure to ask for "mental health" or "behavioral health"
benefits. They may be different from your medical benefits.
- Most insurance companies do not pay for couple/marriage counseling. Insurance
companies usually do not see couple/marriage problems as medical issues. However,
when there are couple/marriage problems, one or both partner is having depression
and/or anxiety related to having problems in the relationship. Depression and anxiety
are medical issues. So, when you call for benefits, you are going to be asking them
about individual mental health benefits.
- Be sure to tell the person verifying your benefits that you will be seen in an
office. You do not want inpatient or outpatient benefits. These benefits are related
to hospitalization for mental health problems.
- You can find the number to call to verify your benefits on your insurance card.
The right number to call will be designated as "customer service",
"benefits", "eligibility", etc. Do not call a pre-certification
number. If your card has a specific number for "mental health" or
"behavioral health," call that number.
- Is the therapist you will be seeing an in-network provider or an out-of-network
provider on your insurance. If you do not know, just call us and we will provide
you with that information.
- You will be paying your fee for each session at the time of service. We can give
you a receipt that you can send to your insurance company for reimbursement, or if
you would like, we will file your claims for you. If we file, you will be reimbursed
faster because the claims are filed electronically.
Information you need to provide to the person verifying your mental health benefits:
- Your name, date of birth, address, and phone number
- If you are not the insured and are a dependent on the policy, you will be asked for the
insured’s name, date of birth, address, and phone number
- Your ID number. You can find this on your insurance card. If you do not know the
number, give them the insured’s social security number.
Questions to ask the person verifying your mental health benefits:
- What is your mental/behavioral heath deductible? The deductible may be different
for in-network and out-of-network benefits.
- Has your deductible been satisfied? If you have called a "mental health"
or "behavioral health" number from your card, they may tell you that you
have to call the main insurance company for this information.
- Does the deductible year run from Jan. to Dec.? If not, what is the deductible year?
- Will you be paying a co-pay, or a percent of the therapy fee? What is this co-pay/percent?
- How many visits do you get per year?
- Do you need to pre-certify the sessions? If so, find out the number to call.
- Is there a "pre-existing" clause?
- What is the electronic claim number and claims address? We will need this if you want
us to file your claims. You will need the address if you are going to be mailing in
receipts from the sessions.
- What is the name of the person who is giving you this information? Make a note of
the date and time you called to get your insurance information. If you had a dispute
with the insurance company, this would be good information to have.
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