Understanding Your Insurance Benefits
It is your responsibility to know and understand your insurance benefits, including co-payments, deductibles, co-insurance amounts, and coverage limitations. Insurance policies vary widely, and it is important that you are familiar with your specific plan details before your first appointment.
Pre-Authorization Requirements
Some insurance plans require pre-authorization or referrals for mental health services. It is your responsibility to obtain any necessary pre-authorization or referral from your insurance company or primary care physician before your appointment. Failure to obtain required authorization may result in denial of coverage and full financial responsibility for services rendered.
Verification of Benefits
While our office may contact your insurance company to verify your benefits, this verification is only an estimate of your coverage and is not a guarantee of payment. Your insurance company makes the final determination of your eligibility and benefits at the time they process the claim.
Payment Responsibility
You are responsible for any co-payments, deductibles, or co-insurance amounts at the time of service. You are also responsible for any charges not covered by your insurance plan. If your insurance company does not pay for services within a reasonable time frame, you will be responsible for the full payment.
Out-of-Network Benefits
If your therapist is not in your insurance network, you may have out-of-network benefits. It is your responsibility to understand these benefits and any additional costs associated with seeing an out-of-network provider. You may be required to pay in full at the time of service and then submit claims to your insurance company for reimbursement.
Changes in Coverage
You are responsible for notifying our office of any changes in your insurance coverage, including changes in policy, carrier, or eligibility. Failure to provide updated insurance information may result in claims being denied and you being held financially responsible for all charges.
Claims Submission
Our office will submit claims to your insurance company on your behalf as a courtesy. However, the relationship for payment is between you and your insurance company. Any disputes regarding coverage or payment are your responsibility to resolve with your insurance carrier.
Acknowledgment
By signing below, I acknowledge that I have read and understand this Insurance Responsibility Agreement. I understand that it is my responsibility to know my insurance benefits and to comply with all requirements of my insurance plan. I agree to be financially responsible for any charges not covered by my insurance.