Verify benefits

To understand your benefits, call the customer/subscriber services number on the your insurance card and ask the following questions:

 

If you give us a dated copy to put in your chart, we will do what we can to code your invoices in a helpful way.

1. What is the effective date of the policy?

2. What is my deductible for the year?  Is there a separate deductible for out-of-network providers? Have I met any part of the deductible?  When does the deductible reset?

3. Do I have benefits for an office visit with an out-of-network Naturopathic Physician?

4. If yes, what percentage of coverage?  Is there a co-pay amount?

5. Do I need a referral from my primary care physician (PCP) to see an ND?

6. Do I have benefits for manual therapy (CPT code 97140) from an ND?

7.  Is there a limit to the number of visits I am able to have with an ND?  IF yes, how many per year?

8. Is there a limit to the number of times a diagnosis code can be used by an ND?      (This one is very helpful for getting the best reimbursement possible, be sure to let us know the answer)

9. Is there a limit to the type of diagnosis codes and ND can provide?   (Also helpful)

10. Do I have different benefits for preventative vs. illness-related visits?   If so, what is the difference?

11. Do laboratory services count toward my deductible?

12. What types of laboratory testing does my insurance cover?  Screening, diagnostic or treatment monitoring?

13. IF screening is covered, how often (once a year, twice a year, once every 2 years)?

14. Are screening/preventative imaging tests covered (DEXA, mammogram)?  If so, how often?