We accept BCBS, Aetna and Cigna only.

You can either fill out following form to verify your benefits with you insurance or just prepay the appointment and get a refund later, once insurance pays.

If you prepaid the appointment, then there is no need to fill out this form.

If you will be using your insurance benefits to pay for your mental/behavioral health services, please call your insurance company prior to your intake session with us to find out the answers to following questions. The number should be listed on the back of your card as member’s call number. You have option to fill out the following form online or Click here to download and bring this completed form or send it to us through email.

Note: If you do not complete this form to your intake session, you might be charged the full contracted insurance rate for each session until you complete this task. We encourage you to take the time to call the #800 on the back of your insurance card to confirm your Mental/Behavioral Health benefits.

Insurance might ask our tax ID or NPI number. If they do, please use following information.

Billing provider= Happy Minds Psychiatry PLLC; Tax ID: 813989390; Group/Billing ​NPI: 1629515648

Service Rendering provider= Mudassar Tariq, MD; ​NPI: 1588895825

If they ask for CPT code, you can use 90837 and if they ask about a diagnosis, you can ask for any diagnosis (e.g Generalized Anxiety, code: F41.1)

Please fill out the form below

The questions in following form will help you understand your benefits. You might have to call insurance or look in your insurance account online to get answers to these questions. Having answers to these questions will avoid any billing surprises later.

Required questions are marked with an asterisk. This is because additional questions might appear or disappear depending on your answers to those required questions. We do require an email address and phone number in case we need to reach you.

It is helpful to upload pictures of insurance card and your state ID, in case we need to do any additional verification on our end.

After you fill out these forms, you will get an automated email with next steps. Please make sure to follow the link in automated email to request a portal account in our EMR Luminelllo. We will do further communication through the luminello portal to protect your privacy. Luminello is HIPAA compliant electronic medical record.

Are you the patient, or you are filling out the form for someone else (child, sibling, spouse)? *
I have called the behavioral health phone number on the back of my insurance card and made sure that Dr. Mudassar Tariq (NPI 1588895825, Tax ID: 81-3989390) is in network *
If you have out of network benefits, do you want to see Dr. Mudassar Tariq, MD using your out of network benefits?
My Plan type is
Do you have a deductible for mental health (A certain dollar amount (e.g $1500) that you will have to pay first before insurance starts paying.)) *
Who is the main subscriber on insurance (Primary insured)? *

In some HMO plans, the mental health is contracted out to third party insurance. You might not even be aware of the name of that insurance. Few examples are Magellan, compsych, Beacon, optum etc.  We are in network with Magellan and Compsych but not with Beacon and Optum. So we just want you to be aware, that if it is a third party carve out, even if your card says Blue Cross Blue Sheild, we might not be in network and you might be billed for full fee. If you are not sure, just google the behavioral/mental health phone number on the back of your insurance card, or you can call that number and ask them this question.