Is the policy active?
Confirm that the member’s policy is active on the expected date of service and that behavioral-health benefits are included.
Insurance eligibility and benefits
Get the coverage answer that actually applies to you.
A payer logo alone cannot answer whether a service is covered. Verify the exact plan, behavioral-health administrator, network, service, location, authorization rules, and expected member responsibility.
Six questions to verify
Turn a payer name into a usable coverage answer.
Ask these questions for the exact person, plan, service, location, and expected date of care.
Who manages behavioral-health benefits?
The name on the card may not be the organization that manages behavioral-health care. Ask whether benefits are carved out to another payer or administrator.
Is the exact care in network?
Network status can differ by legal entity, location, clinician, service, level of care, and plan—not only by the payer logo.
Is authorization or a referral required?
Ask about prior authorization, referral requirements, clinical review, visit limits, and any continued-stay review before care begins.
What might I owe?
Request the deductible, amount already met, copay, coinsurance, out-of-pocket maximum, and remaining out-of-pocket amount.
What proof should I keep?
Record the date, representative or portal, reference number, benefit summary, network answer, and authorization details. Benefits quoted by a payer are not a guarantee of payment.
Crimson Coverage Compass
Nine answers. One call.
Check each one off as your plan confirms it.
Nothing you tap is saved or sent.
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Answers confirmed
Tap a card to check it off.
Read this to your plan
I am checking behavioral-health benefits for this plan and start date. Please confirm: coverage is active, who manages behavioral health, whether Crimson Heights is in network for this service and location, what is covered, whether approval is required, any visit limits, and my deductible, copay, and out-of-pocket maximum. Please give me a reference number for this call.
Rather have us walk through it with you?
Our team can talk through your plan, our services, and the next step for care.
Use the payer portal well
A login is a starting point, not the final answer.
Portal information can lag, omit delegated behavioral-health administrators, or show a provider without confirming the exact service. Use this sequence before relying on the result.
- 01
Sign in through the official payer resource
Use the member portal tied to the exact plan. If the directory cannot verify an official portal, use the URL or member-services number printed on the insurance card.
- 02
Open the plan documents
Look for the Summary of Benefits and Coverage, Evidence of Coverage, benefit booklet, exclusions, and behavioral-health or mental-health benefits.
- 03
Search the provider directory precisely
Match the network, service, location, and provider or facility details. A directory result is useful evidence, but it is not a guarantee of payment.
- 04
Confirm by phone when anything is unclear
Ask member services to verify every unresolved item and provide a call reference number. Use the number on the card when it differs from a public website.
Verification workflow
A clear record beats a verbal assumption.
Ask the payer to answer each item and keep the reference number. If the answer conflicts with another source, call before care begins.
- 01
Identify the exact plan
Start with the payer, plan, member prefix or group, behavioral-health administrator, requested service, and preferred location.
- 02
Check eligibility and network
Confirm active coverage and whether the exact Crimson Heights entity, location, clinician or facility, and service are participating.
- 03
Confirm clinical and payer requirements
Review referral, prior authorization, medical-necessity, visit-limit, and continued-review requirements before care begins.
- 04
Document the answer
Keep the verification date, source, reference number, network answer, benefit summary, authorization details, and expected member cost sharing.
Ready to look up your payer first?
Search all 118 current source records by payer or plan name.