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Insurance Information

Thank you for choosing us as your therapy provider. We are committed to providing you with quality and affordable care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have put together this payment policy for your review.

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  • Insurance. We participate in most insurance plans, including Medicaid. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

  • Co-payments and deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.

  • Proof of insurance. We must obtain a copy of your current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you will be responsible for the balance of a claim.

  • Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

  • Coverage changes. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.

  • Nonpayment. If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative care.

  • Payment options. For ease of account reconciliation, we require keeping your credit or debit card on file as a convenient method of payment. Your card information is kept confidential and secure. Signing below indicates that you have read and agree to these terms.

  • Payment Arrangements. If you need alternate payment arrangements, those can only be done with our office staff. Please contact them for more details.

Using Your Insurance

If choosing to use your insurance, please contact your insurance company to find out if we are a provider on your specific plan, with in your specific insurance company.  While our office as a whole tries to cover many insurance companies we are not on all insurance plans.

 

Questions to ask your insurance company in regards to your benefits:

  • Do I have In Network mental health benefits?

    • What are they?

    • How do I get an authorization?

    • How many sessions will I be approved of.

    • What is the coverage per session

      • Before deductible is met

      • After deductible is met

    • What do I need to do to obtain reimbursement??

 

 

At A New Hope Therapy Center, it is your responsibility to call and check your benefits before the first session. If you have not done so, you will be responsible for the full fee at the time of your first session.  

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Reasons for NOT using insurance:

 

Some clients choose not to use their insurance for a wide range of reasons. Some popular reasons are:

  • Insurance companies REQUIRE a diagnosis in order to pay for your session.  What we find is that not everyone who comes to counseling has a diagnosis. Some are just struggling in relationships, in their jobs or working through grief.

  • The diagnosis that is given, will REMAIN on the client’s permanent health record.   This diagnosis will follow the client in school, military, landing federal jobs, security clearances, applying for life insurance, etc.

  • Insurance companies can REQUEST the clients’ session notes at any point in time (by using your insurance you waive confidentiality) and many clients feel uncomfortable with this.

  • Insurance companies DECIDE what type of treatment they will cover, what type of treatment they will not.  Example: Many companies will not cover couples counseling, or will not cover specific diagnosis.

  • Insurance companies can LIMIT the number of sessions that a client can have.

  • The provider a client wants to see is not PANELED with their insurance company, or perhaps is paneled with their insurance company but not your specific plan.

  • Insurance company copay or deductible is too high; therefore client may opt to utilize our self pay option. 

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If you still have questions, you are welcome to contact Lacey, our Billing Specialist, at lacey@anewhopetc.org.

  • Do I have Out of Network mental health benefits?

    • What are they?

    • What is the coverage per session

      • Before Deductible is met

      • After Deductible is met

  • What is my annual deductible?

    • What is my deductible balance

    • Do I have a general medical deductible or do I have a separate one for mental health?

Good Faith Estimate

 

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises

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