Burkhardt Services, Ltd                  
60 Orland Square Drive     
Suite 203
Orland Park, IL 60462

708.364.7046
708.364.7048 (fax)

burkhardt.services@sbcglobal.net

 

Telecom Answering Service: 708 957-6484

Dale Burkhardt, MBA

Practice Manager

 

Mental Health/Chemical Dependency Insurance Hints

 

If you will be using insurance to pay or partially pay for services, the following will be informative:

  1. Before the start of Mental Health/Chemical Dependency (MH/CD) services, we strongly recommend contacting your insurance company to receive specific detailed benefit information. Ask questions, avoid making assumptions. MH/CD benefits are frequently less generous than their medical counterparts (see #7).
  2. MH/CD benefits are often subcontracted to a company different from the insurance company's name printed on your ID card. This subcontractor may have rules and fee schedules different from medical providers. For example, a different co-pay, separate deductible or an authorization requirement may apply.
  3. Although not a requirement, you may wish to see if the professional provider (psychologist or counselor) is contracted with your insurance company and its subcontractor. This information can be obtained by calling your insurance company or visiting its web site. Check with the provider's office to confirm that this information is still accurate.
  4. Typically, insurance companies will only pay for services considered "medically necessary." Some services are seldom paid by insurance. Examples are: environmental interventions, telephone consultations, court testimony, missed appointment fees and special reports. The provider's office may be able to provide some information on medical necessity.
  5. HMO plans seldom pay for services rendered outside of the organization. Sometimes an exception will be made if a necessary service is available only outside the plan.
  6. PPO plans do allow for non-contracted provider benefits but the payments for these services are often reduced.
  7. In Illinois, the General Assembly passed laws, signed by the governor, which mandate that fee-for-service group policies containing MH/CD benefits provided to employers with more than 50 employees and subject to other restrictions must reimburse services for "serious mental illness" at the same level as medical benefits. The insurance company, not the provider, determines if the combination of your plan, the service provided and diagnosis rendered meets these mandated standards. You will find the entire statute in the Illinois Compiled Statutes, Illinois Insurance Code, 215 ILCS 5/370c; www.ilga.gov/legislation/ilcs/ilcs.asp. Although this statute has many if, ands and buts, it will reduce the direct cost of MH/CD for many clients. Your insurance company may have some information on specific applications of this law.
Our practice is located in the southeast corner of the Orland Square Mall area, at the intersection of 151st Street and Regent Drive. The map below contains a minor error. Our building is actually east of the green arrow which presently points to a carpet store. 

 

 


 

Map

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