Children's Resource Group

Serving Children, Adolescents and Adults

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9106 N. Meridian, Ste 100
Indianapolis, IN 46260
Phone: (317) 575-9111

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Home » Patient Information » Insurance Information

Insurance Information

In today’s insurance environment, clients and their families have an increased responsibility for working with their insurance carriers, specifically with regard to their mental health coverage (also referred to as behavioral health coverage).  The following is designed to help you understand CRG’s billing and insurance procedures while at the same time providing information that will assist you in understanding your individual insurance plan.

Most services at CRG are considered mental health services.  Insurance coverage for mental health services is often different than coverage for medical services; therefore, we recommend you contact your insurance carrier to verify your mental health benefits prior to coming to our office.

When checking your benefits, it is important to note that most of CRG’s clinicians are participating providers with the Sagamore Provider Health and Multiplan networks only.  If your insurance carrier provides mental health coverage through Sagamore or Multiplan, you are considered in network and should receive the in-network benefits for covered services outlined in your policy.  CRG will collect copayments, deductibles and coinsurance amounts at the time of service and will file the charge balances with your insurance carrier.  Any unpaid amounts will then be billed to you for payment.

If your mental health coverage is not through Sagamore or Multiplan, you are considered out of network.  We expect full payment at the time of service from our out-of-network families; then we will submit claims to your insurance carrier as a courtesy to you and your family.  If you have out-of-network benefits, you should receive reimbursement for services directly from your insurance carrier.

Insurance carriers sometimes have specific requirements that must be satisfied before benefits are administered (such as prior authorization for services).  It is important for you to determine what steps need to be taken to ensure you satisfy your carrier’s requirements.  CRG is happy to assist you with meeting policy requirements; however, payment for services is ultimately the responsibility of the financially responsible party, not your insurance company.

 

Checking Your Benefits

We recognize that the current insurance environment is complex, especially when it comes to mental health.  We hope that the following points will assist you when checking on your plan’s coverage:

  • The Sagamore Provider Health Network and Multiplan are in network.  All other provider networks are out of network.
  • CRG’s speech/language and educational services are out of network, even with Sagamore and Multiplan.
  • Please note that some insurance plans have separate mental health coverage through another carrier or network.  If this is the case with your plan, the name and contact information for your mental health carrier should be included in your policy handbook and on the back of your insurance card.
  • Some plans only cover services with particular types of providers (for example, your plan may cover services with a psychologist but not with a social worker).  It is important to inquire which types of providers are covered under your plan.  CRG’s staff or our website can provide you with the credentials of the provider(s) you are scheduled to see.
  • Additionally, some plans only cover particular types of services (for example, they cover individual therapy but not family therapy).  It is important to ask your insurance company if the service(s) you are scheduled to receive are included in your plan.
  • It is also important to find out if your insurance policy has any diagnosis exclusions (for example, your plan may cover treatment for depression but not treatment for ADHD).  We recommend you ask if there are any psychological conditions that are not covered by your policy.
  • Some policies only cover services up to the point of diagnosis (e.g., they will cover psychological testing but not treatment for certain conditions).  We recommend you ask if this is the case with your plan so you know what to expect once claims are filed for your services.
  • CRG tries to accommodate families’ schedules as much as possible by allowing patients to coordinate medication management and therapy appointments on the same day.  However, please keep in mind that while this can be more convenient for families, some insurance companies will not cover two appointments for a patient within the same day.
  • Some of our clinicians schedule phone appointments for patients who are unable to travel to the office on a routine basis.  Insurance plans often do not cover telephone services at the same rates as office visits, if they cover them at all.  Before scheduling phone services, we recommend you verify your coverage.

Pre-Authorization for Services

You are responsible for checking if prior authorization must be in place prior to your first appointment.  Lack of obtaining required pre-authorization results in immediate denial for payment by insurance companies.  To assist with obtaining a prior authorization:

  • The initial visit with any one of CRG’s providers is considered an “Initial Diagnostic Interview.”  If requested by your insurance company, the procedure code for the visit is 90791.
  • Be prepared to give the provider’s name and licensure (e.g., Ph.D., M.D., LCSW) as well as the date of the scheduled appointment.
  • Please take into consideration the turnaround time for your insurance company to complete a prior authorization once they receive all the necessary information.
  • It is important to follow up with your insurance company to verify the authorization is in place prior to services as it can be extremely difficult or impossible to obtain authorization after services have occurred.
  • If you or a member of your family receives additional treatment at CRG, we recommend you again check with your insurance company to determine if pre-authorization is required.  For instance, ask what steps need to be taken to obtain authorization for ongoing services such as therapy or medication management.
  • Often, insurance carriers require providers to send in forms indicating clients’ treatment progress and recommendations for ongoing services.  CRG will assist with this process but it is your responsibility to ensure authorizations are current.  We ask that you provide us with the appropriate forms in advance of the deadline to allow timely submission back to your insurance carrier.

We hope this information helps you in obtaining quick and accurate reimbursement from your insurance company.  We have experienced that educating our families on what to expect both clinically and financially helps with decision-making in treatment and enables our clients to focus on what is most important – leading happy, healthy lives.

The following worksheet has been created as a tool to aid you when checking with your insurance carrier on your plan’s benefits.  If you have any questions, please do not hesitate to contact CRG’s billing department at (317) 575-9111, Option #156.

Checking Your Benefits Worksheet

 

 

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» Suicide in Adolescence: A Wake-Up Call"

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Blog News, Events and Announcements

New Insights about Technology and Social Isolation…from Japan

CRG’s Adolescent and Adult Psychiatrist, Dr. Joshua Lowinsky, recently came across some fascinating research in Asia that may provide insight into a growing American phenomenon.  Today nearly 500,000 young adults in Japan (almost all males) live as modern-day hermits.  … more...

Students Giving Nazi Salute

It’s happened again.  Some students who attend a local high school were recently seen in a group photo on social media, raising their arms to give the Nazi salute.  To countless Americans who fought in World War II or lived through the Nazi era, this behavior is … more...

Screening Young Students for Dyslexia

Due in part to advocacy work by Hoosier parents and educators, Indiana’s legislators passed Senate Bill 217 last year.  This law requires schools to screen students for dyslexia.  Dyslexia is a type of learning disability that primarily affects how intelligent kids, … more...

» View More From Our Blog

CRG Webinars

Upcoming Webinars:

Watch our YouTube site for two new webinars that will be posted soon:

Dr. Jill Wise recently recorded a webinar entitled, Pediatric Neuropsychology: An Introduction to the Basics of Neuropsychological Evaluations. This webinar outlines the role of a pediatric neuropsychologist, identifies common referral questions for evaluation, and describes the neuropsychological evaluation process with the use of case studies.

Dr. Anna Merrill recently recorded a webinar entitled, Understanding Intellectual Disability: Definitions, Intervention, and Resources. This webinar reviews what the term “intellectual disability” means and how it is diagnosed through psychological evaluation. We also discuss the different levels of intellectual disability and how this impacts intervention and treatment. In addition, resources useful for parents, teachers, and other health care providers working with individuals with an intellectual disability are shared.

Looking ahead, Dr. Julie Steck will present a webinar on March 22, 2019 entitled, Attention Deficit Hyperactivity Disorder in Females: Underdiagnosed and Misunderstood. Over the past 30 years there has been prolific research in the area of ADHD and we know a great deal about this condition. Despite the available research, many parents, teachers and other professionals are uninformed about ADHD and the significant risk factors for those with ADHD when they are not appropriately diagnosed and treated. While the incidence of ADHD in females is less than that in males, females are also less likely to be diagnosed with ADHD if they have the condition. Multiple research studies have shown that that females with ADHD have higher rates of depression and dysthymia, anxiety, cigarette smoking, substance use, academic difficulties, impairment in driving, eating disorders and relationship difficulties than their non-ADHD peers. This presentation will include an overview on the research on females with ADHD, signs and symptoms of ADHD in females, treatment approaches and therapeutic interventions. The overall goal of the presentation will be to bridge research to practice and parenting.

 

To view our previous webinars, please click here .

CRG Providers Out and About

Spring 2019:  Dr. Joshua Lowinsky, CRG’s adolescent and adult psychiatrist, will once again teach his class on Psychopathology and Assessment this semester at Christian Theology Seminary.  This popular 14-week course for CTS graduate students pursuing careers in the mental health field combines lectures with panel discussions involving individuals with the diagnoses being studied.  CRG providers often participate by presenting guest lectures in their areas of specialty.  This semester, CRG psychologist Dr. Anna Merrill will present a lecture entitled “Neurodevelopmental Disorders” on February 13th.

April 27, 2019:  Dr. Joshua Lowinsky will give a lecture at the Indiana Psychiatric Society’s annual conference in West Baden, IN.  His talk is entitled, Depression Across the Lifespan, will focus on depression in childhood, adolescence and adulthood.  A colleague will give a similar talk at the conference focusing on depression in old age.

CRG’s Speaker’s Bureau helps schools, colleges, community agencies and other organizations learn more about children, teens, and adults with disabilities and/or behavioral health issues such as depression and anxiety. Most of our providers are available to give talks and/or conduct trainings on a wide range of topics. We work with you to customize a presentation that combines research-based knowledge with practical strategies and applications. As you plan your group’s professional development events for the year ahead, we invite you to contact Dr. David Parker to discuss your needs.

CONTACT US

CRG
9106 N. Meridian, Suite 100
Indianapolis, IN 46260
Phone: (317) 575-9111
Fax: (317) 571-4470
Email: crg@childrensresourcegroup.com

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PROVIDER UPDATES

CRG pediatric neuropsychologist, Dr. Jillian Wise, and psychiatric mental health nurse practitioner, Carolyn Krueger, APRG, PMHNP-BC, are accepting new patients! Please contact our Intake line at (317) 575-9111, Option 3, to learn more about their services and to schedule an appointment.

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