If your BCBS home plan is administered as a PPO, even if it is underwritten elsewhere in Washington, DC metro area (i.e., Care First) or in a state other than Virginia, you should be able to use your benefits for the services we provide. Organizations that administer the behavioral health provider networks on behalf of BCBS PPO plans frequently provide incorrect information to subscribers about a provider’s network status; use Anthem’s Find a Doctor site to confirm network participation.
When you use your eligible BC/BS benefits plan with one of our Anthem in-network providers, it means that we will accept whatever fee reduction/discount Anthem BCBS may impose, according to the terms of our provider contracts with Anthem. You are not balance-billed for the difference between our usual fee, and the reduced fees that are allowed by Anthem BCBS of Virginia. However, you are financially responsible for any co-payments/co-insurance, deductibles, and non-covered services. If you have questions about covered services, or about your anticipated out-of-pocket expenses, please contact your plan administrator, or log in to view your plan information on the Anthem Website.
Because some of the benefit plans administered by Anthem BCBS require preauthorization prior to receiving services (such as psychological and neuropsychological testing, or developmental assessments), you should check with your plan administrator or call the Customer Service number on the back of your insurance card to see if an preauthorization is necessary before to your first appointment.
The therapists at our office are approved network providers only with the HMO plans administered by Anthem Blue Cross Blue Shield in Richmond, Virginia. Unfortunately, this is not the case with HMO plans; generally, HMO plans, including those administered by Care First BCBS in Washington, DC, require you to see a provider in their approved HMO provider network.