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  • Insurance and Rates Explained

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    Insurance, Briefly Explained

    There is no way one can adequately explain the ins and outs of insurance billing in a way that is easy for everyone to understand. However, with the intention of transparency, we are going to try.

    • All clients are asked to provide the front and back of their insurance cards.
    • Ideally, we will do our best to verify benefits as a courtesy. However, it is exactly that — a courtesy. There is no way to absolutely, with certainty, determine what is covered under an insurance plan until an Explanation of Benefits is processed by an insurance company. Ideally, a courtesy benefits check will happen before you arrive in the office; however, this is not always possible due to various factors such as scheduling and technology challenges.
    • An Explanation of Benefits is exactly what it sounds like. It is a detailed account of what we billed to your insurance and what your insurance will, or will not, cover after processing by your insurance. Typically, an Explanation of Benefits will arrive within one month but can take up to three months.
    • We process claims on a monthly basis. A claim entitles us to get paid by the insurance company.
    • Any patient financial responsibility (i.e., co-pay or co-insurance) is due at the time of appointment and is processed the same day as the appointment.
    • We currently accept (in-network) UHC, Oxford, UMR, and Cigna.

    Common Vocabulary

    Deductible

    The amount paid out of pocket by the policyholder before an insurance provider will pay any expenses.

    Each insurance plan varies as to whether or not the policyholder must pay down their deductible in full before the policyholder is only responsible for their co-pay or co-insurance.

    Co-Pay

    This is the client’s financial responsibility for each session.

    Co-Insurance

    A percentage of the contracted rate agreed on between an insurance plan and provider for payment.

    For example, if a contracted rate is $100 and the co-insurance is 15%, the client owes $15.

    Contracted Rate

    The contracted rate is the agreed-upon amount an insurance company will pay for services to a provider. This rate is what your provider must bill insurance, It is not negotiable. Your provider cannot legally waive any patient responsibilities, including co-pay, co-insurance, and deductibles. It is considered insurance fraud.

    Rates

    Rates vary depending on the type of therapy, and length of sessions. Our rates range is $225-300. We do offer a limited sliding scale fee.

    Payment

    We accept cash, check, and all major credit cards as forms of payment. Our preference is for clients to select auto-payment by credit card in Simple Practice.

    Cancellation Policy

    If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. We offer each client one free pass for a canceled appointment of less than 24 hours. Commitment and consistency of therapy are important and we will do our very best to offer an alternative time during the same week of the cancelation if possible.

    Any Other Questions?

    Please contact us with any additional questions you may have.

    Banner photo by Daniel Thomas on Unsplash