Insurance +Billing

If you plan to use your insurance for therapy sessions at Northwest Relationships, here’s what you can expect regarding your billing responsibilities:

 

Insurance Coverage:

• Copay: If your insurance plan covers therapy sessions, you will typically only need to pay a copay amount as specified by your insurance provider. The copay is a fixed fee you pay for each session.

 

Deductibles:

• What is a Deductible? A deductible is the amount you need to pay out-of-pocket for covered services before your insurance begins to pay.

• Your Responsibility: If you haven’t met your deductible for the year, you will be responsible for paying our contracted rate for each session. Once your deductible is met, your insurance will cover a larger portion of the costs, and you will continue to pay only the copay or coinsurance as applicable.

 

Coinsurance:

• What is Coinsurance? After meeting your deductible, coinsurance is the percentage of the session cost you are required to pay, while your insurance covers the remaining percentage.

• Your Responsibility: For example, if your coinsurance is 20%, you will pay 20% of the session fee, and your insurance will cover the remaining 80%.

 

Out-of-Pocket Maximum:

• What is It? This is the maximum amount you will pay for covered services in a plan year. After reaching this limit, your insurance will cover 100% of the costs for covered services.

• Your Responsibility: Once you reach your out-of-pocket maximum, you won’t have to pay any more for covered therapy sessions for the rest of the year.

 

In-Network vs. Out-of-Network:

• In-Network Providers: We are an in-network provider for many insurance plans, which means your out-of-pocket costs may be lower.

• Out-of-Network Providers: If we are out-of-network with your insurance, you may have higher out-of-pocket costs. It’s important to check with your insurance provider to understand the difference.

 

Session Limits and Pre-Authorization:

• Session Limits: Some insurance plans limit the number of covered therapy sessions per year. Please verify with your insurance provider if there are any limits.

• Pre-Authorization: Certain insurance plans require pre-authorization for therapy services. We recommend contacting your insurance provider to determine if pre-authorization is needed for your sessions.

 

Billing Process:

• Claims Submission: Northwest Relationships will submit claims to your insurance company on your behalf. You may receive an Explanation of Benefits (EOB) from your insurer detailing what was covered and what you owe.

• Payment Responsibility: You are responsible for any amounts not covered by your insurance, including copays, coinsurance, deductibles, and services that exceed your plan’s coverage.

 

Important Notes:

• Estimate Disclaimer: The information provided is an estimate. Actual costs may vary based on your specific insurance plan and coverage.

• Verify Coverage: We recommend contacting your insurance provider directly to confirm your coverage details, including copays, deductibles, coinsurance, and any session limits.

 

Need Assistance?

If you have any questions about your insurance coverage or need help understanding your benefits, please contact our billing department at admin@northwestrelationships.com or 253-234-5129. We’re here to help you navigate the billing process and ensure you receive the care you need.

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