Select providers at Upside Therapy and Evaluation Center are currently in-network with Blue Cross Blue Sheild of Texas. This guide is intended to assist you in determining your in-network benefits and out of pocket cost for services, particularly for psychological evaluations. You are responsible for looking up your benefits and calling your insurance provider to verify whether the services will be covered and what amount you will owe.

1. Look at the back of your insurance card.

2. Call the Member Services number.

3. Follow the prompts to check eligibility and benefits. You will need:

a. Insurance holder member ID Number.
b. Client’s (whomever is receiving services) date of birth.
c. Client’s first and last name.

4. Determine your In-Network deductible, out of pocket, coinsurance, and copay and how much you have met towards each.

5. Check if your plan covers individual, couples, family therapy, or group therapy:

a. CPT codes: 90791 90837, 90834, 90847, 90853  (these are codes billed for therapy services).
b. Place of Service: Office (Code 11; this is where the testing will occur).
c. Provider type is Professional.
d. Provider NPI is 1184413999
e. Provider Tax ID is 87-4016564
f. Provider name is Dr. Charleen Wilder
g. If you need a diagnosis code, use: F41.1 (Generalized anxiety disorder)
**You may need to talk to a customer service representative.

6. Check if your plan covers psychological testing; the following information will help.**

a. CPT codes: 96132, 96133, 96136, and 96137 (these are codes billed for testing services).
b. Place of Service: Office (Code 11; this is where the testing will occur).
c. Provider type is Professional.
d. Provider NPI is 1184413999
e. Provider Tax ID is 87-4016564
f. Provider name is Dr. Charleen Wilder
g. If you need a diagnosis code, use: F41.1 (Generalized anxiety disorder)
**You may need to talk to a customer service representative.

7. Determine if you need preauthorization for testing.**

a. If you need preauthorization for testing, you will need to get the phone number and/or website of where the forms can be located.