General FAQs
Do I need a referral from my physician?
Will CRG coordinate with my physician?
How do I know what services to ask for?
If I am a parent, what should I tell my child about the appointment?
Billing FAQs
Will insurance cover my appointments?
Do you file to my insurance?
Why are we paying in full?
Why does my EOB say the allowable charge is less than what I paid for my visit?
Do I need prior authorization?
Why is CRG only contracted with the Sagamore Provider Health Network?
If I leave my credit card on file, will I automatically be charged for appointments?
General FAQs
Do I need a referral from my physician?
CRG does not require a referral from a physician in order to see a new client. However, your insurance may require that you obtain a referral in order for the services to be covered by your insurance plan. Please visit our Insurance Information page to gain further information regarding checking your insurance benefits.
Will CRG coordinate with my physician?
At CRG we feel that collaboration with your physician is very important and we try to remain in contact with other professionals who provide care for you and/or your child. However, due to the nature of our practice, we have stricter requirements under HIPAA and Indiana state legislation which mandate that we must have your signed consent to share any of your information with your other treatment providers.
How do I know what services to ask for?
When you first contact CRG, you will speak with a member of our Intake Team. If you have not been referred to a specific provider or are unsure of what service you need, the Intake Coordinator will spend time with you discussing your concerns and giving you guidance regarding the likely “best fit” of services and provider to meet your needs. The purpose of your initial appointment is to further develop the best treatment plan.
If I am a parent, what should I tell my child about the appointment?
We believe that the best thing to tell your child is the truth but at a level he or she can understand. The more comfortable and positive you are with about taking the step to seek assistance at CRG, the more comfortable your child should be.
Billing FAQs
Will insurance cover my appointments?
Benefits for mental health services vary from policy to policy. It is your responsibility to contact your insurance company to determine your policy’s outpatient mental health benefits. If your insurance company is not a part of the Sagamore Provider Health Network, make sure you are checking on your out-of-network benefits. Please note that CRG’s speech and language services are always out-of-network and are sometimes considered a medical expense rather than a mental health expense. Additionally, CRG’s educational services, such as strategy instruction and assistive technology consultations, are not insurance reimbursable.
Do you file to my insurance?
CRG will file claims to your insurance company on your behalf, but payment in full will be required at time of service for patients whose coverage is not through the Sagamore Provider Health Network. Please note that CRG does not accept Medicare, Medicaid, TRICARE, or ICHIA and will not file to these companies.
Why are we paying in full?
CRG collects payment in full at time of service for all patients whose insurance is out-of-network because the benefits paid by these insurance companies should be sent directly to the insured instead of to CRG.
Why does my EOB say the allowable charge is less than what I paid for my visit?
CRG only participates with the Sagamore Provider Health Network. This means that we do not accept the allowable amounts set forth by other provider networks. Therefore, even if your visit was $140 and your insurance allowed only $51.35, you are still responsible for the entire $140.
Do I need prior authorization?
We recommend you inquire with your insurance company about any required prior authorizations for services you receive (or are scheduled to receive) at CRG. If you need assistance in obtaining these authorizations, please contact the billing office at (317) 575-9111 ext. 156.
Why is CRG only contracted with the Sagamore Provider Health Network?
When CRG was established in 1993, our providers were contracted with a number of provider networks. This experience taught us that contracts force providers to adapt their treatment recommendations to meet insurance companies’ stipulations. For example, most insurance companies do not consider educational services “medically necessary.” Consequently, contracts with those companies would prevent CRG from providing educational evaluations for children and adolescents with developmental, learning or behavioral difficulties. This remains true even if the services are in the patients’ best interests and families are willing to pay for the services themselves.
Additionally, because of the differences between CRG fees and the reimbursement rates of many insurance companies, CRG could be forced to increase fees for out-of-network and self-pay patients in order to compensate for the low level of reimbursement from in-network patients. For instance, initial appointments with CRG providers are 90 minutes to allow adequate time to review comprehensive clinical information, establish successful treatment relationships and formulate effective treatment plans. While rates of reimbursement vary among insurance companies, most companies reimburse at a rate which assumes only 50 minutes for an initial appointment.
If I leave my credit card on file, will I automatically be charged for appointments?
Our automatic credit card runs were developed as a convenience for families with children who attend appointments by themselves, or who would prefer not to check out after each appointment. You may opt to leave a credit card on file for us to charge automatically as fees are incurred on your account, but providing your credit card information will not automatically enroll you in this optional service. Please speak to one of our front office or billing staff if you’d like more information or would like to sign up for this service.
