Is Wilmington Mental Health Conrtacted with my insurance/behavioral health plan?
To verify whether your insurance/health benefit plan covers services provided at KRH facilities, please contact your insurance/health benefit plan directly by either visiting your insurance/health benefit plan’s website or calling the phone number listed on your insurance/health benefit plan identification card.
Do I need a referral before making an appointment?
Your insurance/health benefit plan may require a referral from a primary care provider or have other requirements for approval of care prior to scheduling an appointment. Please contact your insurance/health benefit plan to learn about your coverage.
What if my insurance/behavioral health benefit plan is not contracted with Wilmington Mental Health?
If your insurance/health benefit plan is not contracted withWMH, then WMH is considered a non-participating provider (also called “out of network”). A non-participating provider is a health care provider that does not have a contract with your insurance/health care benefit plan. This means that the non-participating WMH provider will not be obligated to directly bill your insurance/health benefit plan or to accept the payment rates offered by your insurance/health benefit plan. You will be personally responsible for payment of the charges by the non-participating WMH provider. You will need to deal directly with your insurance/health benefit plan to get whatever reimbursement you may be entitled to.
What if I still want to receive treatment?
If you choose to receive health care services from a non-participating WMH provider, unless you qualify for other adjustments to the amount of your bill, you will be required to pay for the full amount of your care out of your own pocket. An example of an adjustment would be qualifying for the WMH financial assistance policy. Except for emergency services, you may be required to pay for all or some portion of your health care services at or before the time they are provided or make other payment arrangements with the non-participating WMH provider’s patient accounts department.
Will I be reimbursed by my insurance?
It is possible that you might be able to receive reimbursement from your insurance/health benefit plan for some or all of the amounts that you pay for your health care services that are provided by a non-participating WMH provider. However, you will have to contact your insurance/health benefit plan directly and follow its rules. Upon request, the non-participating WMH provider will provide you with a copy of an itemized statement ("superbill") of the health care services that you received from WMH and the charges for those services. However, it is your obligation to file a claim with your insurance/health benefit plan and WMH is not obligated to accept the payment rates offered by your insurance/health benefit plan.