Helpful Information and Hints when Determining Insurance Benefits:

Before calling your insurance company, have ready both sides of your insurance card, as well as the full name, address, and date of birth of the person to be evaluated.

1. Call the number on your insurance card for mental health services, eligibility and benefits, or customer service. Choose the number for mental health/substance abuse, if there is one.

2. When inquiring about services for a psychological evaluation, clarify that you are asking for benefits for an out-of-network provider. Our provider information, if required, is:         Dr. Glori Gray and Psychological Associates NPI # 1336876994

*Please note: It is a new policy for many insurance companies to require that you give your verbal permission before my office can even inquire further about benefits. Please be sure to sign the release of information included on the portal as well as give your permission when you call.

3. Ask for benefits for psychological therapy services billed under CPT code 90847 or 90846. Be sure to clarify, if the deductible applies, how much of the deductible has already been met, and what percentage of the bill will be paid by insurance. Also, ask for benefits for CPT code 90791 for the initial intake.                

-> Note: If you are interested in psychological testing, the CPT codes are 96130, 96131, 96136, 96137, 90847, and 90887. Insurance companies typically do not pay for services that they do not deem “medically necessary,” which includes testing for academic purposes (including learning disabilities), giftedness testing, and sometimes testing to get a diagnosis of attention-deficit/hyperactivity disorder. Please request benefits for psychological testing for general cognitive functioning and behavioral concerns.

4. If inquiring about testing, ALWAYS ask specifically if a prior authorization is necessary prior to beginning psychological testing. If so, ask for the procedure to complete the authorization and how long it will take to complete the process. Have them send/fax the forms that need to be completed for preauthorization and give you the phone number to check on the authorization process. The forms can be faxed to us directly at (704) 765-4749.

5. If inquiring about testing, ALWAYS ask if any specific mental health diagnosis is not covered.

6. Our providers are willing to fill out all paperwork needed to complete a prior authorization and to prepare a Superbill at the end of our process for you to give to your  insurance company, as needed. *With regard to comprehensive psychological testing, our policy is for you to have you pay the full amount at the time of the initial appointment, if you decide to proceed with the assessment process. Whatever is covered by the insurance company is then usually submitted to you directly. So please be sure to ask the insurance company upfront.

Thank you for helping us work with your insurance company, as needed. We look forward to working with you further.