FAQ

  • Yes, The Next Step is In-Network (INN) with many insurance plans. Our clinicians are credentialed with most policies offered by Aetna, Blue Cross Blue Shield, Cigna/Evernorth, and Optum/United Healthcare.

  • No, unfortunately, at this time The Next Step is not In-Network (INN) with Medicare or Medicaid/AHCCCS. Please refer to your plan’s customer service to locate a provider that is right for you.

  • Absolutely! We’re always happy to help. Even if we are not the right provider for you, we can provide you with a list of referrals who may be a great fit.

  • No, The Next Step offers self-pay rates for those who; elect to not utilize their insurance coverage, may be under or uninsured, as well as plans that are Out of Network (OON).

  • Yes, we are happy to provide you with an estimate of your out of pocket (OOP) cost for mental health care. In order to do so, please be ready to provide a copy of the front and back of your insurance card, the legal spelling of the first and last name of the primary insured, and their date of birth. We are only able to provide an estimate and our quote is not a guarantee of how your insurance plan will process the claims submitted on your behalf. You are encouraged to call your insurance plan directly to verify your benefits as well. We are happy to help you ask the questions necessary to have a better understanding of your coverage. All insured individuals are encouraged to independently retrieve a verification of benefits directly from their carrier.

  • This depends on the benefit coverage offered by your insurance carrier. Some insurance plans require your deductible to be met before the insurance carrier pays for services. If your deductible applies, then you will owe the rate set by your insurance carrier. If your deductible does not apply, then you may owe a copay or coinsurance amount set by your plan. A copay is a set rate for each appointment. A coinsurance is when the insurance plan splits the cost with the insured individual and is usually a set percentage of the total cost of each appointment.

  • We ask that you please provide a 24 hour notice of cancellation to avoid a fee. Effective July 1, 2024 the fee for Late Cancellations will be $75. Please access the secure Client Portal to manage your appointment status.

I would like to verify my benefits, but I’m unsure what to ask.

Don’t worry. We’re here to help. 

Provide the below information to your insurance plan so they can help you be an informed consumer:

The Next Step Counseling Services, LLC
1166 E. Warner Rd., Suite 206
Gilbert, AZ 85296

National Provider Identifier (NPI) 1881235356

Step 1: Call the insurance customer service phone number listed on your insurance card.

Step 2: Request “verification of benefits” or “eligibility and benefits.”

Step 3: Ask the following: 

  1. What is the plan’s coverage for “mental health” or “behavioral health” services that are provided “outpatient.” The Next Step offers “in-office” as well as “virtual/telehealth” appointment options.

  2. What is the plan deductible? Does the deductible have to be met before the plan begins to pay for services?

  3. Do I have to pay a copay or coinsurance?

  4. Are these primary service codes covered?

    1. 90791 - Intake (55 minutes)

    2. 90837 - Psychotherapy (55 minutes)

    3. 90834 - Psychotherapy (40 minutes)

    4. 90832 - Psychotherapy (25 minutes)

  5. Are these specialty service codes covered?

    1. 99404 - Cigna EAP (40 minutes)

    2. 90846/90847 - Family (30 minutes)

    3. 90839/90840 - Crisis

    4. 96127 - Assessment

    5. 99050/99051 - Services provided outside of standard business hours.

      1. Example of use - 

        1. Prior to 9am or after 5pm, Monday through Friday.

        2. Weekend or Federal Holidays. 

    6. 90785 - Interactive Complexity 

      1. Example of use - 

        1. Have other individuals legally responsible for their care, such as minors or adults with guardians, or 

        2. Request others to be involved in their care during the visit, such as adults accompanied by one or more participating family members or interpreter or language translator, or 

        3. Require the involvement of other third parties for coordination of care, such as medical providers, child welfare agencies, parole or probation officers, attorneys or schools. 

** The above listed service codes are the most commonly billed service codes at The Next Step. The Next Step may be considered an In-Network provider with your insurance carrier and your plan may still not cover all of these primary and specialty service codes listed. Informed Consent to Treatment includes consent to pay an additional fee of up to $5 per appointment (not per code) when specialty services such as 96127, 99050/99051, or 90785 apply. (Effective July 1, 2024) **

Contact SUPPORT@TheNextStepAZ.com with any additional questions or concerns.