1. What is the amount of your deductible for out-of-network providers?Have you already met your deductible? Do both in-network and out-of-network services count towards the same deductible?

2. Do you need any kind of special referral (from your primary care physician/pediatrician) before you can be reimbursed?

3. How much of each therapy session will your insurance provider reimburse (this is typically a percentage)?

4. How many mental/behavioral health sessions per calendar year will your insurance plan cover?


5. How much of the assessment cost will the insurance provider reimburse? 

6. Are there any rules related to seeking services (e.g., only a certain amount of money allowed for behavioral health reimbursements, reimbursement only for certain types of diagnoses, etc.)? 

Payment

Currently, Dr. Shital accepts Medicaid/Peachcare for Kids, Amerigroup, Blue Cross Blue Shield, and Aetna. She will be happy to provide documentation required by other insurance companies for reimbursement. 

It should be noted that payment for services is the responsibility of the client. Hence, it is recommended that families contact their insurance company regarding reimbursement for both, “out of network providers” as well as "in-network providers."

​Here are some of the questions that you may ask your insurance company if you wish to get reimbursed: