If you are unable to access your portal, please download and complete the forms below and email it to email@example.com before your appointment.
Concerning Mental Health Benefits
*Do I have behavioral/mental health coverage?
*How many outpatient psychotherapy sessions am I allotted in my plan?
*Are there any limitations, requirements, or restrictions in accessing my plan?
Additional questions for more detail:
Do I need a referral from my Primary Care Physician?
Do I need to have pre-authorization from my insurance company?
Is my therapist in your network? If not, what are my out-of-network benefits?
Am I authorized to see only a particular kind of therapist? (psychiatrist, psychologist, licensed mental health counselor, licensed marriage and family therapist, licensed clinical social worker, etc.)?
What is the effective date of my insurance coverage?
Am I limited to a dollar amount per year ($500, $250 etc.) that will be covered?
What is the amount of my deductible, co-pay, and co-insurance amounts after insurance adjustment is applied?