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Guzman & Baker accepts Blue Cross Blue Shield (BCBS) insurance plans. If you are a BCBS member, your mental health benefits may cover a significant portion of your therapy costs. This page explains how your coverage works with our practice and how to confirm your benefits before your first session.

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How BCBS coverage works here

When you use your Blue Cross Blue Shield insurance at Guzman & Baker, our billing team submits claims directly to BCBS on your behalf. You are responsible for your share of the cost, which is determined by your specific plan. Your out-of-pocket costs typically include one or more of the following:
  • Copay — A fixed dollar amount you pay per session (for example, $30 per visit).
  • Coinsurance — A percentage of the allowed amount you pay after meeting your deductible (for example, 20% of the allowed fee).
  • Deductible — An annual amount you pay out of pocket before insurance begins covering costs.
The exact amounts depend on your specific BCBS plan.

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Common BCBS plan types

PPO (Preferred Provider Organization)

PPO plans give you the flexibility to see any licensed provider. You typically pay less when you see in-network providers like Guzman & Baker, and more if you go out of network.

HMO (Health Maintenance Organization)

HMO plans generally require you to see providers within a defined network and may require a referral from your primary care physician. Confirm with BCBS whether a referral is needed before your first session.

EPO (Exclusive Provider Organization)

EPO plans cover services only within the network, with no out-of-network coverage except in emergencies. Our providers must be in your EPO network for your plan to apply.

HDHP (High Deductible Health Plan)

HDHP plans have a higher deductible before coverage begins. You may be paying full cost per session until your deductible is met. These plans are often paired with a Health Savings Account (HSA).

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How to verify your BCBS benefits

Before your first appointment, take a few minutes to confirm your mental health benefits. This prevents billing surprises.
1

Find your member ID card

Locate your Blue Cross Blue Shield insurance card. Your member ID number, group number, and the phone number for member services are printed on the card.
2

Call member services

Call the member services number on the back of your card. Ask the representative about your outpatient mental health benefits.
3

Ask the right questions

When you reach a representative, ask:
  • Is Guzman & Baker Behavioral Health Services (NPI: 1669265328) in my network?
  • What is my copay or coinsurance for outpatient mental health visits?
  • Do I have a deductible, and how much have I met so far?
  • Do I need a referral or prior authorization for therapy?
  • Are there any limits on the number of sessions covered per year?
4

Share your findings with our office

When you schedule, let us know what you learned. Our billing team can also help verify your benefits before your first session or answer additional questions.
You can also log in to your BCBS online member portal to review your benefits summary, see your deductible status, and find in-network providers.

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What to complete prior to your first appointment

Submit the following in your secure patient portal prior to your first session:
  • Your Blue Cross Blue Shield insurance card (front and back)
  • Complete additional intake forms (sent to you before the appointment in your patient portal)
  • A form of payment for your copay or cost-share amount
If you are unsure of your copay amount before your first session, bring a credit or debit card so you are prepared to pay whatever amount applies.

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Questions about your BCBS coverage

If you have questions about how your BCBS plan applies to your care at Guzman & Baker, call the member services number on the back of your insurance card. We are here to help you understand your benefits as well.