Visit us Mon-Fri from 9:00am to 6:00pm
 3825 Market St, Suite 4
 info@wmhwc.com
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Pre-Registration
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Patient Portal

Call or Text: 910.777.5575

Appointment Request
REASONABLE AND APPROPRIATE

Medical Necessity

Health care services that are paid by insurance companies require reasonably justification based on evidence-based clinical standards of care before evaluation, diagnosis, or treatment of an illness, injury, disease, or its symptoms can take place.

Most insurance companies require a diagnosis that will remain on your permanent medical records and usually dictates how many, and what types of therapy you are eligible to receive. We believe that all your treatment options should be decided between you and your therapist.

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FULL REIMBURSEMENT
Out of Network

Our services are reimbursable by most "out of network" insurance plans. Meaning that your insurance company will fully or partially reimburse for care that is outside their network of health care providers. Please contact your insurance company and request an authorization for out-of-network treatment prior to initiating contact with us. Questions about out-of-network benefits, or what percentage you will pay for out-of-network psychotherapy can typically answered by your insurance benefit plan manager.

We currently do not accept Medicaid or Medicare. We also do not participate with BCBS Blue Value Plan.

NORTH CAROLINA’S TRANSFORMATION

Medical Necessity

If you are eligible for managed care and receive benefits under North Carolina’s Medicaid program, you probable were asked to choose a health plan. Wilmington Mental Health participates in the following managed care plans:

AmeriHealth Caritas NC
AmeriHealth Caritas NC
BCBS Healthy Blue
BCBS Healthy Blue
WellCare of NC
WellCare of NC
Carolina Complete Health
Carolina Complete Health
UHC Community Plan
UHC Community Plan
LIMITED NETWORK
Not Participating

We currently do not accept Medicaid or Medicare. We do not participate with some commercial insurances that are part of Medicaid. We also do not participate with BCBS Blue Value Plan (this network product has been closed since 2014).

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blue cross blueshield of north carolina
ELIGIBILITY
Insurance Verification

Before your first appointment, we need to figure out exactly what your investment in treatment may be. Let’s start by verifying your payment plan and accurately calculating your financial responsibility.

Patient Eligibility And Benefits Information
Subscriber’s Name:
Address:
Date Of Birth:
Gender:
Yes
Female
Subscriber’s Relationship To Patient:
Insurance Card:
Primary Insurance
Play Type (if known):
Insurance Company:
Subscriber ID/Policy No:
Group No.:
Effective Date of Coverage:
Is Referral necessary:
Yes
No
Is Prior-Authorization Necessary:
Yes
No
Out-of-Network Benefits:
Yes
No
Secondary Insurance
Play Type (if known):
Insurance Company
Subscriber ID/Policy No:
Group No.:
Effective Date of Coverage
Is Referral necessary:
Yes
No
Is Prior-Authorization Necessary:
Yes
No
Out-of-Network Benefits:
Yes
No
I attest the information above is correct to the best of my knowledge and reflects my current insurance coverage or my confirmation that I have no coverage (Insurance, Medicare, or Medicaid) for these services. I have also been advised to notify the hospital as soon as possible if there are any changes to the insurance coverage listed above to ensure I am not held financially responsible for services that could be covered by insurance. I understand that failure to disclose insurance coverage may result in the responsible party having to pay for services that would have been paid by insurance if the hospital is unable to bill the insurer within their billing deadlines.
eSignature (First and Last Name):
EXPECTED CHARGES
Billing Protections
Good Faith Estimate: We have a responsibility to outline the estimated cost of the total expected cost of any nonemergency service we offer, including related costs like refills, tests, and other company fees. You can ask us to provide you with this estimate before you choose to schedule an appointment.
No Surprise Bill: You are protected from balance billing when you receive services by an out-of-network. In this case, you will not be charged more than your plan’s copayments, coinsurance and/or deductible.
Billing Questions: If you have questions about your WMH bill, please call (910) 777-5575 Monday - Friday 9:00 a.m. to 7:30 p.m.