What you need to know about payment for Mental Health Services

This information sheet provides general information to prospective clients of the Mental Health Services Division about your responsibility for payment for mental health services.

 

1. General Information
• Mental Health Services staff generally will meet with you before the onset of treatment to collect financial and insurance information and determine whether or not you are responsible for fees for yourself or your child.
• This information must be updated every year you remain in treatment.
• If you do have a fee, you are expected to make a payment each month.
• If your financial or insurance information changes mid-year, inform your clinic receptionist right away so that we can update our information and assure that you and your insurance are billed correctly for services we have provided to you.\
2. Sliding Fee Scale
• The Mental Health Services Division is required to use the State's sliding scale fee to determine client fees.  Based on the sliding fee scale, some clients are eligible for free care, and others have to pay an annual deductible, pro-rated into a monthly fee.  If you have "full-scope" Medi-Cal linked to SSI/SSDI, your services may be fully paid, but some people with Medi-Cal benefits will have a deductible they must pay beofre Medi-Cal will pay.  Healthy Families, HealthWorx, and Healthy Kids beneficiaries may have a co-pay for each visit.
3. Medi-Cal Eligibility
• If you do not have Medi-Cal and it looks like you may be eligible for this insurance coverage you will be asked to make an appointment with a Medi-Cal Eligibility Worker.  Even if you are not eligible for Medi-Cal you may be eligible for other low-fee insurance such as Healthy Families.
4. First Visit Paperwork
• Fifteen minutes before your first visit one of our staff will meet with you to complete information about your insurance coverage and eligibliity for the sliding fee scale. You may be asked to bring the following documentation to your first visit unless you already have full-scope Medi-Cal or Healthy Families:
• Documentation of insurance such as insurance/Medicare cards, Healthy Families, Healthy Kids or HealthWorx programs, insurance policy number, group number, or correspondence that includes these elements such as remttance advice statements.
• Documentation that verifies amount of client, spouse, parent income: pay stubs, W-2 Forms, tax returns, unemployment or General Assistance papers, bank statements.
• Bank/investment statements that verify amount of savings, bank balance, and assets.
• Documentation of monthly expenses: court-ordered payments, childcare, dependent support, mandated retirement contributions, and housing (rental agreement, cancelled check, receipt).
• Documentation that shows your address.
• This will allow us to identify the correct funding sources to help pay for your care.  You will be asked to sign a Payment Agreement explaining what, if any, fees you owe.  Clients who do not complete their paperwork will be considered 100% Self Pay and will be billed for full fee for all services.
5. Payments
• If you have a payment obligation, you will be asked to make payments once per month, based on your payment agreement.  Administrative staff will collect these payments when you check in for your appointment.  We will send you bills for the amount we do not collect on-site at our clinics.  Your bill has a phone number to call if you have questions about your bill.  We accept cash and checks.  The Address of the mental health office is 225 37th Ave., MLH322, San Mateo, CA 94403-4324.
6. Insurance Deductibles
• The Mental Health Services Division does not pay insurance deductibles for individuals who have received mental health services including pharmacy and lab tests and have been billed by their insurance.  It is the client's responsibility to pay his/her deductible.
7. Questions
• If you have a specific question about a bill you have received, call the phone number on the bill and someone will answer your question.  If you have more general questions about your financial obligations, please discuss them first with your clinician.