Billing

You can use your HSA or FSA account for your care with CRC. 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. 

Core Revitalizing Center in Lakewood Ranch (serving Sarasota, Manatee, and surrounding counties) does our best to help you get the most of 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).

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!

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 other outpatient visit for the evaluation and management of a new patient
99204 (moderate complexity) +90833 (psychotherapy time) or
99205 (high complexity) +90833 (psychotherapy time)

Follow-Up Appointments – Office or other outpatient visit for the evaluation and management of an established patient
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-10DescriptionICD-10Description
F90.2ADHD (combined)F63Impulse Control Disorder
F10.20Alcohol DependenceG47.00Insomnia
F41.9AnxietyF32.9Major Depressive Disorder
F84.0AutismF33.8Mood Disorder
F31.13Bipolar (manic)F42 Obsessive Compulsive Disorder
F31.30Bipolar (depressed)F91.3Oppositional Defiant Disorder
F12.29Cannabis DependenceF11.20Opioid Dependence
F14.20Cocaine DependenceF41.0Panic Disorder
Z71.41Counseling on Sustance UseF60.9Personality Disorder
F34.8Disruptive Mood Dysregulation DisorderF29Psychosis
Z55.9Educational ProblemF43.10Post Traumatic Stress Disorder
Medicare

How to File a Claim

Medicare Claim Form (pdf)

Claims (including the CRC superbill) should be mailed to:

First Coast Service Options, Inc.
P.O. Box 2525
Jacksonville, FL 32231-0019

United Healthcare

How to File a Claim

Claim Form – Direct-link

Claim Form – Pre-filled

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)

How to File a Claim

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
PO Box 7981
Madison, WI 53707-7981

West Region Claims

Claims Department
P.O. Box 202112
Florence, SC 29502-2112

Tri-Care for Life Claims

WPS TRICARE For Life
P.O. Box 7890
Madison, WI 53707-7890

Active Duty Claims

P.O. Box 7968
Madison, WI 53707-7968

Cigna - Open Access Plus

Member Claim Forms

Claim Form (Blank)

Guide to Explanation of Benefits

Claims (including the CRC Superbill) should be mailed to:

Medical Claims
P.O. Box 188061
Chattanooga, TN 37422-8061

Florida Blue (BlueOptions or BlueSelect Plans with Preferred Provider Provision)*

Member Claim Forms

Claim Form (Blank)

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

How to Submit a Claim

BC/BS FED Claim Form (2018)

Claims (including the CRC superbill) should be mailed to:

Claims
P.O. Box 1798
Jacksonville, FL 32231

Blue Cross Blue Shield of California

Forms and Applications

Claim Form (pdf)

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

Forms and Applications

Claim Form (pdf)

Check Status of Claim

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

Claim Form (pdf)

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 (Blank)

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

How to Submit a Claim

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

Claim Form (Blank)

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

Member Claim Forms

Claim Form (Blank)

Claims (including the CRC Superbill) should be mailed to:

Columbia Service Center
P.O. Box 100121
Columbia, SC 29202-3121

 

Revitalizing the Mind-Body Connection

(941) 500-9292 - phone/fax

core@corerevcenter.com

7357 International Place Ste. 107, Lakewood Ranch, FL 34240

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