Billing
Core Revitalizing Center utilizes a direct-care model. With the direct-care model, health care becomes personalized again. This modality improves health care quality while reducing costs by removing the “middle man” (i.e. insurance companies) from the relationship between the patient and provider. The actualized outcome of the direct-care model is beneficial for the patient and the provider: longer, appointments, timely access to providers, and real accountability.
You can use your HSA or FSA account, actual cash, a check, or a debit/credit card to obtain one-on-one, high quality, direct care from Core Revitalizing Center. Your visits may also be covered by your insurance provider as out-of-network medical care. We provide you with a superbill to submit for insurance reimbursement using simple online applications (Reimbursify.com, Claimeye.com, Getbetter.co). Core Revitalizing Center in Lakewood Ranch (serving Sarasota, Manatee, and surrounding counties) does our best to help you get the most out of the insurance premiums you are paying.
Why is CRC “Out of Network”?
Confidentiality
CRC provides direct care to you and your family. No front desk staff. No nurses. No tech support. Hence, there is no room for “leakage” of your private information from a personnel standpoint. Dr. Tariq Halim or Dr. Banu Acan, DPT will contact you directly. CRC will NEVER provide any information to outside sources unless you provide written authorization to do so. Upon request, CRC will document all of your or your loved one’s medical records on paper (yes… hand-written notes stored securely and only accessible to the provider).
Example: If you have United Health Insurance, each time a provider submits an invoice to the insurance agency, Optum (United Health Group’s care services group) collects the patient’s medical diagnoses, tests, prescriptions, costs, and socioeconomic data. Optum has information for over 150 million Americans going back to 1993. The personalized information is then marketed to other companies (including those that are not involved in direct health care – such as life insurance companies).
Quality of Care
Obtain the highest level of care immediately with Core Revitalizing Center. When you come into the office, your provider greets you directly. There are no mid-level or paraprofessionals handling your care.
Healthcare parity, the equal treatment of all conditions in insurance plans, is an illusion. Insurance companies create numerous barriers to providing the highest quality of care. There are no set standards of care for wellness, mental health or physical therapy services.
Patient/Provider Autonomy
CRC and you determine when you should be seen, for how long, and if you need to continue receiving services. Dr. Tariq Halim and Dr. Banu Acan work with you in all facets of the treatment plan. What you need to get better is not dictated by any other parties. Insurance plans are able to set criteria for “medically necessary;” thus limiting your and the provider’s autonomy.
Treatment Options
Many “consumers” of medical services may not know, but insurance companies dictate treatment “options” for providers. This is especially short-sighted when it comes to mental health and physical therapy services.
Example: A 12-year-old patient with ADHD who has been on the same medication for 2 years requires refills. She is seeing a new provider in Florida after her parents moved due to an employment change. According to NCQA, the patient will need to be seen within 30 days after the initiation of the same medication. If the physician does not bring the child in within the 30 days, the provider is penalized and will likely receive less per patient from every single person with the same insurance the following year.
Need help submitting your insurance claims?
There is an app for that!
CRC Recommends using Reimbursify
- Download the Reimbursify App:
- Create an account – add yourself and/or dependents for whom you wish to file claims.
- Click the plus sign to create a claim.
- Add the Dr. Tariq Halim or Banu Acan, DPT as the provider and specify the Tax ID number: 47-3721200.
- Enter information about your claim.
- Reimbursify works with your insurance to get you paid.
- Find out more at reimbursify.com and remember to use promo code reimbursifive for FIVE free claims!
- Reimbursify is safe, secure, and HIPAA-compliant.
Submitting Insurance Claims
Core Revitalizing Center will assist you with submitting the claims reimbursement forms to your insurance plans. Your policy is an agreement between you and your carrier. If the claim is rejected or partially paid, your insurance company should send you an explanation of benefits.
Billing Codes (CPT)
Initial Evaluation – Office or
99204 (moderate complexity) +90833 (psychotherapy time) or
99205 (high complexity) +90833 (psychotherapy time)
Follow-Up Appointments – Office or
99214 (moderate complexity) +90833 (psychotherapy time)
99215 (high complexity) +90833 (psychotherapy time)
If a young child or disabled adult with a caregiver:
+90875 (interactive complexity present)
Common Diagnostic Codes (ICD-10)
ICD-10 | Description | ICD-10 | Description |
F90.2 | ADHD (combined) | F63 | Impulse Control Disorder |
F10.20 | Alcohol Dependence | G47.00 | Insomnia |
F41.9 | Anxiety | F32.9 | Major Depressive Disorder |
F84.0 | Autism | F33.8 | Mood Disorder |
F31.13 | Bipolar (manic) | F42 | Obsessive Compulsive Disorder |
F31.30 | Bipolar (depressed) | F91.3 | Oppositional Defiant Disorder |
F12.29 | Cannabis Dependence | F11.20 | Opioid Dependence |
F14.20 | Cocaine Dependence | F41.0 | Panic Disorder |
Z71.41 | Counseling on |
F60.9 | Personality Disorder |
F34.8 | Disruptive Mood Dysregulation Disorder | F29 | Psychosis |
Z55.9 | Educational Problem | F43.10 | Post Traumatic Stress Disorder |
United Healthcare
Claims (including the CRC superbill) should be mailed to the address on the back of the insurance card.
Tricare (Prime, Select, For Life, Active Duty, Reserve)
Claim Form – Requires Adobe Acrobat Reader
Claims (including the CRC superbill) should be mailed to the specific address based on the plan:
East Region Claims ATTN: New Claims |
West Region Claims Claims Department |
Tri-Care for Life Claims WPS TRICARE For Life |
Active Duty Claims P.O. Box 7968 |
Cigna - Open Access Plus
Guide to Explanation of Benefits
Claims (including the CRC Superbill) should be mailed to:
Medical Claims
P.O. Box 188061
Chattanooga, TN 37422-8061
Anthem - California
Claims (including the CRC Superbill) should be mailed to:
Anthem Blue Cross
P.O. Box 60007
Los Angeles, CA 90060-0007
Florida Blue (BlueOptions or BlueSelect Plans with Preferred Provider Provision)*
Claims (including the CRC Superbill) should be mailed to:
Medical Claims
P.O. Box 1798
Jacksonville, FL 32231-0014
*BlueCare, SimplyBlue, and myBlue plans do not provide out-of-network benefits.
Blue Cross Blue Shield - Federal Employee Program
Claims (including the CRC superbill) should be mailed to:
Claims
P.O. Box 1798
Jacksonville, FL 32231
Blue Cross Blue Shield of California
Claims (including the CRC Superbill) should be mailed to:
Blue Shield of California
P.O. Box 272540
Chico, CA 95927-2540
Blue Cross Blue Shield of Michigan
Claims (including the CRC Superbill) should be mailed to:
Blue Shield of Michigan
Member Claims MC 0010
600 E. Lafayette Blvd.
Detroit, MI 48226-2998
Blue Cross Blue Shield of Illinois
Claims (including the CRC Superbill) should be mailed to:
Blue Cross Blue Shield of Illinois
P.O. Box 805107
Chicago, IL 60680-4112
Tampa General Hospital (Health Insurance) - Licensee of Blue Cross and Blue Shield
Claim Form (Pre-addressed from CRC)
Claims (including the CRC Superbill) should be sent (mail or fax) to:
Birmingham Service Center
Claims Department
P.O. Box 10527
Birmingham, Alabama 35202-0500
(205) 220-2146 or (800) 526-8529
Hawaii Medical Service Association (HMSA) - Licensee of Blue Cross and Blue Shield
Claims (including the CRC Superbill) should be mailed to:
HMSA – BlueCard Claims
P.O. Box 2970
Honolulu, HI 96802-2970
Dental Care Alliance (Health Insurance) - Licensee of Blue Cross and Blue Shield
Claims (including the CRC Superbill) should be mailed to:
Columbia Service Center
P.O. Box 100121
Columbia, SC 29202-3121
Publix Health Plan (Health Insurance) - Licensee of Blue Cross and Blue Shield
Claims (including the CRC Superbill) should be mailed to:
Columbia Service Center
P.O. Box 100121
Columbia, SC 29202-3121