Would psychiatrist require co-pay if my insurance covers visits & would my file info be seen by insurance co?
I have a great health plan with Blue Shield, it costs a lot - over 0/month excluding maternity services (it would be a lot more with) and I’m relatively young, but if I were to use the 20 psychiatry visits/year, does a) the insurance company have access to what I get diagnosed with as it may affect future coverage/rates (I read an article that women who are sexually abused and have mental issues are oftentimes declined coverage b) psychiatrists are very expensive - do you think the doctor would require an additional co-pay? If you have used insurance to see a psychiatrist that would help. Thanks.
Posted in Psychiatry
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October 25th, 2009 at 3:31 pm
Yes, the insurance company does have to know your diagnosis in order to keep covering your visits. They do not have access to the particulars of your file (that is, the things you share with your psychiatrist are not going to be visible to BCBS) but your psychiatrist has to put your DSM-IV diagnostic code on your billing papers.
So if your psychiatrist diagnosed you with Generalized Anxiety Disorder, for example, GAD’s code in the DSM is 300.02. On the billing information your psychiatrist submits to Blue Shield, they would indicate that the diagnosis was "300.02 - Generalized Anxiety Disorder".
As for your second question, if your psychiatrist is a BCBS preferred provider then no, they are not going to require an additional co-payment. If they are a preferred provider then all you have to pay is the $20 (or however much it is) co-pay, as long as you have already met your deductible for the year, and your insurance will pick up the rest.
There is a chance that a diagnosis with a mental health condition will affect your coverage and rates in the future, but this is usually more of a problem for people who are switching insurance providers or plans than it is for someone who is maintaining the same health insurance plan over time. You may want to call somebody at BCBS and talk to them directly about how certain pre-existing conditions will impact your coverage and rates.
Good luck!
October 25th, 2009 at 3:31 pm
–HI DAISY !! YOU DON’T NEED A PSYCHIATRIST !! YOU NEED TO GET TOGETHER WITH ME AND MAKE MAD PASSIONATE LOVE FOR A FEW HOURS !! MY TALENTED TONGUE WILL HAVE YOU MOANING !!!