Using Blue Cross Blue Shield PPO
Prior to initial session, please call the number on the back of your insurance card and ask the following questions:
- Does my plan cover mental health services?
- Is mental health covered through BCBS or is it subcontracted out?
**If you are told that your mental health coverage is managed by another provider this means that I am an “Out of Network Provider.” Please see this page for additional information.**
- What is the amount of my deductible?
- How much remains to meet my deductible for the year? When does it reset?
- What is my co-pay amount? Am I responsible for co-insurance?
- Is pre-authorization needed for mental health services (specifically, for initial evaluation and individual therapy)?
- Is there a yearly session limit?
Using your BCBS benefits with me:
- If you have a deductible that you have not yet met for your plan year, you will be required to pay the full fee until you meet it. I will submit a claim at least monthly to BCBS. They will process the claim and inform me of the status of your deductible, confirmation of your co-pay, and make payment if appropriate.
- You will receive an “Explanation of Benefits” (EOB) from BCBS each time I submit a claim
- Once your deductible has been met, your co-pay will be collected on each visit.
- If you remain in treatment until the time that your deductible resets (usually January 1 of each year), you will again need to satisfy your deductible in order to use your insurance benefits.
- If you are billed for a missed session (session missed or cancelled within 24 hours of appointment), a claim will not be submitted to your insurance as insurance does not pay for missed sessions. You will be personally responsible for the full fee.