BENEFITS GUIDE

Mental or behavioral health benefits are often sub-contracted by major medical policies, so what you pay to see a medical doctor may be different than what you will pay to see a psychologist or counselor. If you are unsure what your mental health benefits are, call the number on the back of your insurance card and ask. Your insurer will tell you that the benefits they give you over the phone are not a guarantee of payment. Occasionally, they pay differently than what they tell their customers on the phone. The following tips will help you get the most accurate information possible:

  1. When calling, you will need your insurance card for reference as well as the provider’s name and address which is Psychological Healthcare of South LA, 126 Rue Colette, Thibodaux, LA, 70301.  Our phone number is 985-625-0023.

  2. Ask for Outpatient mental or behavioral health benefits in an office setting for a Psychologist (NOT a psychiatrist) or Licensed Professional Counselor (LPC).

  3. You will be asked to provide a diagnosis or general reason for your visit. (If you do not yet have a diagnosis, tell the representative that and give a one-two word possibility, such as depression, ADHD, anxiety, possible autism, etc.).

  4. More than likely you will be given a “general quote of benefits”. The following are important:

    • Do you have mental health coverage?

    • Is there a deductible? Individual/family? How much? How much has been met?

    • Once deductible is met or if there is no deductible, is there a $ copay or coinsurance %? How much/percent?

    • What is the maximum out of pocket amount? How much has been met? Usually you are covered at 100% once this is met. Verify that.

    • Are there any exclusions? E.g., most policies exclude educational testing.

    • Is it the same for psychological testing (if this is what you are seeking)? Please note that most testing (psych, neuro, autism) falls under the policy deductible even if office visits have only a copay. 

    • Is prior authorization needed for office visits or testing?

  5. Ask for a reference number in case you need it to call back or once claims are made and you have further questions.

Note: Please understand that a quote is NOT A GUARANTEE of payment. You are ultimately responsible for the portion your insurance does not cover.

Visit

126 Rue Colette

Thibodaux, LA 70301

Call

T: 985.625.0023

F: 985.625.0022

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© 2014 by Psychological Health Care of South Louisiana