Why are you asking me that?

Welcome to the second of the insurance explainer series! When you are filling out all of the paperwork for insurance, we do have a tendency to ask a boatload of questions. Yes, I know it is super tempting to skip some of the things that don’t feel necessary or accurate. However, we are asking some of these questions so that we can properly bill your insurance company.

In order for insurance to cover your therapy, providing specific details is non-negotiable. Otherwise, we can not file insurance claims on your behalf. This shows up particularly around Sex and Gender questions. We are very much a queer and trans affirming practice, so why the hell do we need this info? Honestly, I have no idea why insurance absolutely insists we have this, but we do need it. So below I am listing a few things you absolutely must add:

Sex-This is the one we need. It is your gender assigned at birth AND/OR the one your insurance has on file. Please do not enter 'Prefer Not To Say'. We need it and do also feel like complete jerks for having to ask. If you aren’t using insurance, then don’t worry about it.

Gender-We don’t need it but for some reason our EHR (Electronic Health Record) does not give us the "Prefer Not To Say' option here.

Legal Name- If your insurance company has a name that is your dead name or even one you do not use, we do need your full legal name. Insurance companies do not care about much outside of profits; don’t view this as not being respectful of your identity so much as they are rigid and work to find ways to make sure that we are absolutely seeing the correct person.

Date of Birth-This we need; many plans show us benefits with your full legal and DOB. They will not let us file or even look up your information if we do not have this.

Address-Yup, we need it. Some plans are very persnickety, and we need to have included the exact address they have. We also need an updated address if you have moved. Honestly, this helps protect the practice to get paid by insurance. It also protects you from having us trying to get the money out of you. They often try to come up with one reason or another not to pay, and this prevents an incorrect address from being that excuse.

Phone Number- Honestly, not always necessary for insurance but is helpful for getting your appointments and communication.

Email-This is for notifications, documents and other forms of communication. We do try not to spam you with things.

Weird Things

If your insurance is owned by someone else-your partner, spouse, parent etc.

Address, DOB, and Full Legal Name of the Subscriber-not all insurance plans absolutely require this, but it is very helpful if they begin to ask questions and some do very much require it.

Best Practices for You

1.      Upload the front and back of your insurance card to the EHR

2.      Answer all the questions in the demographics form

3.      Feel free to reach out to the practice admin to ask questions if something feels questionable

Common Warnings

You will get sick of these if you read the whole series.

1.      Pay attention to your plan nuances

2.      Remember that deductible-it is where people end up with a large bill

3.      If your insurance changes let your provider’s biller know IMMEDIATELY. I cannot stress this enough. We don’t know your plan changed unless you let us know. Otherwise, we only find out when the old insurance denies the claims. If you have a high-deductible plan you could end up with a large bill you are required to pay.

4.      Please do not get angry with your provider or provider’s biller. We did not choose the plan.

5.      If you get a big bill, work with your provider to identify a reasonable payment plan.

6.      Therapists want to do therapy; we also find insurance frustrating and confusing.