If you are a current patient and and need to update your insurance plan, please do so by filling out the following form:
Participating Insurance Plans
Some of our clinicians participate in insurance plans. Not all clinicians participate in each plan. Please check provider bio pages for further information about accepted insurance plans.
- EHP-Johns Hopkins Healthcare
- US Family Health Plan & Uniformed Services
- *Tricare
- Conifer/Informed
- Medicare (limited number of providers)
- **Carefirst/BCBS (limited number of providers)
* New patients that are covered by Tricare Prime must have a Prior Authorization from their Primary Care Manager (PCM) with the Waypoint provider specifically listed.
** Due to insurance carriers’ guidelines and Waypoint Wellness Center provider policies, Waypoint Wellness Center wants to be able to facilitate all our clients. To be able to do this, Waypoint Wellness Center has created a subsidiary Tax ID under the name Waypoint LLC for all Carefirst BCBS plans only. Providers who participate with Carefirst BCBS plan ONLY participate with Carefirst BCBS under Waypoint LLC. What does this mean to you?
- If you have Carefirst BCBS as your primary insurance and you are seeing a participating provider but have a secondary insurance such as JHHC/Tricare/etc. The Carefirst BCBS participating provider will bill under Waypoint LLC Tax ID to Carefirst BCBS as a participating provider. Since the provider does not participate with JHHC/Tricare under the Waypoint LLC tax ID, we cannot submit the service to the secondary insurance under a different tax ID. Meaning your secondary insurance will not be billed due to non par status under Waypoint LLC and will be patient responsibility.
- If you have a participating insurance carrier and you are seeing a participating provider but have a Carefirst BCBS as your seconary insurance Waypoint Wellness Center will bill under Waypoint Wellness Center Tax ID to the participating insurance carrier. Since the provider does not participate with Carefirst BCBS under Waypoint Wellness Center, we cannot submit under the subsidary Tax ID. Meaning your secondary insurance will not be billed due to non par status with Carefirst BCBS under Waypoint Wellness Center and will be patient responsibility.
Out-Of-Network Treatment Checklist
When a clinician is considered “Out-of-Network,” payment is required at the time of service. Cash, check, and all major credit cards accepted. You can then request reimbursement from your insurance company.
If you would like to pursue reimbursement, we advise that you contact your member services department to verify if your plan offers out-of-network benefits for outpatient mental health. The number should be located on your insurance card.
If out-of-network benefits are available, you should ask:
- Claims Address
- Do I have a deductible?
- Deductible Amount
- What is the maximum number of visits per year?
- What percent of reimbursement is covered under my benefit?
- What is the reimbursement rate?
- The most used codes at Waypoint are as follows:
- 90791/2, 99204/5-Diagnostic Interview
- 90832, 90834, 90837 – Individual Therapy (each code has different time requirements)
- 90846 – Family Therapy w/o Patient
- 90847 – Family Therapy
- 96130 – Psychological Testing (first hour)
- 96131 – Psychological Testing (each additional hour)
- 96136 – Psychological and Neuropsych Test administration and scoring (first hour)
- 96137 – Psychological and Neuropsych Test administration and scoring (each addiotional hour)
- 99213/4/5 – Medication Managment
- How do I submit the claim?
- Is Authorization Required? YES or NO
- How do I obtain authorization?
- Effective date
- Expiration date
- Number of visits
- Procedure Code(s) Approved
If the provider needs to complete a treatment plan you are responsible for notifying the provider.
If you have any further questions about insurance, please email our Insurance Care Coordinator at Svia ds@waypointwellnesscenter.com.