Counseling in Chicago with Bill Martin, LCSW

If you have a PPO with any major insurance carrier, you will likely receive some reimbursement for the psychotherapy services I provide.

However, many years ago, I resigned from all mental health panels, so I am now considered an out of network provider. Therefore, it is very important for you to contact your insurance company if you are concerned about reimbursement.
Here are questions to help you when you call the customer service dept of your insurance company:

       1) Is there any managed care pre-certification needed?

2) Is William Martin, MSW, Licensed Clinical Social Worker (LCSW) an approved provider?

3) What is the calendar year maximum benefit for mental health services?

4) How many sessions per year are authorized?

5) Is there a per session fee limit?

     6) Where are claims mailed and/or is electronic billing   possible?

7) What is the a difference between in-network or out-of-network benefits?

8) What is the typical reimbursement for individual psychotherapy (the CPT service code is 90806) where services are provided by an LCSW.

9) What is the reimbursement percentage difference between an in-network and out-of network provider, including:

• Deductible

• Session reimbursement

• Calendar year maximum for sessions

10) Is group therapy covered by my plan? What is the exact coverage for group therapy services? Is it the same as coverage for individual services or different?

You can call me anytime to request an updated insurance claim. Calling my voice mail is the easiest and most reliable way to make a request for the most recent claim. Once you make the request, I will provide the information as quickly as possible, usually by mail. Do not hesitate to follow-up with me if you do not receive the information promptly

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