What We Need IF You Use Your Insurance or EAP Benefit

Please read these instructions CAREFULLY and provide ALL the information requested so we can verify your benefits, get authorization for you, and process your claims successfully for BOTH your insurance AND EAP benefits. This information MUST BE PROVIDED BEFORE your first visit. Please consult with Jacqueline BEFORE asking your employer for one.

1. IF you CAN take a picture or make a photocopy of the front and back of your health insurance card:
a. Photocopy or take pictures of the front and back of your health insurance card,
b. Send them to us as attachments to an email,
c. In that email, indicate your name as it is known by your insurance company, and:
d. Your date of birth, and:
e. Your mailing address, email address, and phone number(s) and:
f. If you are not the subscriber, the name, address, and date of birth of the primary subscriber and their relationship to you.

2. If you CANNOT take a picture or make a photocopy of the front and back of your health insurance card:
a. Please send us an email with the name of the insurance company, THE I.D. NUMBER OF YOUR POLICY - including any letters as well as numbers, and the Group Number if any,
b. Your name as it is known by your insurance companyand:
c. Your date of birthand:
d. Your mailing addressemail address, and phone number(s) and:
e. If you are not the subscriber, the name, address, and date of birth of the primary subscriber and their relationship to youand:
f. All the insurance company phone numbers shown on the card, usually on the back.

When we communicate with you about your benefits we will ask you about the days and times you will be available to meet with us as well as what behavioral health needs you may have at the time.

3. When you send this to us we will confirm by email or text message that we have received it. At that time we will indicate whether we are having a problem with the verification of your eligibility and benefits. The quickest way to communicate with us is by email or text message. Please let us know if we can do both. At this time our preference is to communicate with you by text because it’s the most efficient, the easiest way that can be done in between client appointments, especially to acknowledge that we’ve received this information. If you need a phone call, please indicate the times that you can receive calls. We’ll do our best to call you at one of your indicated times.

4. We will either send you a confirmation text, email, voicemail message, or phone call when your coverage is verified. Based on the verification of benefits with your insurance carrier we will be able to inform you of the dollar amount of the co-payment that is required at the session and whether there is a deductible that needs to be applied. Also, we will address any other notable information about your coverage such as how many sessions you have been approved for. You should review the communication and accompanying information we will be sending in their entirety because there will be material in there on HOW TO ENTER THE BUILDING AND WHAT TO BRING ALONG WITH YOU.

5. One of the forms in the packet we send you is the Medication and Hospitalization form. If you are taking any medication, we need the name of each medication, the dosage, how often you are supposed to take it, and the prescriber’s name and phone number. Even if it’s an over-the-counter medication some carriers require us to provide this information. Under the Affordable Care Act we have to introduce ourselves to your primary care physician, so please make sure you complete the Medication/Hospitalization form in the packet with the name, address, phone and fax of your PCP.

6. We would like you to read your insurance company’s benefits handbook so you have an understanding of the policies, processes, and procedures for your behavioral health coverage. Many insurance companies have specific procedures on how to obtain outpatient treatment, group treatment, and partial hospitalization programs, so we encourage you to become familiar with your benefits handbook.

7. Please read the directions and the entire packet that we will be sending you. Your insurance carrier requires that we obtain certain information to be able to provide you with a diagnosis and to develop a treatment plan. Therefore we are requesting that you fill out all of the forms that are included in the packet by your first session. The information obtained from these forms will be helpful in developing the diagnosis that we will be providing for you, and the diagnosis will provide the framework for your personalized treatment plan. So you’re highly encouraged to come to your first session with your paperwork completed, including any questions that you might have.

. There are a few additional things that we think might be helpful as you start this process of obtaining behavioral health services. We’d especially like you to become familiar with the concept of “medical necessity,” because that is what behavioral health treatment covered by insurance is based on. You should be able to find an explanation of the concept of medical necessity in the behavioral health section of your benefits booklet. During our initial session, we won’t go in-depth into this concept, but we will make reference to it. We think it would be helpful for you to have a reference point, so that’s why we encourage you to review that part of your benefits booklet.

9. If there is a payment or co-payment required for each visit, your payment or co-payment is due on the day of service, which is customary for the medical and legal professions. Please be prepared to have your payment ready for each scheduled session. And, as a reminder, please keep your PayPal receipt for your personal records as documentation of your visit and payment.

10. IF you are using an Employee Assistance Program (EAP) benefit provided by your employer, you need to provide us with:

(1) The EAP authorization number for your particular participation,

(2) The number of sessions authorized,

(3) The time frame the sessions must fall within,

(4) The phone number(s) of the EAP program administrator so we can verify the authorization,

(5) Your social security number, or, if you are not the primary subscriber, the social security number of whoever is the actual employee, who would be the primary subscriber -- because that is usually needed for EAP claims to be paid.
We look forward to servicing you with your behavioral health needs and providing you with a pleasant and helpful experience.

Therapist Jacqueline McLean, MSW, LICSW 508-579-1575

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