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This includes in network provider coverage, co-payments, deductibles, referral requirements, and laboratory contracts. Your health insurance plan is a contract between you and your health insurance company. Our practice does not share in that contract. You are responsible for any outstanding amounts, including but not limited to copays, deductibles, coinsurances, fees that are not reimbursed by your insurance, and fees for services rendered that are not covered by your insurance.
You must provide a valid insurance card, or other written evidence of insurance coverage, and a government issued photo ID at the time of services. It is your responsibility to provide the office with updated insurance plan information if your coverage changes or ends.
The best way to find out information about your plan is to call the member number listed on your insurance card. Understanding your plan can help you plan financially and avoid unexpected bills.
After your insurance provider has processed a claim with a full or partial payment or denial, you will be responsible for the remaining balance, and it is due immediately. If you have an outstanding balance of 90 days or more, your account may be turned over to a collection agency. If you have outstanding balances, you will be unable to schedule a future appointment until your bill has been paid in full, or you have enacted a payment plan with our office. Failure to pay outstanding balances may lead to dismissal from the practice.
+Blue Cross Blue Shield
+Cigna
+Aetna
+Optum
+United Health Care
+Mass General Brigham Health Plan
+Harvard Pilgrim Health Care
A copay is a fixed amount that you must pay for at the time of the visit. Copay amounts are usually on the front of your insurance card and may vary depending on the type of provider you are seeing. Our providers are considered specialists or mental health providers.
Coinsurance is a percentage of the visit that you are responsible for, while your insurance may pay for the remainder. For example, if your coinsurance is 20% and the visit cost is $200, you may have to pay $40 in coinsurance while your insurance covers the rest.
A deductible is an amount you are responsible for before your plan starts to pay for services. For example, if you have a $1500 deductible, you may have to pay up to $1500 on health care services before your plan will start to pay. Deductibles typically reset at the beginning of the year.
Our providers are in network with several plans and we are able to bill those insurances for services provided to you.
If we are in network with your plan, we will submit a claim to your health insurance plan for visit charges, but depending on your specific plan, you may be responsible for copays, deductibles, and/or coinsurance. Sometimes mental health benefits are not included in a plan, or are even covered by a different insurance than your medical benefits.
Every plan has different requirements. Before your appointment, call the 'member number' on your insurance card and ask if you need a referral from a primary care provider before your first appointment. If your plan requires a referral and you do not have one at the time of your visit, you may be responsible for the full cost of your visit.
Out of network plans are insurance plans that our providers are not contracted with. Patients with out of network insurance are welcome to private pay for services. If you have out of network benefits with your plan, an itemized and coded receipt can be provided upon request so that you may request reimbursement from your plan.
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Phone: 617-383-7839. Fax: 949-655-5995.