Office Located in SE Portland
(503) 462-7146
fleur

It may be helpful for you to contact your insurance company prior to our initial session. Please refer to the questions below when speaking to your insurance company. When speaking with your insurance company, you will need to have your client ID# and Group # available. Feel free to print this page to use as a guide when asking questions. If you have questions, please feel free to contact me.

Date:
Name:
Client ID #:
Group #:
Date of birth:

Are mental health services covered?

Is the licensed professional counselor (LPC) license permitted?

Is the insurance year yearly or bi-yearly?

What is the effective date of the insurance?

What is the deductible? (Be sure to ask for out-of-network deductible)

Is the deductible met this year? Amount paid to date?

Is there a per session co-pay? Is there a per session co-pay out-of-network?

Is there a limit on amount of sessions per year or two years?

Is pre-certification required?

Are there any limits on what mental health services are covered?

Insurance company website:

Insurance Claims Phone # and Address: