Instructions For Completing The Insurance Verification Worksheet:

The worksheet itself is sent to you as a Questionnaire through the Charm portal and includes instructions. I’m including additional information and instructions here so that this page could be open in one tab as a reference and the Charm Questionnaire could be open in another tab.

How to Use the Worksheet:

The Questionnaire is broken up into sections. A few sections can be completed ahead of time and a few of them may not be required depending on your insurance situation.

Collapsible Sections
- Most sections of the worksheet are collapsible when completed within Charm as a questionnaire. You can expand sections as you need them and hide sections you’re not using. If forms tend to feel overwhelming, this can help reduce visual clutter and make the form feel more manageable.

Step-by-Step Guidance
- The worksheet is designed to walk you through the whole process step by step to reduce the cognitive and emotional effort these types of phone calls can take. The “Before You Call” steps can help you prepare so the call itself goes more smoothly.

Before You Call:

• Gather your insurance card(s).

• If available, log in to your insurance app or member portal, as it may contain information that isn't on your insurance card.

Sections to complete before calling:

These sections can be completed using information from your insurance card or insurance member portal.

• Section 1: Patient Info & Call Setup

  • Includes the phone number you’ll be calling, which should be on the back of your insurance card (often “Customer Service” or “Member Services”).

• Section 2: Insurance Plan Details

• Section 3: General Medical Benefits - You may be able to fill in some of this section using your insurance card or portal, but plan to confirm it with the insurance rep so you can correct it if needed.

  • This section is about your general medical benefits, NOT naturopathic medicine-specific coverage.

  • e.g. deductible info, out of pocket max, primary care vs specialist costs, both in-network and OON.

• Section 6: Secondary Insurance - This section requires that you select “yes” or “no.” If you have a secondary insurance plan, fill out this section before you call.

Other Preparation Tips: 

• Skim the form in its entirety to get oriented to the form and what you’ll be asking about.

• Set an intention for the call: to allow yourself to pause, ask questions, or request clarification as needed. (You're not expected to be an insurance expert.)

During the Call:

General Tips:

• Use this worksheet to guide the conversation and record the rep’s answers in the fields provided.

• If a question or field doesn’t apply to you or your plan, write “N/A” rather than leaving it blank, when possible.

• Include “$” or “%” when entering copay or coinsurance amounts.

• Fields marked with a red asterisk (*) are required.

Sections to Complete or Review During the Call:

• Section 3: General Medical Benefits - Verify your general medical benefits - e.g. deductible info, out of pocket max, primary care vs specialist costs, both in-network and OON.

• Section 4: Naturopathic Physician (ND) Visits - Ask if office visits with NDs are covered under your plan at all.

  • If ND visits are covered, you’ll skip ahead to Section 4a or 4b, based on my current network status with your insurance plan.

    • To confirm if I am in-network with your specific insurance plan, you can provide the insurance rep with the NPI(s) below:

      • Dr. Heidi Wilson - Individual/Rendering (Type 1) NPI: 1730430612.

      • If needed: Organization/ Billing (Type 2) NPI for Curio Integrative Mental Health LLC: 1295691244.

    • Section 4a: In-Network ND Coverage - Complete this section if I am in-network with your insurance plan

    • Section 4b: Out-Of-Network ND Coverage - Complete this section if I am NOT in network with your insurance plan.

    • You only need to complete the section that matches Dr. Wilson's current network status. However, if you'd like both in-network and OON coverage information for future reference, you're welcome to complete both sections, but this is optional.

• Section 5: Labs & Imaging - Ask if labs and imaging are covered when ordered by an ND

• Section 6: Secondary Insurance - If you have more than one active insurance plan, ask the insurance rep if they have your secondary insurance on file (this is required for coordination of benefits).

• Section 7: Insurance Rep Info (optional) - record the insurance representative’s name and the call/reference ID.

Note: In Charm, your changes won’t save unless you click “Submit.” Once submitted, you can’t edit your responses, so try to complete the form in one sitting and take a moment to review it before submitting.

QUICK INSURANCE BASICS

COMMON TERMS

Member ID / Subscriber ID:  your unique insurance plan number  (may also be referred to as policy number, insurance ID, member number, or subscriber number)
Deductible: Amount you pay each year before your insurance starts covering certain services.
Out-of-Pocket Maximum: Yearly limit on what you pay for covered care. After you reach this amount, your insurance pays 100% of covered services for the rest of the year.
Copay: Fixed dollar amount you pay per visit (e.g., $25 per visit).
Coinsurance: Percentage of the visit cost that you pay (e.g., 20%).
Subscriber / Policy Holder: Person whose name the insurance policy is under.
In-Network vs. Out-of-Network:
- In-network = provider is contracted with your insurance (usually lower costs for patient) 
- Out-of-network (OON) = provider is not contracted (often higher costs or limited coverage)
Prior Authorization: Approval your insurance plan may require before they will cover a service.

Common Insurance Plan Patterns (though not guaranteed)

• Many health plans don’t require meeting a deductible for certain in‑network services (e.g. you might just pay a copay for office visits even if you haven’t met your deductible).

• For out‑of‑network (OON) care, plans often have a separate, higher deductible that you need to meet before insurance starts paying anything for OON services

• Copays are more common for in‑network services, while coinsurance is more common for OON services.