PLEASE NOTE: THIS NOTICE DOES NOT APPLY TO MEDICARE, MEDICARE ADVANTAGE, OR MEDICAID BASED PATIENTS
Posted 08.01.2024
Our office has been seeing a new trend with insurance plans, in regards to mental health coverage. Should you have a mental health condition, such as depression, anxiety, ADHD, or any other such condition, please contact your insurance company to verify your mental health coverage.
There are some plans which only pay for mental health coverage if your visits are through a Psychologist or Psychiatrist's office. Claims from our office are not paid in these circumstances and payment would the responsibility of you, the patient.
Some plans have done away with mental health coverage entirely. In these instances, should you elect to continue to seek treatment for mental health services with our office, you would be required to remit payment in full for services rendered, at the time of service.
Other plans offer mental health coverage, yet charge a separate copay for mental health services as compared to any other office visit type. For example, a copay which is typically $25.00 may be $50.00 for a mental health visit.
Please contact your insurance company directly to ask about your coverage needs as they relate to mental health visits and notify our office. Our office is not responsible for contacting individual patient insurances, to make these determinations.
We participate with most major health insurance plans. However, it is not possible for us to keep up with each new plan that comes on the market. Additionally, major health insurance companies have many different plan options, some with "limited" provider networks. Therefore, we encourage you to check with your insurance carrier to verify the in-network status of your particular plan with our office.
Patients who have insurance coverage through their employers may check their eligibility and benefits through the insurance website listed on their insurance card.
Patients who purchase insurance through the government marketplace may use the below link to explore plans that our office participates with, currently:
https://www.healthcare.gov/see-plans/#/
We are NOT in-network for Blue Local, Ambetter, Aetna CVS and Blue “High Performance” Network (HPN). These plans are affiliated with Atrium Health. We are also NOT in-network for Blue Home with Novant Health, GHI (Emblem Health) and Carolina Complete Health Tailored Plans.
The NC Medicaid managed care plans we participate with are Healthy Blue, WellCare and Carolina Complete Health Standard Plans.
Most insurance companies cover preventative care at 100%. Preventative care typically consists of a vitals check, discussion and completion of health screenings you may be due for - these services are offered during your annual wellness exam.
Preventative care does not include discussions concerning pre-existing health conditions, new health conditions, or medication changes.
For this reason, you may be charged for an office visit in addition to your annual wellness exam. You will be responsible for any applicable copays, deductibles, or coinsurance related to the office visit.
For your convenience, our office partners with LabCorp and offers an onsite lab technician. Completed lab draws are processed and billed by LabCorp to your insurance company. LabCorp will bill you, the patient, for any remaining balance not covered by your insurance carrier.
Questions regarding an outstanding lab bill should be directed to LabCorp at (800) 845-6167, option 1.
Questions regarding insurance coverage or in-network lab services should be directed to your insurance carrier. This information may be found on the back of your insurance card, under Member Services.