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How to Select a Provider Using Insurance

How to Select a Provider Using Your Insurance

Step 1. Find Your Insurance Card
If you do not have your card at Montclair State, ask your parent or guardian to text you a photo of the front
and back of the card.

Step 2. Call Your Insurance Company
Call the number on your card for mental health services. The phone number is likely on the back
of your card and may be listed under ‘behavioral health services’.

Step 3. Get Information about Your Benefits
After dialing the mental health services phone number, you will speak with a representative from
your insurance company. They will ask you to verify some information to ensure that you are the
individual covered by the insurance plan. When they ask why you are calling you can say, “I
want to find out what my benefits will cover for outpatient counseling.”
Some insurance plans require a payment for each visit you make to a provider. Ask how
much you will pay per session; this is called a “co-pay”.
Some insurance plans have an amount that you have to pay out of your pocket first; this
is called a “deductible.” Once you pay that amount your insurance company will cover
part or all of your visit depending on your coverage.

Step 4. Find In-Network Providers
Ask your insurance company for assistance with finding a mental health provider.
If you are looking for someone to talk with, ask for a list of in-network clinicians (Counselors and/or Psychologists). If you are looking for someone who can prescribe medication, ask for a list of in-
network Psychiatrists or Psychiatric Advanced Practice Nurses.

Step 5. Call Providers
Start by calling one or two of the providers on the list you were given by your insurance
company. You may need to call more than one, if the first provider doesn’t return your call
within 24-48 hours. If you need a clinician and a Psychiatrist, you will need to call people from
both lists. Providers almost never pick up the phone due to being in session during the day. You
will need to leave a message with your name, phone number, and a good time to reach
you. Be sure to speak clearly and slowly in the message and say your phone number twice.

When you leave a message or talk to the provider, ask if they are accepting new clients,
tell them what kind of insurance you have, and say something about what has been
bothering you that has led you to call them. Make sure that your voicemail is set-up and able to accept new messages. If a provider is not able to leave a message, you may not know they called. Most providers won’t email or text to set-up an initial appointment, so talking to them on the phone is necessary. If you are unsure how to proceed, you can call CAPS (973-655-5211) and ask to schedule an appointment with the Referral Coordinator/Case Manager who will assist you in verifying benefits, identifying providers, and in scheduling an appointment.