What to Ask Your Insurance Company

Health insurance can be confusing. When it comes to therapy,  you might need to call you insurance company and find out what is covered. Make sure  you get the answers you need by following this example: (Download this Worksheet)

"My name is ____. I'm interested in going to River City Clinic for help with my mental health and I am calling to verify my benefits. First, I would like some general information."

Policy Effective Date: _______
Office Visit Co Pay: ____
Deductible: ____
Out of Pocket Max: ____
Do my deductibles, co-pays and co-insurance apply toward my out of pocket max? ____
How much of my deductible have I spent this year? ____
Do I need a referral to see a mental health/behavioral health therapist? ____
If yes, who needs to refer me? ____
Is River City Clinic (Clinic Director: Mark Hansen) and/or Heather Holt in-network? ____
If not, how does my insurance work if River City Clinic and Heather Holt is out of network? ____

Individual Therapy
River City Clinic usually uses CPT codes 90834 and 90837 for these services. 
What's my co-pay/co-insurance? ____
Is there a limit on the number of sessions per year? ____
If so, how many individual therapy sessions per year? ____
Is authorization required for individual therapy? ____

Lastly, ask for the representative's name: ____