What is a copay, coinsurance and deductible?
A copay is a fixed dollar amount that you pay for a covered health care service, usually when you get the service. The amount can vary by the type of covered health care service.
Coinsurance, like a copayment, is a form of cost sharing for health services between insurance companies and the insured. Unlike copays, which are flat fees, coinsurance is a percentage of the cost for a health service or prescription drug paid by a member after they have reached their deductible. As part of our contractual agreement with your insurance company we must collect these fees directly from you. Coinsurnace is an estimated amount and we may not know the exact amount until the claims are processed. The estimate is based on the average allowable rate set forth by your insurance carrier. If there is a balance due after your insurance processes, we will bill you for the difference between the amount you have paid and what the insurance states is the patient responsibility amount.
A deductible is the amount you owe for health care services before your health insurance or plan begins to pay. Deductibles are applied based off service type and plan year. Not all services are subject to the deductible.
Do you offer a discount or sliding scale fee?
We have an adjusted fee agreement available if you do not have insurance coverage or if you choose to work outside of your insurance network. If you are unable to find an in-network therapist we do have a few therapist(s) in the practice who offer a reduced rate of $95-$125 per session for individuals who wish to work outside of their insurance.
What is your cancellation policy?
In order to keep our schedules running smoothly and to serve as many people as possible, the policy of KCA is to assess an $95 no show/late cancellation fee when an appointment is missed or not cancelled 24 hours prior to the scheduled time. In order to avoid this fee, you may simply contact our office within this time frame if you are unable to keep your appointment. It is acceptable to leave a message or send us an email.
How do I know if my insurance will cover counseling?
Our office does offer courtesy benefit checks, however, the benefit check is not a guarantee of coverage. We urge you to review your insurance policy’s “Schedule of Benefits”. It will help you understand the agreement you have with your insurance company. You can also call your insurance company with any specific questions related to your policy relating to outpatient psychotherapy benefits. It is important to accurately verify and understand your policy’s deductible, co-payment, coinsurance, visit limitations, effective annual calendar, renewal ate, and any pre-authorization requirements. As a courtesy, we will also verify your coverage, but we will not guarantee the accuracy of the information we receive. Your insurance policy is a contract between you and your insurance company. You are responsible to know your level of coverage, and you are ultimately responsible for the full payment of the bill.
How long will it take for my account to be resolved with my insurance carrier?
Each insurance company and account is different but the usual length of time required to resolve all claim issues is 60 days. If you have not received your Explanation of Benefits from your insurance company within this time frame, we urge you to contact your insurance company directly for the status on the claim processing.
What is my role in the billing process?
- Contact our billing office at 303-487-4943 with any changes to your insurance information or demographics.
- Sign all necessary client agreement and/or release forms.
- Immediately communicate with us if you have any questions regarding your billing.
How do I reach the billing office?
If you have questions please call Julie at 303-487-4943.