Resources

Yes! Please follow the instructions below prior to seeing your doctor. Fill out this form Email the form to our office manager at cobrien@forsythiabhs.com

You can use a computer, tablet, or smartphone (iPhone, iPad, and Android devices). Search for "Kareo" in the app store on your mobile device, or click here to log in on your computer.

We want to help you in any way we can and thus have created a detailed article on how to get reinbursement for out-of-network visits. Take me to the article

Yes! The video technology uses bank-grade encryption. However, make sure you find a quiet, private place in your home or office for your appointment.

Unfortunately, we do not accept health insurance. Though we require you to pay the full cost of your visit at the time of service, many insurance companies will reimburse a portion of the cost. Most PPO (preferred provider organization) and POS (point of service) health plans offer partial reimbursement for out-of-network services.

Click here to request a video visit online, or call our office directly to schedule: (401) 424-5200.

You'll enter a credit card before the appointment and will be charged the same co-pay as an in-person visit.

Ask them the following questions Can I get reimbursed for out-of-network visits? How much is my deductible for out-of-network outpatient mental health? $500? $1000? Have I paid anything towards my deductible yet this year? How much of my deductible has been met this year? When does the calendar year for my deductible start? When does it end? What is my coinsurance for out-of-network outpatient mental health? Do I need a referral from my in-network provider (ex: PCP) for my out-of-network provider? How do I submit claims for reimbursement? (Go to the Submit your claim are below for detailed information for most major insurers)

A Superbill is a document that you send directly to your insurance company at the end of each month. It details how many sessions you’ve had, and the total fee. Here is the information the Superbill contains: i. A letterhead from the provider that MUST include all of the following: Provider name Provider address Provider Tax ID/NPI Provider credentials, i.e., the initials associated with the educational degrees the provider has earned. Examples include: MD, LICSW, DC, PT, OT, ST i. Patient’s name ii. Date(s) of service iv. Itemized charges for each date of service and type of service received v. Procedure codes (HCPCS/Revenue codes) for all services received Used to indicate a specific healthcare service, procedure, or treatment, often referred to as a CPT code vi. Diagnosis code(s) for services received Tells your insurance provider why you saw your clinician for this service vii. Number of Units - this is the number of times a service was performed on a particular date of service. This is required for occupational, physical & speech therapies, anesthesia and chiropractic services. viii. Attach any related claim summaries or Explanation of Medicare Benefit Forms you may have received for these services, including those received from other insurance companies.

Contact your insurance company (either call them or go online) and request a copy of your Summary of Benefits (SOB) Check the SOB to see if you have an Out-of-network deductible or Coinsurance Out-of-network deductible (OOND) An OOND is the amount of money you’ll have to pay before you are eligible for reimbursement For example, if your deductible is $500, you will have to pay the $500 deductible in full prior to your insurance company taking over payments. So if your psychiatry visits from FBHS cost $1400 in one year (a $200 initial eval and twelve $100 monthly visits), once you pay first $500, your insurance company will pay the rest of the bill, which in this case would be the remaining $900. Deductibles reset every calendar year ANY out of pocket health care expense (not just mental health) goes towards paying your deductible Coinsurance The percentage of a service fee that you are responsible for It changes between insurance companies Let’s say your coinsurance is 25%. If a 15-minute follow-up med management appointment at FBHS is $100, you’d have to pay $25. First you would pay the whole $100 up front. Then you would submit a monthly Superbill from FBHS to your insurance company. They would then send you a check in the mail for $75.

Here’s some detailed info for a few insurers to get you started BCBS BCBS has different rules for each state. We’ve added hyperlinks to the states that we’re credentialed to practice medicine in. If your state isn’t here please go on-line and google the state your BCBS comes from and “out-of-network benefits”. Please contact us with any questions you might have. RI MA NY CA UHC Submit a claim online Submit your claims on myuhc.com®. Log in and click the “Claims & Accounts” tab, then click the “Submit a Claim” tab. There, you’ll be able to select the “Mental Health Claims Online Submission Form” to begin the process of submitting your claim. Submit a claim by mail Download the form for your clain on myuhc.com®. This form may either be completed on your computer and printed out, or printed blank and then completed by hand using black or blue ink. Once your claim form is complete, mail your form with the claim details and receipts to the address on the back of your health plan ID card. Tufts Visit this link Harvard Pilgrim Visit this link

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