Fees and Commercial Insurance FAQs
- Is there a fee for services provided by PerformCare?
- What kind of services can I access?
- Are services that I am referred to by PerformCare free?
- My family or child does not have insurance or Medicaid. How can I apply for Medicaid?
- Why am I being asked for my insurance information?
- What will you do with my insurance information?
- What does coordination of benefits mean?
- Can I still get services if I don't give you or I don't have my insurance information?
- Why do I have to complete an application for Medicaid/NJ FamilyCare when I have commercial insurance?
- I don't understand why I have to apply for Medicaid/NJ Family Care in order to receive your services?
- Will my insurance be billed?
- Do you accept commercial insurance?
- How do I find an outpatient counseling therapy provider when I have commercial insurance?
- How can I get outpatient counseling/therapy services for my child when I don't have commercial insurance and I don't qualify for Medicaid or NJ Family Care?
PerformCare does not charge you for calling us. PerformCare helps families by making service recommendations and linkages that will best meet the needs of your youth and family. Families will be asked to provide insurance information as part of this process.
Youth can receive needs assessments, case management, mobile response services, and various treatment programs based upon a decision by PerformCare that considers the youth’s needs and most appropriate type of service. That decision may be made after a clinician speaks with you over the telephone or after your youth has received a face-to-face assessment.
Services recommended and authorized by PerformCare are paid by a variety of sources, such as public funds including Medicaid and NJ Family Care, and commercial insurance or self-pay. Although families may not be charged for certain services, they are not free and families will be asked to provide insurance information as part of their contact with PerformCare. All families referred for service that are not already Medicaid or NJ Family Care eligible will be required to complete an eligibility application.
For questions about Medicaid/NJ Family Care you can get information online at NJHelps. To request applications for Medicaid/NJ Family Care you may contact your local County Welfare Agency or you can complete an application online.
If your child is assessed as requiring Mobile Response and Stabilization Services or Case Management, the Medicaid/NJ Family Care application can be completed when you meet with them. The Mobile Response or Case Management staff will have the application available and will assist you in completing it.
It is necessary to collect all information about health benefit resources available to the family in order to coordinate all available services across funding sources which best suit the needs of the youth.
Your insurance information is recorded in your youth’s file so that our service providers have all the information necessary to identify services and treatment options for which your youth is eligible, and to determine who will be responsible for funding those services. We strongly encourage families to use their commercial health insurance as there may be more behavioral health treatment options available through the commercial insurance plan.
Your insurance information will be stored in your youth’s electronic behavioral health record that is maintained by PerformCare as a part of the identification of available health coverage and resources. Your insurance information is transmitted to NJ Medicaid where it is centralized and used for coordination of benefits if your youth has or becomes eligible for Medicaid/NJ Family Care.
Coordination of benefits identifies the primary payer for each service. Some services may be covered primarily by your commercial insurance carrier, while others are covered if you are found eligible for Medicaid, NJ Family Care or other public funding. NJ regulations require commercial insurance to be billed first if a youth is covered by both Medicaid and commercial insurance.
We can refer you to access services but you will have to give your insurance information for actual delivery and continuation of any services provided with public funds. If the youth does not have Medicaid or NJ Family Care, you will be required to complete applications for Medicaid/NJ Family Care and/or other state benefits as a condition for receipt of continued services. These applications will require you to provide income and insurance information. If you are referred to Mobile Response Stabilization Services or Case Management Services, the service providers will assist you in completing the applications. Any delay in completing the application could result in delayed access to services provided through the NJ Children's System of Care (CSOC).
Your family may be found to qualify for Medicaid/NJ Family Care as secondary insurance or your child may be approved for other public funds that will cover the cost of certain behavioral health services to supplement your commercial insurance benefits.
Medicaid/NJ Family Care is the primary funding source for most of our services that are traditionally not covered by commercial insurance. Qualifying for Medicaid /NJ Family Care provides access to and coverage for these services. If your family does not qualify for Medicaid, your child may qualify for other public funds to cover the cost of certain behavioral health services.
PerformCare does not bill for the services we refer you to. Some service providers we refer you to may bill your insurance company if the service is covered or reimbursement may be sought from your insurance company as part of coordination of benefits.
PerformCare is an information and referral resource for families. We are responsible for authorizing services covered by Medicaid/NJ Family Care and other public funds, but we do not actually provide billable services. The service providers who actually provide the service may bill your insurance company if the services are covered by your health benefit plan.
You can contact the telephone number on the back of your insurance card to find a provider and determine your behavioral health coverage.
Many community mental health centers provide services on a sliding fee scale.