Insurance
Our office is happy to accept insurance assignment and file insurance claims to receive payment for our time if we have a contract with your insurance or third party payer. The plans that we participate with are:
- Horizon BCBS
- Aetna,
- Cigna
- MagnaCare
- QualCare
- Tricare
Understanding Your Insurance
Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have about your mental health coverage. The following questions may serve as a guide in helping you obtain pertinent information regarding eligibility and benefits.
Questions to ask your Insurance Carrier
The representative of your insurance carrier may ask for BN Counseling information
In-network Insurance |
||||
| Brian Nandy, LPC | National Provider ID: 159-808-9633 | TAX ID: 383-77-3599 | ||
| BN Counseling, LLC | National Provider ID: 164-950-9308 | TAX ID: 383-77-3599 | ||
| Address: 25 Hanover Road, Building B, Suite 120, Florham Park, NJ 07932-1400 | ||||
| Is there an annual deductible for in-network mental health benefits?
If so, how much? |
Yes No | |||
| Is there a limit on the number of sessions your plan will cover per year?
If Yes, How many? |
Yes No | |||
| Does my policy cover 60 minute sessions?
If yes, how many? |
Yes No | |||
| How much is your co-payment for mental health services? | ||||
| What is the policy year (i.e. Jan 1 – Dec 31)? | ||||
| Does your plan require pre-authorization for psychotherapy? | ||||
| Does my insurance policy offer out-of-network benefits for mental health services? | Yes No | |||
| In order to find out the reasonable and customary fee, the representative may ask for a
Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows: |
||||
| 90791 Initial Assessment
$__________________ |
90834 Ongoing psychotherapy
$__________________ |
90837 Psychotherapy
$__________________ |
||
| 90847 couples/family psychotherapy
$__________________ |
90853 group psychotherapy
$__________________ |
90785 Interactive psychotherapy
$__________________ EMDR |
||
Out-of-network Insurance |
|||
| Brian Nandy, LPC | National Provider ID: 159-808-9633 | TAX ID: 383-77-3599 | |
| BN Counseling, LLC | National Provider ID: 164-950-9308 | TAX ID: 383-77-3599 | |
| Address: 25 Hanover Road, Building B, Suite 120, Florham Park, NJ 07932-1400 | |||
| Does your plan include “out-of-network” coverage for mental health? | Yes No | ||
| Is there an annual deductible for out-of-network mental health benefits? If so, how much? | |||
| Is there a limit on the number of sessions your plan will cover per year?
If Yes, How many? |
Yes No | ||
| Is there a limit on out of pocket expenses per year? | Yes No | ||
| What is your co-insurance percentage for mental health services? | |||
| Does your plan require pre-authorization for psychotherapy? | |||
| What is the policy year (i.e. Jan 1 – Dec 31)? | |||
| What is the reasonable and customary fee (the amount that your plan determines is the normal range of payment within a given geographic area)? | Florham Park:
Bayonne: |
||
| In order to find out the reasonable and customary fee, the representative may ask for a
Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows: |
|||
| 90791 Initial Assessment
$__________________ |
90834 ongoing psychotherapy
$__________________ |
90837 Psychotherapy
$__________________ |
|
| 90847 couples/family psychotherapy
$__________________ |
90853 group psychotherapy
$__________________ |
90785 Interactive psychotherapy
$__________________ EMDR |
|
Co-payments and deductibles
All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.
Non-covered services
Please be aware that some – and perhaps all – of the services you receive may be non-covered or not considered reasonable or necessary by your insurers. You must pay for these services in full at the time of visit.
Proof of insurance
All patients must complete our registration form before seeing a BNC therapist. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
Claims submission
We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
Coverage changes
If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.
Nonpayment
If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative care. During that 30-day period, our therapist will only be able to treat you on an emergency basis.
Missed appointments
Our policy is to charge for missed appointments not canceled within a reasonable amount of time. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment. Our practice is committed to providing the best treatment to our patients.
Other Professional Services & Documented Reports
In addition to weekly appointments, we will charge an amount for other professional services you may need such as report writing, crisis intervention, attendance at meetings with other professionals you have authorized, preparation of records or treatment summaries, and legal proceedings that require our participation.
Questions to ask Your Insurance | IN-NETWORK BENEFITS Brian Nandy, LPC • National Provider ID: 159-808-9633
BN Counseling, LLC • National Provider ID: 164-950-9308 TAX ID: 383-77-3599
Add: 25 Hanover Road, Building B, Suite 120, Florham Park, NJ 07932-1400
- What’s my deductible for in-network mental health benefits?
- Is there a limit on sessions your plan will cover per year?
- If Yes, How many?
- Does my policy cover 60 minute sessions?
- If yes, how many?
- How much is your co-payment for mental health services?
- What is the policy year (i.e. Jan 1 – Dec 31)?
- Does your plan require pre-authorization for psychotherapy?
- Do I have out-of-network mental health benefits ?
In order to find out the reasonable and customary fee, the representative may ask for a Clinical Procedure Terminology (CPT) code for the service you plan to receive. Please note that the CPT codes for services are as follows:
- 90791 Initial Assessment:
- 90834 Ongoing psychotherapy:
- 90837 Psychotherapy:
- 90847 Couples/family psychotherapy:
- 90853 Group psychotherapy:
- 90785 Interactive psychotherapy: