We Are Not Providers For Blue Cross Silver Pathways (The Obamacare Health Insurance Exchange)
When you are using health insurance for mental health treatment, there are several important considerations. First, mental health treatments are usually handled differently than your general medical insurance benefits. You may have different copays or not even be covered at all.
All providers are individually credentialed so just because one person at this facility may be on your plan, another may not be. You must check with the company and provider before your visit.
Also, mental health benefits may be handled by a different company than your medical benefits. So for example, if Blue Cross is your medical insurance, you could have another company like Magellan handle the mental health payments.
Usually, you must initially call the insurance company to “open your case.” We often cannot do that. After you start seeing someone, we can get future authorizations for visits (unless you change insurers). We ask also that you call your insurance to verify benefits, deductibles etc so there is no confusion about what the benefits are, and if your insurer is misinformed, you are in a better position to tell them or discuss it with your insurance agent or human resource department.
Keep in mind you do lose some confidentiality rights when you use insurance since they have access to diagnosis and treatment. As a result some people choose to pay out of pocket if that is an option.
Ultimately, you are responsible if your insurer will not pay for the services but we are more than willing to do whatever is possible on our end to make sure they do.
We share your frustration with using insurance. Many mental health providers do not take insurance as a result of these administrative burdens and reduced fees from the insurance companies but have a commitment to be available to as many people as possible in the community.