Insurance / Billing

 

Charges for our Education and Counseling Center (ECC) providers are handled differently than medical visits under most health insurance plans. Some insurance companies may not cover mental health services or may have in-network/out-of-network coverage. Prior to your child’s first appointment, we will contact your insurance company to verify eligibility and obtain mental health benefits. Some insurances require an authorization to see ECC providers. We will obtain this authorization if it is needed.

Our mental health providers do not participate with all insurance plans.

Matt Benin, Licensed Professional Counselor, participates with Anthem, most BC/BS policies, Optima Behavioral Health, and Valley Health Plan (VHP), Tricare, and Value Options.

Kathryn Litten, Licensed School Psychologist, participates with Anthem, and most BC/BS policies.

If we participate with your insurance, we will file a claim for your visit.

If we do not participate with your insurance, we are considered an out-of-network provider, Out-of-network benefits will apply meaning you may have a higher co-pay, deductible or co-insurance for your visit. If we do not participate with your insurance company, we DO NOT file your claims. If you wish to file the claim yourself, please ask for a copy of the bill and submit the claim to your insurance company for reimbursement.

ALL co-pays, deductibles, and/or co-insurance amounts are due at the time of service regardless of whether we participate with your insurance. If you have no mental health benefits, payment in full will be needed before your child can be seen. We do make an exception to this policy if your child is undergoing an ADHD evaluation or having testing performed by Kathryn Litten.

If at any time your insurance coverage changes, please notify us BEFORE your appointment so we may contact your insurance company. Failure to do so may delay or require us to cancel your appointment.

If we refer your child to a mental health provider or counselor in the community, it is your responsibility to contact your insurance company for benefit information and authorization. Mental health can be a sensitive issue. Privacy requirements do not allow our practice to request an authorization for your child to see a provider/counselor outside of our office.

We encourage you to contact your insurance company to learn what mental health benefits your plan offers. You may also contact our insurance department if you have any questions or concerns. We look forward to caring for your child!