Insurance Questions

The most important question is to ask is:

“Is William F. Martin, LCSW an approved PPO/HMO provider? His NPI # is 1710072244.”

After making sure I am a PPO provider in your network, ask and record the answers to the following questions:

    • Do I need pre-authorization? If yes, how is that done?
    • What is my annual deductible?
    • How much of my deductible has been met?
    • How much of my deductible remains to be paid?
    • When does my deductible period begin and end?
    • What is my co-payment to the provider at each session?
    • How many sessions are available during the calendar year (Calendar Year Maximum sessions)?
    • What is the address for mailing claims?
    • Does my insurance cover family or marital therapy? If yes, what is the CPT code and/or an authorization number?

Your responsibility:

      • Pay any necessary deductible and co-payment at the beginning of each session.
      • If out of network services, you must pay the full fee at the time of the session, then submit all claims to any other insurance company (other than the three above) and then be reimbursed by your company for your benefits.

      Any questions, let me know.