Cheat Sheet for Inquiring About Your Insurance Benefits

No one likes surprises, especially when it comes to insurance and medical costs. To help avoid unexpected expenses, we recommend that new clients contact their insurance company to confirm their benefits BEFORE beginning services. This cheat sheet will help prepare you for that call.

Empower Family Therapy is in-network with the following insurance plans:

  • BCBS Illinois PPO plans

  • Aetna

  • Cigna

  • Curative

  • United Healthcare

For In-Network Coverage

  1. Call the number on the back of your insurance card. Some insurance companies have a specific number for mental health benefits.

  2. Tell the representative that you would like to confirm that Empower Family Therapy is an in-network provider for your insurance plan. For your reference, our group NPI number is 1538700273.

  3. Confirm that your insurance plan covers mental health benefits as well as medical benefits. Ask if you have a carve-out or if your plan requires pre-authorization.

  4. Some insurance plans have a carve-out, which means they contract out mental health coverage to another company that we may not be in-network with. You may not know if you have a carve-out unless you ask. Other plans require pre-authorization, meaning your benefits may not be used until you complete the authorization process. Most plans do not allow backdating, so it is important to know these requirements ahead of time.

  5. Ask the representative to confirm that the most common billing codes are covered: 90791, 90837, 90847, 90846, 90832, and 90834. Confirm that these codes are covered for both in-office and virtual sessions.

  6. Ask if you have a deductible that must be met before insurance covers the cost of sessions. Have you met your deductible? Once you meet it, what will your out-of-pocket cost be?

  7. Ask if you have a copay and whether it applies to both in-office and virtual sessions.

For Out-of-Network Coverage

If you have an insurance plan that we are not in-network with, Empower Family Therapy provides clients with the necessary documentation to seek reimbursement from their insurance company.

Clients can call the number on the back of their insurance card to inquire about their out-of-network benefits and the submission and reimbursement process.

We gladly provide clients with a superbill (a receipt for paid therapy services) that they can submit to their insurance companies for reimbursement. Most of our clients who use out-of-network benefits prefer to batch their submissions and submit claims monthly or quarterly rather than weekly to reduce paperwork.

Please provide this information to your therapist or intake coordinator when discussing the use of insurance benefits.

Empower Family Therapy is unable to submit claims directly to insurance plans with which we are not in-network.

Clients are responsible for the cost of services rendered.