Shellie Fidell, MSW, LCSW,LLC

Questions for Insurance

What questions should I ask my insurance company?

Call the number on the back of your insurance card for the Benefits Department. Write down every answer you receive. Don't be intimidated. Ask for explanations of anything you don't understand. Ask to speak to a supervisor if you are not happy with the answers you are getting. You'll need careful records later if the company fails to follow through with what they've told you.

1) What is your name and extension number?__________________________________________

2) Does my policy cover Out-of-Network, Licensed Clinical Social Workers? ___yes ___no

3) My therapist is willing to provide a statement of Session Dates Attended, the CPT code, and the Diagnosis. Is this acceptable to the insurance company? ___yes ___no

4) Does my policy cover Individual Psychotherapy? (CPT code 90834) ___yes ___no

5) What mental health Diagnoses are NOT reimbursable? _______________________________

6) How many Sessions are covered per year? _______

7) What is the Lifetime Maximum for mental health benefits? $_____________

8) What is my Out-of-Network Deductible? $_________

9) What is the Allowed Amount of the fee?

a. Individual session ( CPT code is 90834): $______

10) What percent of the Allowed Amount will be reimbursed? _______%

11) How do I file a claim?____________________________________________________________

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