Questions to ask your insurance company

I am currently paneled with CareFirst Blue Cross Blue Shield. However, because every health insurance plan is different, you will need to call the benefits hotline number on the back of your insurance card to ask about your specific coverage details. These are the questions that I would suggest asking:

  • Do I have in-network mental health benefits?
  • Is Doug Girard considered an in-network provider?
  • Is pre-authorization required for treatment with Dr. Girard? If so, what documentation is necessary?
  • Do I need to meet a deductible each year before I can begin to receive reimbursement for sessions? If so, what is my annual deductible amount? And what amount is currently left for me to pay this year?
  • How much will I be reimbursed for the following services:
    • CPT Code 90791 (Initial intake) at a fee of $200?
    • CPT Code 90837 (Individual psychotherapy session) at a fee of $150?
  • Am I required to give a copay to the provider at the time of session? If so, what is the copay amount?
  • Do I have a session limit for psychotherapy?

 

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