Michael I. Vickers, PhD
Family Development Associates
40 Speen St., #106
Framingham, MA 01701
(508) 877-3660 ext. 6
email: m-vickers@comcast.net
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Using Your Health Insurance

Insurance Plans Covered  |

 How to Access Your Benefits
Information You Need to Get  |
 If Your Insurance Changes

 

PLEASE CHECK WITH YOUR INSURANCE COMPANY DIRECTLY TO BE SURE ABOUT YOUR BENEFITS. What follows are some guidelines, but there are constant changes and many exceptions. I cannot guarantee that you will receive any benefits for meeting with me.

Insurance Plans that Will Pay for My Services: I am an "in-network" provider for Blue Cross / Blue Shield of Massachusetts (which means that out-of-state BC/BS plans will also pay for my services). There may be some BC/BS plans that will treat me as "out-of-network". I am an out-of-network provider for United Behavioral Health. I am also in-network for BC/BS HMO Blue.

I am NOT a network provider for ANY other HMO (Tufts, HPHC, Fallon, etc.). I am NOT a provider for MassHealth.

Because the insurance industry is constantly changing and consolidating, I occasionally find out that I am a network provider for additional plans. The best approach is always to call your plan directly, give them my name and location, and ask them to explain what your benefits will be for meeting with me.

How to Access Your Benefits:

Check the back of your insurance ID / membership card. There should be a statement about accessing "mental health" or "behavioral health" services. Call the number listed there. Give the insurance company my name and location and ask for specifics about what benefit you will recive for meeting with me. Look below for a list of the information you should obtain before we meet.

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Information You Need to Get:

When you speak with your insurance company, be sure to obtain the following information and then pass it on to me. (You can use my "New Client Info Sheet" to guide your information gathering.)

Annual benefit you will receive for meeting with me: this is usually in the form of number of sessions of "outpatient psychotherapy" per year.

Is "authorization" required before benefits can be paid? If so, ask for an authorization for your initial sessions. Typically they will authorize an initial 8 - 12 sessions.

If you obtain an authorization, write down the authorization number or code and give that to me.

Deductible you will be responsible for paying to me before your insurance will begin paying.

Co-payments you will be responsible for, for each session.

Ask if you have "parity" on your insurance plan. This provides for more extensive benefits for certain "biologically based" mental health issues.

Ask for the address for submitting "paper claims".

 

 

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If Your Insurance Changes:

It is your responsibility to keep up with changes in your insurance and to let me know well ahead of time of any changes that would effect your benefits for meeting with me. If your insurance is changing, you need to make sure you know the new insurance benefits and obtain authorizations as may be needed.

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Please be sure to talk to me about any unanswered questions about your insurance coverage.

 

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