Why am I paying a deductible? I thought I just had a co-pay? Co-pay’s are usually applicable for office visits only. Certain services are not considered office visits, such as Psychological/ ADHD testing. Your therapy visits may have a co-pay only. However, should you have a deducible, the testing and sessoins may go towards your deductible which will be reflected on your statement. Please call your insurance company and ask before your appointment.
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, the address to which claims are to be billed, your policy identification number, your group number (if applicable), and a phone number.
Has your office billed my secondary insurance? Our policy is to first bill the patient’s primary insurance. After the claim has been processed, any remaining balance is the patient’s responsibility. As a courtesy, we will send a claim to the secondary insurance with the information that has been provided. However, it is the patient’s responsibility to follow up with the secondary to be sure the claim has been received and processed.
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.
Do I have to pay my co-payment at the time of registration? Yes, you are expected to pay your co-payment when you arrive. 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.
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.
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.
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.