INSURANCE AND BILLING

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UNDERSTANDING HEALTHCARE BILLING

Billing in the current healthcare market can be complicated.  Here is an explanation of options to meet your particular needs.

 

Fee For Service

 

All of us accept "fee for service" meaning payment is paid by you directly to your provider and you are given a receipt that can be submitted to any insurance and/or health care spending account for reimbursement according to the specifics of your particular plan.  

 

We Bill For You

 

Some of us will file claims for you and either direct their payment to you (if you have paid for the session in full), or to your provider (who will bill you for the portion your insurer has not paid).

 

Out-of-Network

 

Those of us who are out-of-network for your plan would do one of the two options above.  You may have to reach your yearly deductible prior to receiving any reimbursement and would typically have a copayment or coinsurance amount which often ranges between 60% and 80% of the fee.  Additionally, sometimes there is a "non-allowed amount" deduction (when the fee is higher than what an insurance company allows) for which you would be responsible.

In-Network

 

Those of us who are in-network file your claim and receive reimbursement from your insurance leaving you responsible for the copay amount.