Insurance Tips for New Patients

by Joel Campnell, Billing Specialist

Beyond the important clinical considerations for finding a new mental health provider, don’t let the insurance aspects fall by the wayside. Unexpected costs arising from insurance confusion can be a significant source of stress. To help reduce your risk of these, follow these tips before scheduling your first appointment:

1. Call your insurance to verify your benefits and the provider’s network status.

Many insurance plans will utilize provider networks and encourage members to seek in-network providers. Seeing an in-network provider will in most cases reduce your out-of-pocket cost as a patient. Additionally, understanding your plan’s benefits beforehand will help you estimate potential costs for services. Knowing whether or not a copay will apply or if you need to meet a deductible first is a powerful first step towards making informed choices regarding the cost of your healthcare.   

 2. Verify with the clinic/provider to make sure they accept your insurance.

I know this part seems unnecessary from the first tip, but there are several scenarios that make it important. Sometimes providers might work at two different locations, but will only be contracted at one of them. Other times a provider may have just terminated their contract and the insurance has not updated their network status just yet. Don’t be blindsided! After you get an idea from your insurance which providers might be in network for you, always verify it with the provider’s office directly.

 3. If you are looking to pay for services out of pocket, verify the fees.

If you are not insured or don’t want to bill your insurance, be sure you have a clear understanding of how much each session will cost and when that payment is due. If you want to learn about our self-pay policy, check out the Policies page on our website.  http://www.madisonpsychiatricassociates.com/policies

For current rates at MPA, contact us in the billing department at 608-274-4273.