Determining how to access mental health services can sometimes be overwhelming. Below is a list of steps that will help you navigate insurance and seek the appropriate support for your child and family. If you have questions, contacting your insurance company is often a good start.
1. Determine what insurance benefits are for mental health services. Then,
Call insurance company
Request benefit summary
2. Find out specifics regarding what services are covered (length of stay, special assessments, number of sessions covered)
Who is in the network (location)
Who/what provider is approved (i.e. find out what credentials are required)
How does the insurance company define a “service” (for example, is it residential treatment, day treatment, etc.)
3. What is the prior authorization process?
4. What documents does the insurance company need for approval? Do they need a clinician to assess the “day of”?
5. Do you have a co-pay?
6. Does the insurance company have a case manager assigned?