Insurance Verification Checklist for Prospective Clients
Here is a how-to guide on verifying your benefits before seeking care:
Part 1: Preparation
Before you call, have the following ready:
[ ] Your BCBS Member ID card.
[ ] Your full legal name and date of birth.
[ ] The name of the therapist or practice (CARE Counseling, Naperville).
Part 2: The Call Script & Questions
Call the "Member Services" or "Behavioral Health" number on your card. Once connected to a representative, you can use these questions:
1. General Eligibility
[ ] "I am calling to verify my outpatient mental health benefits. Is my policy currently active?"
[ ] "Is CARE Counseling in Naperville, IL an in-network provider for my specific plan (e.g., PPO, Blue Choice, HMO)?"
2. Financial Responsibility
[ ] "Do I have a deductible for outpatient mental health? If so, how much is it, and how much has been met so far this year?"
[ ] "Once my deductible is met, do I have a copay (flat fee) or coinsurance (percentage) for each session?"
[ ] "What is my out-of-pocket maximum for the year?"
3. Coverage Specifics
[ ] "Does my plan cover Telehealth (video sessions) for mental health at the same rate as in-person visits?"
[ ] "Are there any session limits (e.g., 20 visits per year) or is coverage based on medical necessity?"
[ ] "Do I need a referral from my Primary Care Physician (PCP) or a prior authorization before I begin therapy?"
4. Documentation for Your Records
[ ] Date of Call: ____________________
[ ] Representative Name: ____________________
[ ] Call Reference Number: ____________________
Part 3: Next Steps
Once you have this information, you can make an informed decision about your care.
If everything looks good: Head over to our scheduling page to book your intake.
If you're still unsure: Don’t worry! Send us a copy of your insurance card through our secure portal, and our administrative team will do a secondary verification to ensure you have the most accurate cost estimate possible.
