Having some information available before you call your insurance company will make the process flow more smoothly. Most of the information you need will be on your insurance card and includes:

Your Name (or the client's if other than yourself):
Client's Date of Birth:
Social Security # and/or member ID#:

Employer's Name:
Employer's Group No:

Insured/Employee Name:
Insured/Employee ID #
Insured/Employee SS#

You will want to ask these questions (some may not apply):

Begin by telling them you want to "check my mental health benefits."

What is the Effective Date of my Coverage?
How Much is my Deductible?
How Much of the Deductible have I (or family) met?

What is the Maximum Number of Psychotherapy visits allowed per year?
How many visits have I used so far?

What is the Maximum Amount of Mental Health Benefits paid per year?
How much has been Paid to Date?

Is Dr.Shealy (John Steven Shealy, PhD) a Prefered Provider?
If so, is Pre-Certification Required before we begin therapy?

If pre-cert is required, what's the process for obtaining this authorization? What's my authorization number?

What address (and hopefully electronic filing number) should be used to file these "mental health" claims? (Note: it's not always the address listed on your card and if claims are filed to the wrong address, many companies won't forward to the correct one, thereby holding up your payment for weeks. Not a good thing.)

How much will my Co-Pay be?

If Dr. Shealy is NOT a Prefered Provider, does my plan have Out of Network Benefits for Licensed Psychologists?

What % of fee for services does my policy pay?

What is the Fee Schedule (how much does my policy pay) for the service code 90808 (75 minute sessions)?

With this information, we can explore options to best to utilize your benefits. Give me a call at 813-980-2700 and we'll get started.

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