Navigating the World of Insurance

Insurance benefits can be confusing! Here is some helpful information about utilizing your insurance benefits at Lake Norman Family Therapy.  Hopefully this will allow you to easily navigate your insurance benefits as they pertain to services rendered in our office.

The most common question I receive is “How much will a visit cost?”  Unfortunately, when utilizing your insurance benefits, I cannot provide an easy answer.  Your out-of-pocket cost will be based on your mental health benefits.

In network versus Out of network:

As of January 1, 2020 Lake Norman Family Therapy is in-network with BlueCross Blue Shield PPO*, NC State Health Plan, traditional Medicare, and Blue Medicare HMO (Blue Care HMO) supplemental plans.  We are out-of-network with all other insurance plans, including BlueCross BlueShield Blue Value and Blue Local and Medicare replacement policies.  We will file claims to all insurance companies, except Medicaid, and accept reimbursement directly**.  We are unable to file claims to Medicaid.

Prior to your appointment, please verify your mental health insurance benefits:

Your insurance company can provide you with benefits specific to services provided at Lake Norman Family Therapy.  Benefits for a mental health office visit will apply to initial evaluations and therapy sessions.  Benefits for psychological testing will apply to psychological evaluations.  You can call the customer service number on your insurance card to verify your benefits using the following script:

“I’d like to verify my benefits for a mental health office visit with an in-network provider (or out-of-network provider if your insurance is anything other than BlueCross Blue Shield PPO, NC State Health Plan, or traditional Medicare).”

If applicable, you should also verify your benefits for psychological testing (CPT codes 96130, 96131, 96136, and 96137).  Insurance may request the name of the specific provider with whom you are scheduled.

Using your insurance coverage at LNFT:

Please bring your insurance card to your first appointment.  If you experience a change of insurance during treatment, please present a copy of your new insurance card as soon as possible.

Finally, you may always reach me directly with any insurance questions at 704-892-9490 x110.

 

* To determine if your BlueCross BlueShield policy is a PPO product look for a suitcase on the front, bottom right of your insurance card.  If you see the letters PPO inside the suitcase your in-network benefits should apply to services rendered in our office.

**We do not accept assignment for Tricare payments and all reimbursement will be payable directly to the member.  BlueCross BlueShield does not issue payments to out-of-network providers and all Blue Value or Blue Local reimbursements will be payable directly to the member.