What does insurance cover?

You’re not alone - navigating insurance can feel confusing and frustrating at the best of times. We are here to walk alongside you, offering guidance and support as you learn what your policy covers and what your out-of-pocket responsibilities may be.

While every insurance plan is different, understanding a few key terms can help you feel more confident and informed as you explore your benefits.

Insurance Terms

Premium - This how much you pay each month for your insurance plan.
Deductible - Some plans require that you pay to a deductible, this is the amount of money you have to pay out of pocket before your insurance will help pay for any services.
Coinsurance - Once you met your deductible your coinsurance takes over. This is the amount you will then be responsible for, it is always calculated as a %. Example if you have a 20% coinsurance and you use a service that costs $100 dollars, then you would 20% of that.
Co-pay - Some plans have co-pays. These plans do not require you to pay a deductible before insurance helps pay for services. You have a set amount to pay for each visit. The copay amount is decided and set by the insurance company. Out of Pocket Max - Confused with “Deductible” the out of pocket max is the most amount you are expected to pay for your covered healthcare needs in a calendar year. It places a cap on how much you will have to spend in 1 year.

How do I find out what I will pay for therapy or testing?

Below is a detailed walkthrough.

  • We are in network with most major Insurance companies including BCBS, United, Optum, Aetna, Cigna, Baylor Scott & White, and the list is growing. For an updated list, please call and ask our admin team at 214-952-2324.


  • On the back of your insurance card is a customer service “1-800” number. This is your best option to get accurate information from your insurance company about your policy. Please make sure you have your card with you when calling. The insurance representative will need some of the information that is on the card, as well as your Social Security Number, DOB and address for verification purposes.

  • Insurance companies will need to know our National Provider Identifier, or “NPI.” This is just a number assigned to our facility for verification. We have 2 different NPIs so please provide both when prompted by the insurance company representative.

    -NPI 1013182914

    and

    -NPI 1952766008


  • CPT billling codes are how the insurance company knows what services we are providing and what the cost will be. You will need to give these to the insurance representative for them to give you a quote. We provide many services, but the 2 most common are:

    Initial intake session - 90791

    Talk Therapy session - 90837

  • This can happen, but is usually because you have a deductible to meet or co-insurance and they need us to verify rates for you. If this happens, please ask the following questions:

    Do I have a deductible to meet? If so, what is it, and how much have I paid towards it?

    Do I have co-insurance, and if so what it is?

    Once you have that information, please email info@mansfieldcounseling.com and we can update your chart.

  • We have cash pay rates we can easily quote because we are in full control of our cash rates. Insurance rates are not in our control. Those are set by the insurance companies.

    Additionally, there are hundreds of types of insurance policies from each insurance company and we are unable to verify which policy you have purchased. Since Mansfield Counseling is not the customer for the insurance companies, they do not respond as quickly or with as much care as they will for you.

  • There are some plans that luckily cover 100% of mental health costs. However, most do not fully cover costs until the out-of-pocket max is reached. Most plans are deductible plans or co-pay plans. Understanding your policy is valuable information and we hope we can help you do just that.

  • Call our main line at 214-952-2324 or email us at info@mansfieldcounseling.com and let our team know so we can make adjustments on your out of pocket responsibility. Once claims are returned to us after your first session, we will make the necessary adjustments and encourage our clients to contact us if they see a discrepency on their end.