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HANDLING YOUR REFERRAL
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Your referral to off-campus services
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Making that first call
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Getting to your appointment
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Dealing with insurance
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Frequently Asked Questions
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Additional support
YOUR REFERRAL TO OFF-CAMPUS SERVICES
You and your UCC counselor have discussed your concerns and the resources that might be of help to you in resolving them. You have been provided with a referral to off-campus services. Your next step is to work with your counselor to connect with services that are as affordable, accessible, and appropriate as possible.
Some students wonder why more extensive psychotherapy and psychiatric services are not available on campus. Ongoing mental health care is generally considered a private health care responsibility, not a service provided by the university. Your health insurance is intended to help you cover the cost of such care.
For many students, college is the first time they have taken responsibility for their own health care. It may be the first time for knowing where to go for help, articulating your symptoms or concerns, making an appointment, finding you own way to your doctor?s office, talking with your family or others concerned for your wellbeing, or following through treatment recommendations.
This pamphlet will provide you with information and guidance as you get connected to the mental health support you need. You should not hesitate to call your UCC counselor, to help you through the process.
MAKING THAT FIRST CALL
GET STARTED
After your UCC counselor gives you the names and numbers of off-campus providers, make your first calls as soon as possible to get the process started. If you need company or support making these calls, you might ask a friend or UCC counselor to sit with you as you do so.
LEAVE MESSAGES
Don't be surprised if you get an answering machine. Leave a message something like this:
"Hello, my name is Lee and I was referred to you by the George Washington University Counseling Center. I'd like to discuss the possibility of working with you. Please call me back at (202) 885-0000. The best time to reach me is before 10 a.m. or after 7 p.m. Thank you."
ASK QUESTIONS
Here are some good questions to ask a potential provider during your first phone call:
"I have United Healthcare insurance. How would we handle my insurance claims? What are your fees and payment policies?"
"My concerns have to do with (an eating disorder/anxiety/depression/
grief/etc.). Is this something you work with?"
"I don?t know my way around DC very well?would you please give me directions to your office?"
GETTING TO YOUR APPOINTMENT
PLAN AHEAD
Get directions and determine in advance your mode of transportation. Leave plenty of extra travel time for your first appointment. Find out about metro bus and subway schedules, shuttle schedules, getting a taxi on campus, and how to get there.
BE IN TOUCH
If for any reason you are going to be late or miss the appointment, call your provider to let them know. If you have trouble connecting with a provider, contact your UCC counselor for assistance or additional referrals.
DEALING WITH INSURANCE
KNOW YOUR INSURANCE PLAN
You are not required to use your insurance to pay for private care, but most people do. Keep in mind that you are responsible for paying any fees you incur that are not paid by your insurance. If you have the United Healthcare insurance plan, you must be referred by the UCC or Student Health Services in order to waive your deductible when paying an off-campus provider. Check to be sure SHS or your UCC counselor has registered your referral. If you have some other insurance policy, determine your policy's requirements by contacting your insurer directly. If you are on your parents' plan, you may have to speak with your parents to gain access to your insurance. Your UCC counselor can help you think through how to have such a conversation with your parents, or he/she can speak to your parents for you (with your written permission).
WORK WITH YOUR INSURANCE COMPANY
You must work directly with your insurance company and your off-campus provider to file insurance claims. Every insurance policy is different, so you must take responsibility for finding out how your insurance policy works. Policies differ in terms of which providers you can see or how often, whether a referral is required, the amount of your coverage, etc. Good ways to find out about your insurance policy include calling your insurance company on the phone, looking them up on the Web, or reviewing your policy brochure.
QUESTIONS TO ASK YOUR INSURANCE PROVIDER
1. Does my plan cover mental health outpatient visits?
2. Do I have to see someone on the provider list?
3. If yes, where can I get a copy of the provider list for providers in DC?
4. Is there anything I need to do to have my counseling sessions covered by insurance, if I am living out of state?
5. How does my coverage differ if I see a participating provider versus a provider "outside the network"?
6. For how many sessions can I be seen?
7. What is the percentage co-pay for sessions?
8. Do I have a deductible that I must satisfy? If yes, how much?
9. Is there a pre-existing conditions clause for my plan? If yes, what is the length of time I have to wait prior to my insurance covering a pre-existing problem?
10. What is the effective date of the plan?
11. Do I have to fill out any paperwork or be pre-certified prior to seeing a therapist?
12. How do I submit claims for payment?
13. What information will you need from my therapist in order for my claims to be paid?
14. Where do I send my claims?
15. Approximately how long does it take to receive a reimbursement?
LEARN THE TERMINOLOGY
Below are some general descriptions of insurance terms. Refer to your own in Provider - the professional or facility providing you with a service.
Claim - the request submitted to your insurance company by either you or your provider, asking them to help pay for the services you receive. Some policies require that the provider submit the claim and be reimbursed directly by the insurance company; other policies require that you pay your provider and then submit a claim.
Deductible - the amount you must pay out-of-pocket before your insurance company will begin to help cover your bills. For example, if your policy has a $100 deductible, you must pay the first $100 of the fees you incur for that insurance year.
Co-pay - the amount you pay for a service in addition to whatever your insurance company pays. For example, your insurance company may require that you co-pay a certain amount (e.g., $20) or a certain percentage (e.g., 20% of the bill) per visit, while the company pays the rest.
Benefits - the types of services and costs that your insurance policy covers. For example, some policies have no outpatient mental health benefits, or require a referral/approval in advance, or have a "cap" or upper limit of payment, or require that you use only their "preferred" providers. You must determine the benefits of your policy by contacting your insurance company or by reading your policy carefully.
ADDITIONAL INFORMATION ABOUT YOUR INSURANCE
The UCC website (gwired.gwu.edu/counsel) offers additional information about insurance/referrals. Information about the United Healthcare student insurance plan is available at www.uhcsr.com.
FREQUENTLY ASKED QUESTIONS
Will my health insurance pay for off-campus care?
Health insurance, whether through United Healthcare or some other plan, can often help with the cost of off-campus services. Your counselor can help you with insurance referrals. The best source for information about your coverage and benefits, however, is your particular insurer.
Why can't I see a counselor/psychiatrist on campus?
Ongoing mental health care is generally considered a private health care responsibility, not a service provided by the university. Your health insurance is intended to help you cover your costs. Even though most students feel that reduced-fee ongoing counseling on campus would be more convenient and less expensive, your mental health support may need to be more specialized, extensive, or immediately available than the services that can be provided on campus.
Why do some students prefer off-campus care?
Some students prefer to go off-campus rather than see a counselor at the Counseling Center. It can feel more private to have your own therapist off-campus rather than to come in to the Counseling Center. There is a wider choice of therapists off-campus. Some services simply aren't available at the Counseling Center, such as neurological services, intensive individual psychotherapy, alcohol and drug detoxification/treatment, inpatient services, etc.
What if I don't like the person I was referred to?
We cannot monitor or guarantee the quality of care students receive from private providers, yet it is important that the services you receive off-campus are helpful to you. If you feel you have not found a good match, call your Counseling Center intake counselor at 994-5300 and s/he will help you sort out your next steps. You can consult with us about any concerns you have about your private care, but you should certainly call if you feel that the person or place you have sought treatment from has not treated you well. If your counselor is not available at the time of your call, please leave a message or ask the receptionist if another counselor is available.
All I need is a prescription refill - why can't I get that at the Counseling Center or the Student Health Center?
If you are on medication for a psychological/psychiatric condition, it is important that your medication be well-supervised, even if your condition has been stable for a long time. The psychiatrist at the Student Health Services is a part-time consultant who only sees students who are in counseling with an on-campus counselor. Most students who need medication see a psychiatrist off-campus who can provide them with more accessible and tailored care. Excellent psychiatric services are available to students in the greater DC area and in many cases insurance can help with the cost or sliding fees can be arranged. Either the SHS or UCC can help with referrals for psychiatric services.
ADDITIONAL SUPPORT
▪ Contact a UCC counselor if you need practical help or emotional support in connecting with off-campus services.
▪ Information on choosing a therapist, the nature of psychotherapy, and assessing the quality of your off-campus care is available on the UCC Web site: gwired.gwu.edu/counsel.
▪ Information is also available in the UCC Self-Help Library located at the Counseling Center.
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