FAQ

Frequently Asked Questions:

Do you accept insurance?

Yes! All clinicians at Three Oaks Behavioral Health & Wellness are in-network providers with AetnaEvernorth (formerly known as Cigna) & Blue Cross Blue Shield including all PPO plans, Blue Advantage, Blue Select, Blue Care, Classic Blue, Blue Options, NC State Health Plan, Blue Federal, and Out of State BCBS PPO plans.

We also accept the [North Carolina State Health Plan]. Teachers, state employees, retirees, and their dependents are eligible for health coverage through the Plan. Additionally, we are able to bill out-of-network with other major insurance companies.

Our practice is not in-network with: BCBS Blue Value, Blue Local, Blue Home, United, Tricare, Medicare and Medicaid. 

If using health insurance, insurance companies & employee assistance programs (EAPs) often require that you receive a mental health diagnosis in order to access benefits. This mental health diagnosis becomes part of your permanent medical record. We will inform and discuss with you any relevant diagnosis. Please consider this information when determining whether private pay or filing with your insurance is the desired option for you.

*Note: If the client is NOT the primary insured person, please include the policy holder's full legal name in addition to the client's name. (Example: The client is a minor and/or dependent & is insured under their parent; The parent’s legal name and date of birth needs to be shared.)

It is ultimately the responsibility of the client to monitor their insurance benefits (meeting deductible, copay changes, etc). We highly encourage that you also reach out to your insurance company to verify the same information. Our group NPI is 1528563194 and the primary CPT codes used for outpatient therapy sessions with our providers are 90837 and 90791. When you call your insurance company and provide them with the NPI & CPT codes, they should provide you with the same verification information our billing team provides.

Any relevant deductible, copay or coinsurance amount will be expected at the time of your therapy session and will be processed by your provider.

We ask all clients to notify us as soon as possible when they believe they have met any relevant deductible or have any change to their insurance as this will impact the amount owed for each session. Inaccurate billing information could lead to outstanding invoices that are the responsibility of the client to reconcile. We want to prevent outstanding balances by ensuring all insurance & billing information is accurate and up-to-date. Thank you for partnering with us in this effort!

What methods of payment do you accept?

Cash, check, credit card, Flex Spend Accounts (FSA) and Health Savings Accounts (HSA) are accepted forms of payment.
*Regardless of payment method, we ask that a credit card be saved on file.

I have a billing question. Who can I connect with?

Please reach out to our Billing Team via email:
clients@threeoaksbehavioralhealth.com

Do you offer sliding scale/reduced rates, or payment plans?

We are dedicated to providing quality mental health care services & do not want finances to be a barrier to treatment. Some of our therapists offer flat-fee, reduced rate sessions for select appointment times and clients in need. Please ask about the availability of our clinicians' reduced rate fees & payment plan options during your first communication with us.

Self-paying clients, or those who are considered out-of-network with our contracted insurance plans, are eligible for reduced fee services. We are unable to offer payment plans to clients utilizing insurance as that would put us in violation of our contracts.

See 'Working with an Intern' section on the main FAQs page.

Are you an out-of-network provider?

If we do not accept your current insurance plan, you may be eligible to use your out-of-network benefits. We are happy to provide you with a "superbill" for your services. (A superbill is an itemized form- similar to a receipt- that is used to create a healthcare claim, which can then be submitted for potential reimbursement.)

Please follow the steps below to determine your own reimbursement and benefits made available to you from your insurance provider. Three Oaks' Group NPI number is: 1528563194. Keep careful records of your conversation in the event you need to appeal a future decision by the insurance company regarding reimbursement. Call the number on the back of your insurance card to reach the Benefits Department and ask the following questions: 

  1. What is the representative's name and extension number?
  2. Does my policy cover an Out-of-Network, Licensed Clinical Mental Health Counselor/Licensed Clinical Social Worker/Licensed Clinical Addiction Specialist/Certified Rehabilitation Counselor?
  3. My therapist is willing to provide a statement, or superbill, of Session Dates Attended, the CPT code, and the diagnosis. Is this acceptable to the insurance company?
  4. Does my policy cover Individual Psychotherapy (CPT code: 90834 or 90837)?
  5. What mental health diagnoses are NOT reimbursable?
  6. How many sessions are covered per year?
  7. What is the lifetime maximum for mental health benefits?
  8. What is my Out-of-Network deductible?
  9. What is the allowed amount of the fee?
  10. What percentage of the allowed amount will be reimbursed? 
  11. How do I file a claim?

Many insurance companies will reimburse a percentage of the total fee paid. For example, your company may reimburse you 80% of the total fee paid ($80 of the total $100 fee). Other companies will substitute the $100 fee for what they deem appropriate, regardless of what you paid. For example, your company may say that they will reimburse you 80% of the "allowed amount of the fee." (You paid $100 for an individual session, but your insurance company only allows $80; therefore you will be reimbursed 80% of the $80, or $64.)

We have partnered with Mentaya to help clients use their out-of-network benefits to save money on therapy. Use this tool below to see if you qualify for reimbursement for our services!