Whether or not you decide to use insurance for your healthcare may be influenced by your desire or need to maintain privacy. There are several laws in place intended to protect patient’s rights to privacy, including patient records. However, when you choose to use your insurance for payment, the insurance company requires certain information to be released. Some ask only for dates of service, type of service and diagnosis while others may require very detailed reports or even copies of chart notes. Some therapists choose not to take insurance for this reason. At Wellspring Behavioral Health, we allow you to make that choice.
Wellspring Behavioral Health is on several insurance plans and we will work with you to arrange the best approach for using your insurance should you decide to do so. We accept a discounted, direct payment, also called assignment, from some insurance companies and out of network payment for others. Our billing service, Silver Billing, will file a claim for those insurance products accepted. You’re encouraged to secure insurance pre-authorization or approval and/or payment confirmation before making an appointment. Use the insurance confirmation guideline to help you.
We accept assignment from these insurance products:
Insurance Confirmation Guidelines:
When confirming your insurance coverage, you may call our billing service or do this yourself. Call the Customer Service number on the back of your insurance card. Sometimes, there is a specific number for Mental or Behavioral Health.
Tell them you need to “verify outpatient mental health benefits” and document the following information:
- Patient/client name.
- Name and member number of the policyholder.
- Name of the insurance company and/or the name of the company handling mental health benefits.
- Phone number you called.
- The person you talked to on the call.
- Date and time you called
Questions for your Insurance Company:
- Is Wellspring Behavioral Health currently an in-network provider for my plan?
- If not, what are my out-of-network benefits?
- Is pre-authorization necessary?
- If yes, what are the number of sessions approved, the CPT codes covered, the authorization number and the date span?
- In what month does my policy begin?
- Is there a deductible for mental health services and if so, how much has been met so far?
- What is the copayment for each visit? Or, what is the percentage of coverage for each visit?
- What are the restrictions or limitations to my coverage? a) pre-existing conditions; b) dollar amount per year? per lifetime?; c) number of visits per year? number of visits per lifetime?; d) is couples or family therapy covered?; e) is psychological or psychoeducational testing covered? If so, what are the benefits?
- What is the billing address for claims?