Billing Details
We are in network and file insurance claims for these providers.
- BCBS (BLUE ADVANTAGE, BLUE CARE, BLUE OPTIONS, CLASSIC BLUE , NC STATE HEALTH PLAN-PPO)
- United health care, UMR
- Aetna
- NC Medicaid
- NC Health choice
- Cigna
- Managed Care Organizations- Amerihealth Caritas, Healthy Blue, Carolina complete health, UHC of NC, Wellcare of NC.
Know Your Benefits
Your health insurance policy/HSA/FSA is a contract between you and your health insurance company (or your employer, with the health insurer as administrative agent). Please be aware that it is your responsibility to know your benefits, rules and regulations. You should be knowledgeable of any deductibles, copayments, coinsurance, annual visit maximums, and prior authorization requirements. If you are not clear about your current health insurance policy benefits, you should review your plan’s details online (most insurers have web portals), contact your insurer, or speak with your employer to learn about your benefits and responsibilities. We will be happy to provide you with any necessary procedure and diagnosis codes they may require to answer your questions.
For Patients With In Network Insurance:
Proof of insurance is required prior to your first appointment so that we may gather benefit information and obtain prior authorization if required to do so by your carrier. Any co-pays and/or deductibles are expected at the time of service. This is legally required as per your contract with the insurance company. We will submit therapy claims on your behalf, but please note this is not a guarantee of payment. If your insurance company denies part, or all, of the therapy claim, you will be billed at the contracted rate for your carrier.We will make reasonable effort to assist you in collecting payment from your insurance carrier. If your insurance company requires submission of information from you directly, you will be expected to do so in a timely manner. Claims that remain unpaid after 60 days will be billed to you directly.
Out Of Network Status
This means we are considered as “Out of Network” providers and cannot negotiate or guarantee the payment of claims for you. You should be knowledgeable of any deductibles, copayments, coinsurance, annual visit maximums, and prior authorization requirements as we do not perform insurance benefit eligibility for services. For out of network Insurance, we do not bill directly. However we are happy to provide you with the appropriate bills, which are receipts for services containing the relevant diagnosis and treatment codes. It is your your responsibility to check with your insurance provider, and submit to insurance the invoices that we will provide on each visit to determine how many therapy sessions will be covered and what percentage of cost if any will be covered.