Billing & Insurance FAQ
Why do you take a deposit before the first visit?
– We collect a deposit to reserve the one-hour time slot for your initial evaluation with your provider. Initial appointments are longer and require dedicated preparation time, so reserving this slot ensures that the time is held specifically for you. If you aren’t able to attend your appointment, we simply ask that you let us know as soon as possible so that we can offer the appointment to another patient who may be waiting to be seen sooner.
– The deposit is not charged until 24 business hours before your appointment, and you are welcome to cancel or reschedule at any time prior to that without penalty.
– If you attend your appointment and are using health insurance, the full deposit is refunded. No additional charges are processed until your claim is submitted to your insurance company and we receive the final explanation of benefits indicating your co-pay, co-insurance, or deductible responsibility.
– The deposit applies only to the initial evaluation and is not required for future follow-up visits.
Why do you charge a fee for missed appointments or late cancellations?
– Your appointment time is reserved specifically for you. When an appointment is missed or cancelled at the last minute, it prevents another patient—who may be waiting for care—from being able to use that time. For this reason, we ask for 24 business hours advance notice if you need to cancel or reschedule your appointment.
– We understand that unexpected circumstances and emergencies can occur, and we always try to approach these situations with understanding and flexibility. However, in general we must apply this policy consistently in order to keep the practice running smoothly and ensure that appointment times remain available for those who need care.
– Providing high-quality care to our patients is always our top priority, but like any medical practice, we must also maintain consistent policies in order to continue serving our community.
Why do I still have to pay for my visit if I have insurance?
– Health insurance plans vary widely in how costs are shared between the insurance company and the patient. Some plans require only a fixed co-pay at each visit. Others include co-insurance, where the patient is responsible for a percentage of the cost of the service. Many plans also include a deductible, which means you are responsible for paying the contracted cost of services until your deductible has been met.
– These amounts are determined by your individual insurance plan, not by our practice. It can be helpful to review your benefits with your insurance company when selecting or enrolling in a plan so you have a clearer understanding of what your out-of-pocket costs may be.
– The contracted rates for services are set by the insurance company, and the cost for a given service is generally the same regardless of which in-network provider or practice you see.
Why am I not charged the amount I owe at the time of my visit?
– Insurance billing can be complex and sometimes unpredictable. Mental health services are often processed through third-party companies or smaller subsidiary networks under larger insurance carriers, which can affect how claims are finalized. Because of this, we wait for the final determination from your insurance company before charging any patient responsibility. This approach helps prevent situations where we might accidentally over-charge you and later need to process refunds, or under-charge and need to bill an additional balance afterward.
– Once we receive the official Explanation of Benefits (EOB) from your insurance company, we will charge the exact amount they indicate as your responsibility (such as co-pay, co-insurance, or deductible). Insurance claims can take several weeks to process depending on the insurance company. Because we wait for the insurance company’s final determination before charging patients, balances may appear after the visit once the claim has been processed. This helps ensure that you are charged only the exact amount determined by your insurance company.
Why is my bill different from what I expected?
– Insurance companies determine the final amount you owe based on your specific plan benefits. Even when we verify your insurance in advance, the information we receive is only an estimate and is not a guarantee of coverage. Your final balance is determined by your insurance company once the claim is processed. They will apply your deductible, co-insurance, or co-pay according to your individual plan.
– For the most accurate information about your benefits, we recommend contacting your insurance company directly using the phone number on the back of your insurance card.
What is an Explanation of Benefits (EOB)?
– After your visit, your insurance company will send you a document called an Explanation of Benefits (EOB). It simply explains how your insurance processed the claim. The EOB will show: the total cost of the service, the amount covered by insurance, the portion applied to your deductible (if applicable), and the amount you are responsible for paying.
– We use the information provided on the EOB to determine the final patient balance. This document comes directly from your insurance company and is not a bill from the practice.
What if my insurance information changes?
– If your insurance changes, please notify our office before your next appointment. Claims submitted to an inactive or incorrect insurance plan may be denied, which can delay billing and may result in the balance becoming the patient’s responsibility. Keeping your insurance information up to date helps ensure that claims are processed correctly.
While we are happy to assist with insurance billing, patients are ultimately responsible for understanding their individual insurance benefits and for any balance determined by their insurance company.
