Verification of Benefits Letter: What It Is and How to Get One
Last reviewed July 18, 2026 · Reviewed by the TurboVOB team
A verification of benefits is the record of what a payer told you about a specific client's coverage before treatment: who you spoke to, when, the reference number, and the exact benefits quoted. Most payers don't issue a "letter" on request. What practices actually produce and rely on is their own documented worksheet with the payer's reference number on it — which is what a denial appeal requires.
What a complete VOB must record
Each field below is one a practice regularly wishes it had asked for, six weeks later, when the claim denies.
| Field | Why it matters |
|---|---|
| Payer, plan name, and member ID | Benefits vary by plan, not by payer. Without the plan name, the record can't be re-checked later. |
| Reference / call-tracking number | The single most important field. Without it, an appeal is your word against the payer's record. |
| Date, time, and representative's name | Establishes when the quote was given, which matters when coverage changed after the call. |
| Effective and termination dates | A future-dated termination is invisible unless you asked for it directly. |
| Outpatient behavioral-health copay or coinsurance | The card usually prints only the specialist copay, which is frequently a different number. |
| Deductible amount and how much remains | Determines what the client actually pays today, rather than what they'll pay eventually. |
| Prior-authorization requirement, per CPT code | Many payers require authorization for 90837 but not 90834. A single blanket answer is wrong half the time. |
| Annual visit limit and visits used | A cap you can't measure against isn't usable. Sessions past the cap are denied outright. |
| Telehealth coverage, parity, POS code, and modifier | A telehealth claim with the wrong place-of-service code denies even when the service is covered. |
| In-network status for the rendering clinician's NPI | The claim follows the individual clinician, who may not be contracted even when the group is. |
| Timely-filing window | It's the deadline that turns a fixable denial into a write-off. |
Build your VOB call worksheet
Pick what applies to your practice and this client's plan. The worksheet below is the list of questions to ask the payer — print it, take it to the call, and write the answers in. It generates questions, never answers: what a plan covers varies by plan and changes without notice, so the only honest thing a public tool can give you is the right questions.
Question bank last reviewed 2026-07-18 against the current AMA CPT set.
Build your worksheet
The worksheet updates as you change these. Nothing is submitted.
Your practice's name — not the client's. Appears in the printed header only.
23 questions · fits one page
Don't enter patient information here. This is a public page — nothing you type is sent to us or stored.
VOB Call Worksheet
Generated 2026-07-18 · turbovob.com
Reference / call-tracking number — write it here first
Confirm the carve-out first — if behavioral health is administered by a separate company, everything below must be asked of them.
Before you call
- 1.
Is outpatient behavioral health administered by this plan, or is it carved out to a separate behavioral-health company (for example Magellan, Carelon, or Optum)? If carved out, what is that company's provider line?key field
If behavioral health is carved out, every answer the medical payer gives you is the wrong answer. Determine this before you ask anything else.
- 2.
Which number handles behavioral-health benefits? (Check the back of the card — it is often a different number from the main member services line.)
The medical member-services line frequently cannot see behavioral-health benefit detail at all.
Call record
- 3.
Reference / call-tracking number for this call.key field
This is the single most important field on the sheet. It is the practice's only evidence of what was quoted if the claim later denies, and an appeal without it is very hard to win.
- 4.
Date and time of call.
- 5.
Representative's name (and extension or ID if offered).
- 6.
Plan name exactly as the rep states it.
Benefits vary by plan, not by payer. The plan name is what makes this record re-checkable.
Eligibility
- 7.
Is coverage active today?
- 8.
Termination date, if any is on file.
A future-dated termination is invisible unless you ask for it directly.
Outpatient behavioral-health benefits
- 9.
What is the copay for outpatient behavioral health specifically?key field
The card usually prints only the specialist copay, and the behavioral-health copay is frequently different. Quoting the card number is the most common way a practice under-collects.
- 10.
Is there coinsurance after the deductible, and at what percentage?
- 11.
How much of the individual deductible remains?key field
This is what determines what the client actually pays today.
- 12.
Does the deductible apply to outpatient behavioral health, or is it copay-only?
Copay-only behavioral-health benefits are common and change the collection amount entirely.
Prior authorization, by CPT code
- 13.
Does 90834 (45-minute individual psychotherapy) require prior authorization?
Ask code by code. Many payers require authorization for 90837 but not 90834, so one blanket question produces an answer that is wrong for half your sessions.
- 14.
Does 90837 (60-minute individual psychotherapy) require prior authorization?
- 15.
Does 90791 / 90792 (diagnostic evaluation) require prior authorization?
Visit limits
- 16.
Is there an annual visit limit for outpatient behavioral health?key field
Behavioral health is one of the few benefits still commonly capped by visit count.
- 17.
How many visits have been used so far this year?
A limit you cannot measure against is not usable. Ask for the count, not just the cap.
Telehealth
- 18.
Is telehealth covered for outpatient behavioral health?
- 19.
Is telehealth reimbursed at parity with an in-person session, or at a reduced rate?
Parity is frequently assumed and frequently wrong.
- 20.
Which place-of-service code and which modifier does this plan require on a telehealth claim?
Ask, do not assume. These vary by payer and change; a claim with the wrong POS or modifier denies even when the service is covered.
Network and claims
- 21.
Is this specific clinician — by individual NPI — in network for this plan?key field
Ask about the clinician, not the practice. A group can be contracted while an individual clinician is not, and the claim follows the individual.
Before you hang up
- 22.
Read the reference number back to the rep and confirm it digit by digit.key field
A mistranscribed reference number is the same as no reference number.
- 23.
Ask explicitly: "Is this a quote of benefits rather than a guarantee of payment?"
The answer is almost always yes. Asking it on the recorded call establishes that you understood the limits of what you were told.
This worksheet records questions to ask the payer. It does not contain coverage answers — those come from the payer, on the call. Keep the reference number with the client's record.
What to do with the completed worksheet
- Keep it with the client record for at least as long as your own retention obligations require. Those obligations vary by state, payer contract, and practice type — check yours rather than taking a number from a vendor page, including this one.
- Put the reference number on the claim or in the claim note, so it's attached to the thing that might later deny.
- Lead the appeal with it. An appeal that cites a dated call, a named representative, and a reference number is a materially different document from one that says the practice believed the service was covered.
Common reasons a VOB is wrong even when you did everything right
Behavioral health is carved out to another company
- Quoted, not guaranteed. Payer reps quote benefits; they don't guarantee payment. Ask them to confirm that distinction on the call, and note the answer.
- Mid-year plan changes. An employer can change carriers or plan design mid-year. A verification from January can be wrong in July through nobody's error.
- Retroactive terminations. Coverage can be terminated with an effective date in the past — after you verified it, and after you delivered the session.
- Rep error. The person reading you the benefits is reading a screen. The reference number is what makes their error your evidence rather than your problem.
A verification reflects what the payer had on file at the time of the check. It is not a guarantee of payment. Coverage can change mid-year, and retroactive terminations happen. Keep your reference number.
This worksheet is the manual version.
TurboVOB returns the same fields without the phone call. Book a 20-minute demo and we'll run it against the payers you actually bill.
Frequently asked questions
Do insurance companies issue VOB letters?
Usually not on request. Most payers quote benefits verbally by phone or return them through an electronic eligibility response, and give you a reference number rather than a letter. What practices rely on in an appeal is their own documented worksheet with that reference number on it.
How long is a verification of benefits valid?
It reflects what the payer had on file at the moment of the check, and nothing more. Plans change at renewal, employers change carriers mid-year, and terminations can be applied retroactively. Most practices re-verify at the start of each plan year and whenever a client's coverage or employer changes.
What's the difference between eligibility and benefits?
Eligibility is whether the policy is active. Benefits are what the policy actually pays for — the behavioral-health copay, the deductible remaining, whether 90837 needs prior authorization, and whether there's a visit cap. A portal that says "active coverage" has answered the eligibility question and none of the benefits questions.
Do I need a VOB for every session?
No — for every new client, and again when coverage changes or a new plan year starts. What matters more than frequency is that each verification is documented with its reference number, because that's what an appeal needs.
What is a behavioral health carve-out?
It's when the medical payer on the card doesn't administer behavioral health — a separate company does, often Magellan, Carelon, or Optum. If a plan is carved out, everything the medical payer's rep tells you about behavioral-health benefits can be wrong, because they're not the ones adjudicating those claims.
Related
Insurance verification
What verification means — eligibility vs benefits, methods, hub.
How to verify insurance eligibility and benefits
The full step-by-step, from the insurance card to the reference number.
270 and 271 explained
What the X12 eligibility inquiry and response contain — and what they don't.
See it against your payer mix.
Twenty minutes. We'll run a live verification against the payers you actually bill.
TurboVOB acts as a business associate under HIPAA and signs a Business Associate Agreement with every customer that processes protected health information through the platform.