If you are using your insurance to pay for services at our office, it can be a little tricky to understand your payment. When you give us your insurance information, we check with your insurance company, tell them what we will be doing with you at our office, and they give us an estimate of how much you will be paying. They always tell us: “A quote of benefits and/or authorization does not guarantee payment or verify eligibility.” This is a fancy way of them saying that until we actually bill your insurance company for services provided to you, we cannot be 100% sure what your final bill will be. We understand this can be frustrating for you – it is also frustrating for us
Everyone has a different insurance plan, so even though you might be getting the same services as another person, you may be paying a different amount out of pocket. We do not set the rate you pay – this is 100% set by your individual insurance plan.
Insurance can be broken down into two broad categories. Some plans have a set co-pay and others have a deductible and co-insurance.
· If you have a co-pay, this usually means you will pay a set amount each time you see us no matter what you have done at our office. This co-pay usually ranges from $15 to $70 unless you are one of the lucky few people who have a $0 co-pay.
· If you have a deductible, this means you have a set amount you have to pay for the year prior to your insurance starting to pay anything. Usually, this is a total amount for all doctor’s offices, not just our office. For example, if you have a deductible of $1,000, you will pay the full amount for our services until you reach that $1,000. For example, if an insurance company tells us they will pay us $100 for each time you visit us, then you will pay the full $100 for 10 sessions until you have finished paying your $1,000 deductible. For any additional sessions, you will pay us $0 and your insurance company will pay us $100.
· If you have a co-insurance, this means that after you finish paying your deductible, you will then have to pay percentage of the total amount for sessions. For example, let’s say you have that $1,000 deductible we just talked about, but then you also have 20% co-insurance. In this example, after paying $100 person session for 10 sessions, you would then pay $20 for additional sessions (and your insurance company would pay $80 for each of those additional sessions).
Please understand we have to collect payment at the time we see you for your session. We are also legally required to collect the amount your insurance tells us to collect from you, which we understand can be a lot, especially if you are here for a comprehensive assessment.
Sometimes clients ask us if we can bill the insurance company first and then they can pay us their part after we receive the insurance payment. Unfortunately, getting paid by the insurance company can take months, so this is not an option. Just like you pay for a haircut at the time you receive the haircut, you must pay us at the time we see you
We know this is a lot of information. If you have any questions, please do not hesitate to reach out to us!