Insurance & Coverage

Plans With Which CBI May Participate

CBI participates with selected plans offered by:

Insurance companies often offer several different plans and provider networks. Participation with an insurance company does not always mean that every CBI provider or service is covered under every plan.

Our team will be glad to help review your plan information and identify available providers and services.

If your insurance is not listed, please call us at (724) 609-5002. We are happy to look into it with you.

Understanding Your Coverage

Insurance coverage can look different for every patient. It may depend on:

• Your specific insurance plan
• The provider you see
• The type of service you receive
• Whether the service is in person or virtual
• Referral or authorization requirements
• Your deductible, copay, or coinsurance
• Your plan's medical-necessity guidelines
• Annual visit or service limitations

In some cases, behavioral-health benefits are managed by a different organization than the medical insurance company shown on the front of your card. The member-services or behavioral-health number on your insurance card can provide additional plan-specific information.

How We Help With Insurance

Before your first appointment, our team can contact your insurance company to gather available information about your behavioral-health benefits.

Depending on what your insurance company provides, we may be able to help you understand:

• Whether a CBI provider appears to participate with your plan
• Copay information
• Deductible information
• Coinsurance
• Referral requirements
• Prior-authorization requirements
• Visit limitations
• Telehealth benefits
• Diagnostic-evaluation benefits
• Psychological-testing benefits

We will share the information available to us and help you understand what it may mean for your care.

Your Financial Responsibility

We want patients to have as much information as possible before beginning care. Depending on your plan, you may be responsible for:

• Copays
• Deductibles
• Coinsurance
• Services not covered by your plan
• Services requiring an authorization or referral
• Services received after coverage ends
• Amounts assigned to you by your insurance company
• Services affected by outdated or inaccurate insurance information

Our team will do its best to share available information with you. Because insurance companies make the final coverage determination, we also encourage patients to review their benefits directly with their plan.

Using Out-of-Network Benefits

Some insurance plans provide reimbursement when a patient receives care from an out-of-network provider.

CBI does not submit or coordinate out-of-network claims. If you choose to use out-of-network benefits, your services will follow CBI's self-pay process, and you will work directly with your insurance company regarding possible reimbursement.

Before beginning care, consider asking your insurance company:

• Does my plan include out-of-network behavioral-health benefits?
• Do I have an out-of-network deductible?
• What portion of the cost may be reimbursed?
• Is prior authorization required?
• What documentation will I need?
• Is the service I am seeking eligible for reimbursement?

Coverage for Different Services

Therapy

Coverage may depend on the provider, diagnosis, service, location, medical-necessity requirements, and specific insurance plan.

Psychiatry and Medication Management

Psychiatry and therapy benefits may be processed differently. Coverage for medications and pharmacy services is separate from coverage for appointments with a psychiatric provider.

Couples and Family Therapy

Some insurance plans do not cover relationship-focused services or only provide coverage when specific medical-necessity requirements are met. Our team can help gather available information about your plan.

Diagnostic Evaluations and Psychological Testing

Coverage for diagnostic evaluations and psychological testing varies and may require prior authorization.

Coverage may depend on:

• The reason for the evaluation
• The clinical question being addressed
• The specific testing requested
• Medical-necessity requirements
• Provider participation
• Plan exclusions

When applicable, CBI will gather available benefit information and discuss your anticipated financial responsibility before psychological testing begins.

Telehealth

Many plans cover telehealth, but benefits can vary by provider, service, plan, and patient location. Our team can help review available information before virtual care begins.

Keeping Your Insurance Information Current

Please let our Billing Department know about insurance changes within 30 days.

Providing updated information promptly helps us submit claims within your insurance company's required timeframe and may help prevent unexpected denials or balances.

Insurance information should be submitted through CBI's approved secure process rather than ordinary email.

Secondary Insurance

CBI may be able to submit claims to a secondary insurance plan when:

• CBI participates with the secondary plan
• Complete information is provided
• The information is received within the required filing timeframe
• The secondary plan does not create another program restriction

Retroactive billing may not always be possible.

If Medicaid is your secondary insurance, please contact us before scheduling so we can help you understand any applicable restrictions.

Payment Information

Anticipated patient-responsibility amounts are due according to the financial information provided during onboarding. Payment may be required before access to a virtual appointment is provided.

Secure Card on File

To make payments secure and convenient, CBI requires patients to maintain a valid credit or debit card on file.

Patients enter and manage their payment information through the secure patient portal. CBI does not retain complete card numbers or security codes on paper or within the electronic health record.

Details about payment authorization and financial responsibility are provided privately during onboarding.

Self-Pay Services

If you do not have insurance, your insurance does not cover the service you need, or you prefer not to use your benefits, self-pay options may be available.

Our team can explain the current options and provide information about your anticipated financial responsibility before care begins.

Good Faith Estimates

Patients who do not have insurance or choose not to use insurance may be entitled to receive a personalized Good Faith Estimate for scheduled nonemergency services.

The estimate is based on the information available when it is prepared. Our Billing Department can explain the process and help you request an estimate.

Experiencing Financial Difficulty?

We understand that financial circumstances can change and that the cost of care may sometimes feel difficult to manage.

If you are experiencing financial strain, please reach out to our Billing Department as early as possible. We would rather talk with you before finances become a barrier to your care.

Depending on individual eligibility, provider availability, and available resources, certain payment arrangements or financial-hardship options may be available. These options are reviewed individually and cannot be guaranteed.

Frequently Asked Questions