Will you bill my insurance company for me? Yes, we will bill your insurance company for you, provided you have given us complete insurance information, including the name of the company, policy holder’s name and date of birth, your policy identification number, your group number (if applicable). We also require copies of the front and back of insurance cards to make sure claims are sent to the correct payer.
Will I have a co-payment or co-insurance payment due? Yes, copayments and co-insurance are run at your session. Your insurance card should indicate the dollar amount of the co-payment required for each type of service. If you have questions regarding co-payment amounts, please contact your insurance company or your employer.
Why am I being billed when I have insurance? Many insurance companies have amounts which the patient must pay. These are called deductible, co-pay or co-insurance payments. If your insurance plan requires you to pay a deductible or co-insurance, the balance will be billed to you. If you have a question about why your insurance company did not pay part of a claim, you should call your health insurance company directly.
Why am I being charged for more than one copay, co-insurance or deductible at once? Claims are billed daily, and the processing time depends on your insurance carrier, which may result in multiple claims being processed simultaneously. Copayments or co-insurance payments are processed at the time of service according to insurance contracts. Any deductible payments are run after insurance claims have been processed. Kindly refer to your Explanation of Benefits (EOB) from your insurance for detailed information regarding your claim processing or contact your insurance carrier for specific details pertaining to your plan.
I just got insurance this month, can I bill my services from the past to them? No, insurance coverage works only within the effective dates. We can bill all dates that fall within your coverage start and end date.
I have Blue Cross/ Blue Shield of Illinois, why are you billing a different insurance company? Many large companies such as Boeing and UPS contract their behavioral health benefits to other companies such as Beacon Health Options, MHN, Magellan, United Health Care and Cigna Behavioral. Look at the back of your card for a different phone number or address for Mental Health/Substance abuse benefits. In and Out of network benefits are applicable with the behavioral health company contracted and not the primary insurance carrier on the front of your card. Please call the number associated with behavioral health services located on the back of your card before your appointment.
Why is my co-pay different that my regular doctor’s co-pay? Many times there will be a specialist co-pay and a PCP (primary care physician) co-pay. Call your insurance company and check which co-pay applies to Emmaus Counseling Center.
How do deductibles work? Deductibles are the portion of your health care costs that you are responsible for before your insurance will begin paying their percentage. Until you deductible has been met, your insurance provider will transfer ALL payments to your responsibility until your deductible is satisfied. For example if you have a $250 deductible, you will likely receive statements reflecting client until that $250 is met.
What if I don’t want to use my Insurance ? Can I still be seen? Of course. Please call us and we can let you know our out of pocket rates.
What does “in network” or “out of network” mean? When a health care provider is “in network” it means the insurance company will cover a higher amount of the charges. When a provider is “out of network” you can still go to this provider, but you will be required to pay a larger percentage of the bill.
How do I follow up with my insurance company? If your claim has not been paid and you are receiving notices from Emmaus Counseling Center, you should make a follow-up phone call to the insurance company.
What is an Explanation of Benefits (EOB) or Explanation of Payment (EOP)? These are documents showing a detailed listing of how your insurance company processed your claim or bill. An EOB or EOP is mailed by your insurance company directly to you.
What are Rates & Allowed Amounts? Different insurance companies reimburse providers at varying rates. When a plan states 100% reimbursement, it means the insurer will pay 100% of their set rate, not the provider’s rate. Providers do not negotiate these rates; insurance companies set them.
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