Not all BCBS PPO policies cover behavioral health treatment, as these services may be outsourced to another provider (i.e. United Behavioral Health, Magellan, Compsych, etc.). Outsourced providers are considered out-of-network, and you will have to submit for insurance reimbursement. Find out which licensures your insurance accepts for reimbursement. Not all of our therapists are included in all plans. Please check with BCBS before your first session.
If Medicare is your primary insurance carrier, you will need to see a therapist who accepts Medicare. Billing must charge Medicare before any secondary insurance companies (if your insurance ID begins with XOS or XOT, it is considered secondary insurance).
Check with your insurance provider about coverage before your initial session, as you are financially responsible for anything that is not covered.
Your best source of information regarding your insurance and behavioral health benefits is best obtained directly from Member Services. Contact information is usually on the back of your insurance card. If you have learned something new or different about your benefits, please contact our billing team at 847-733-4300 so we can update your account.
- Are mental health benefits covered under my plan?
- Does your company manage my family's mental health benefits or is another company "subcontracted" or "carved out" to manage my mental health benefits?
- Do I need pre-approval from my insurance company before I can see a mental health professional?
- Do I need a referral from my primary care physician to see a mental health professional?
- Do I have a deductible for services?
- Are there co-payments for services?
- Can I only see providers on the list provided by my insurance (in-network) or can I choose to see any qualified professional (out-of-network)?
- If services are covered for providers who are out-of-network, are those services covered differently than services provided by in-network providers?
- Are there visit limits, dollar limits or other coverage limits for my mental health benefits?
Behavioral health benefits are different than those you use to see your primary care doctor or have lab tests. If your insurance does require a referral, the number of sessions will be included in the referral and we will enter this information into your file. Please keep track of this since if you and your therapist determine some additional sessions are needed, you will need to request another referral to cover them.
To have your claims submitted electronically, please fill out the Request for Electronic Claim Submission form, and bring it to your first session. Federal privacy healthcare laws prohibit your employer from obtaining any information about your participation in therapy without your written consent.
We request 24-hour notice for a cancellation in order to help another client get an appointment. No-shows and less than 24-hour notice may result in a full-fee charge, not covered by insurance. You are responsible for calling your therapist to cancel. It is solely up to the therapist to agree to a no-fee no-show or cancellation less than 24 hours before an appointment.
Please note that 5 business days' notice is required to cancel an appointment for neuropsychological assessment. If 5 days’ notice is not given or you miss a neuropsychological assessment appointment, you will be charged $330.
Please refer to the appropriate service agreement for more information: Staff Practice or Clinic Practice (sliding fee scale). Contact our Billing Department at 847-733-4300 with any additional questions.
After you meet with your therapist, he or she will determine the course of your care. The number of appointments you need is challenging to predict at the outset of therapy, but you and your therapist will talk about this together because you have a voice in determining the number of sessions.
The amount you must pay before your health insurance company starts to pay for care, for example, $500 per individual or $1,500 per family. In most cases, a new deductible must be satisfied each calendar year.
A fixed dollar amount designated by your insurance company that is your responsibility to pay at each visit (also known as "co-pay"). Common co-payment rates are $10 or $20 per visit, but be aware that copayment rates vary from insurance plan to insurance plan. Co-insurance – The part of your bill, in addition to a co-pay, that you must pay.
Co-insurance is usually a percentage of the total bill, for example, 20%.
The therapist has a contract with the health insurance company to provide you with care and will submit your bill directly to the health insurance company for payment. However, you may be responsible for a copayment, deductible and/or co-insurance according to your health insurance company benefit plan.
Costs for therapy that your health insurance company does not pay. We recommend that you contact your insurance company prior to treatment to determine if your care is covered by your health insurance policy.
The therapist is not contracted with the health insurance company to provide you with treatment. You are responsible for the payment of the care.