Insurance Coverage
CONFIRMING COVERAGE for MENTAL HEALTH COUNSELING
To determine if your insurance will cover your counseling:
1. Look up the information in your insurance benefits manual/website.
OR
2. Call the company directly to ask them. The phone number will be on your insurance card, usually on the back.
Mental health services are sometimes covered at a different rate than medical services. Rates also differ for Outpatient (seen in an office like RCA) and Inpatient (admitted to a hospital program).
If your insurance plan is an HMO you can only see therapists on their network list. They will not cover therapists outside of their network.
If your insurance plan is a PPO you can see therapists who are not on their network list, but coverage will be at a lower rate.
You will want to record the following information in case you have trouble getting reimbursement in the future:
Name of Insurance Customer Rep you spoke to _______________________
Date & time of call ______________
Deductible for Policy $________
(amount of bills you must pay before your insurance provides coverage).
Amount insurance will pay each visit for mental health services $______
Maximum visits allowed per calendar year for mental health services _____
Maximum paid per calendar year for mental health services $_______
Ask if they cover the DSM diagnosis code of _______________
(You may have received a preliminary dx code from your therapist).
Ask the insurance company to send you their claim form or print it yourself from their website. Get the mailing address since you will be submitting this claim form to the insurance company.
Claim form - fill out the patient information. Attach the RCA superbills to the middle portion. RCA gives you a superbill at each session when you pay for the counseling. You attach 4 or 5 superbills to the claim form and mail it to the insurance company.
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