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Making Your Insurance Claims Insurance_-_Making_a_Claim.pdf

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John DeMarco M.Ed., LPC

License No. 37PC00115000

EIN No. 20-4471278

NPI No. 1336176205

  1. My license allows you to receive insurance reimbursement, if you have coverage.
  2. My policy is that you pay my fee at the beginning of each session and submit the receipt I give you to your insurance company. My receipt is a “super-bill” and contains all the data your insurance company needs from me in order to process your claim.
  3. Additionally, your insurance will need from you other information, such as: policy holder’s full name, date of birth, insurance identification number, and social security number. Submitting the super-bill alone is insufficient, you need to provide other information requested by your insurance company.
  4. Generally, to get insurance reimbursement, you need to call your insurance company and get “preauthorization” before you start counseling. Your insurance company will need to know my EIN number, which is 204471278. Make sure they have this number and not just my name and address.
  5. You are responsible for filling out and submitting your insurance claims forms to your insurance company. You will need to ask your insurance company to send you the appropriate claims form.
  6. Making an insurance claim for mental health services requires a diagnosis. Insurance companies do not reimburse counseling without this. After your initial session (diagnostic evaluation) I will provide a diagnosis for you.
  7. I am not a provider with any managed health care plans. If you have managed health care, tell your insurance company that you want me as an “out of network provider.”  You will need to request an “out of network claims form.”
  8. Tell your insurance company to mail your reimbursement check to you, not me.