understanding and verifying insurance coverage

Sometimes determining your network status can be trickier than expected. Many specialties have benefits that are "carved out" to another payor.  The card may read Aetna, but mental health benefits could go to Magellan Health. If you are not in-network with Magellan, these claims may deny for no coverage. You have now seen this patient 4 times and are hearing that you will not be reimbursed for any of the sessions. So, where do you go from here? You have now established a relationship with someone in need and can no longer see them. This is a lose-lose situation for all involved. Let us help you avoid a terrible outcome! When we verify benefits, the first thing we check is who the payor is, where claims will be submitted, and what your network status is!

Every insurance plan differs greatly. Insurance can be confusing and tricky! Our next step in verifying insurance benefits is to see what your client will owe before they even walk through the door. The last thing you want is for a client to ask you what their copay is and you have no idea what to say. They want the transparency of cost, and providers need to know what to collect to avoid large invoices racking up. We can not always depend on a client to know what their insurance benefits are before scheduling an appointment. They have a lot going on and so do you! Let us help break down those pesky out of pocket expenses! Deductible, copay, coinsurance - We provide a detailed report for each and every client that is easy to understand for all!

We want to be sure each patient is receiving the amount of care they need and deserve, while you are getting paid for your work in healing! We will obtain any and all authorizations required, as well as keep track of how long the authorization is good for, how many units have been used, and what specific codes the authorization covers. We will continue to obtain authorizations as needed for you!