I am in-network with:
- Medicare
- Carolina Behavioral Health Alliance, CBHA (sometimes this is Medcost)
- Blue Cross Blue Shield
- Blue Options
- Blue Advantage
- Blue Select
- Blue Options State Plan (North Carolina SmartChoice PPO Plan)
- PPO Blue Card (not PPO Medicare BCBS)
- Blue Assurance
- Classic Blue
Of note, Magellan is not BCBS, it is the contracted- out mental health of BCBS; I am out of network with Magellan.
Before your scheduled appointment, you must call the customer service number on the back of your card and ask the following questions. Everyone’s policy is different, even within the same insurance company. It is your responsibility to know and understand your coverage, as you are responsible for the bill you incure. With the recent changes in health care law, it is particularly important to understand your coverage.
For in-network:
- How much is my deductible?
- When does my deductible renew?
- Do my medical and mental health copays go towards the same deductible?
- Is my mental health coverage the same company as my insurance card, or do you contract out the coverage? (very important question–especially HMO’s and Medicare)
- How much would I owe for an outpatient mental health, office visit with a PhD?
- Do I need an authorization number or pre-approval?
- How many visits do I have per year?
For out-of-network:
- What would I owe for an in-network provider? What would I owe for an out-of-network provider? (it is helpful to ask, because sometimes the difference is minimal).
- If you plan on submitting a claim, you would pay for your session up front and I would provide you with a superbill that you would submit to your company. They would reimburse you directly. The promptness of payment depends on your insurance company.