STEP ONE: Complete BPMMB Forms
Please complete the BPMMB Intake forms. The file below contains the New Patient Information form, HIPAA and Patient Services Agreement, Preferred Method of Communication, Release of Information(If you would like us to communicate about your assessment or treatment to others such as physician, school, family members,etc.), Adult Intake Form, and Child Intake Form. The forms can be filled out online and printed. If desired, you can print the forms then complete with a pen. Please bring the completed forms with you to the appointment.
STEP TWO: Complete Doctor's Forms
In addition to the forms for our BPMMB office, each patient needs to complete a doctor specific form. Locate your doctor below and select your doctor's form. The forms can be filled out online and printed. If desired, you can print the forms and complete with a pen. Please bring the completed form with you to the appointment.
STEP THREE: Verify Insurance Benefits
If the patient will be using insurance, we request that the insurance coverage is verified before the first appointment and each time there is a change in insurance. To verify insurance, call your insurance provider and ask the questions listed in the Insurance Verification Checklist file below. Please take note of the answers and bring the completed form with you to the appointment.
We are out-of-network providers for most insurance, including Blue Cross Blue Shield of Alabama. We are on very few managed care panels for mulitple reasons. It has been our experience over the past 10-15 years that insurance companies can be detrimental to the process of therapy by abruptly cutting off treatment, pressuring providers to provide certain kinds of treatment, delaying payment, and conducting audits that compromise our ability to protect your confidentiality and privacy. The policies and procedures of some insurance companies are highly disruptive to our ability to provide care. Our commitment to protecting your confidentiality is the cornerstone of what we do and we hold this responsibility in the utmost regard.
If your health insurance provides out-of-network reimbursement for mental health services, you may be able to get direct reimbursement from your insurance company by submitting a statement of services (which we can provide you) and a claim form. For some insurance companies, we can submit these claims directly for you. When we bill insurance directly, most insurance companies require us to provide a diagnosis, dates of service, and all charges on the statement. We will not divulge more detail than that about our clients unless you give us written permission to do so. Please check with your insurance company about whether they require additional information. If so, fill out the release of information form allowing us to release confidential, HIPPA protected information to your insurance company.
If you have a flexible spending account (FSA) through your employer, most will allow you to pay for psychological assessment or treatment on your FSA debit card. You may also be able to deduct the cost of therapy as part of your medical expense deduction on your income tax. Whatever your circumstances, we know that psychotherapy can be expensive and we take your investment in therapy with us very seriously. We are committed to providing the highest quality service at all times.