Navigating the world of healthcare can be confusing, especially when it comes to understanding your deductible. At Anew Era TMS & Psychiatry, we’re here to simplify the process and offer tips to ease any concerns.
What is a Deductible?
A deductible is the amount you pay out-of-pocket for healthcare services before your insurance begins to cover costs. For example, if your deductible is $1,000, you must pay this amount before your insurance covers services (excluding services with no-cost coverage like preventive care).
How to Check Your Deductible
- Review Your Insurance Policy: Look for your plan’s explanation of benefits (EOBs).
- Contact Your Insurance Provider: A quick call can clarify your deductible status.
- Log Into Your Insurance Portal: Most providers have an online account system with up-to-date deductible tracking.
Ways to Pay Your Deductible
We understand that paying a deductible can feel overwhelming. Here are some options:
- Payment Plans: Many healthcare providers, including Anew Era, offer flexible payment plans that break down costs into manageable installments.
- Health Savings Accounts (HSAs): If you have an HSA or a Flexible Spending Account (FSA), you can use pre-tax dollars to pay for your deductible.
- Credit Cards: While not ideal for everyone, credit cards can be a short-term solution for covering high costs.
- Care Credit: We offer financing options through CareCredit
- Insurance Assistance Programs: Some insurance providers offer resources to help with larger out-of-pocket expenses.
Easing Nervousness About Paying Your Deductible
It’s natural to feel stressed about covering healthcare costs. Here are some strategies to help ease your concerns:
- Plan Ahead: Keep track of your deductible progress throughout the year to anticipate upcoming costs.
- Utilize Preventive Services: Many insurance plans offer free preventive care that doesn’t count toward your deductible.
- Ask Questions: Contact us at Anew Era for a detailed cost breakdown of your treatment plan. Transparency helps you plan better!
- Focus on Your Health: Investing in your mental health can lead to long-term benefits. Treatment is an essential step toward a brighter future.
- Communicate: Share your concerns with your healthcare provider. We’re here to listen and help.
Anew Era’s Commitment to Your Well-Being
At Anew Era TMS & Psychiatry, we aim to make your treatment process as seamless and stress-free as possible. From explaining your deductible to offering flexible payment options, we’re here every step of the way.
We understand that medical billing can be complex, and we’re here to help! Below, you’ll find answers to common questions about how our PPS Billing Team handles insurance claims, payments, and billing timelines.
Who will bill my insurance?
Our PPS Billing Team will bill your insurance for your visits. You will be asked to pay your co-payment, deductible and/or co-insurance at the time of service. PPS Billing will then bill your insurance company on your behalf. If your insurance company changes, please notify us as soon as possible at 714-277-3047 so we may change your insurance information and bill the account correctly. If your claim is denied or your insurance determines your patient portion is different, you will receive a bill from us. If your initial payment was more than your patient responsibility, your account will be credited with the difference.
Why am I being asked to verify my insurance at each visit?
We know insurance information can change sometimes, so we want to ensure that we are billing the correct insurance company. Please note that it is the patient’s responsibility to provide their latest insurance information so that we can bill all claims in a timely manner. When insurance information is not updated with Anew Era at the time of care, this could result in charges.
My appointment was several weeks ago, why have I not received a bill?
Depending on how quickly the insurance company processes the claim, it may take 3 to 12 weeks for you to receive a bill. Other causes for delays in receiving your billing statement can be due to the wrong address, or a recent move, therefore, it is important to contact the billing office to update us with your current address and personal information.
I have coverage under both my policy and my spouse’s policy. Since their deductible is less, can you bill their insurance?
Unfortunately, under a provision called coordination of benefits, we are required to bill the insurance that would be considered primary for you. Any health insurance for which you are the primary holder must be billed before any other health insurance.
When will my insurance company settle my account?
While each insurance company is different, we generally expect full payment from your insurance company within 45 days of billing. If your insurance company does not pay the bill within 45 days, there may be an issue with the claim. We will investigate and if the claims need to be rebilled or appealed, we will do so. Once the claim is processed, your account will be updated. If you have a balance, we will bill you at that time.
How will I know how much I will need to pay?
Our insurance verification team will verify your insurance benefits before your first appointment. The office will let you when you check in for your appointment, your co-payment, deductible and/or co-insurance is. This will be a “best estimate” based on the information we have been given by your insurance company and the billing codes we provided to them. If you are insured, it will also be based on your insurance coverage and our contract with your insurance company. Once we receive a payment or denial from your insurance company, you will receive a statement showing the amount that is due from you. This amount should be the same amount noted on the Explanation of Benefits (EOBs) you receive from your insurance company. This amount is due when you receive the statement. If you have questions, please contact your insurance company or our PPS Billing Team at the number on your statement. Please note that if your insurance company fails to make any payment to your account, we may ask for full payment from you depending on the reason for non-payment.
How may I make a payment?
Our PPS Billing Team can take your payment over the phone if you are paying your bill. Our office will take your payment before your appointment. We accept most major credit/debit cards. If additional methods of payment are required, please contact our PPS Billing Team number located on your billing statement, and we will work with you to facilitate timely payment.
Where can I find answers to questions about Medicare?
Go to www.medicare.gov for more information on Medicare.
What is an Advance Beneficiary Notice (ABN)?
An Advance Beneficiary Notice (ABN) is a written notice from either the physicians, providers or suppliers, before they provide a service or item to you, notifying you: That Medicare may deny payment for the specific service or item The reason the physician, provider or supplier expects Medicare to deny the payment That you may be personally and fully responsible for payment if Medicare denies payment An ABN also gives you the opportunity to refuse to receive the service or item.
What if I am unable to make the full payment? Can I set up a payment plan or apply for a financial hardship?
Yes. If you would like to set up a payment plan, please contact the PPS Billing Team at 714-277-3047 or by email at ppsbilling@discoverybh.com. If you are experiencing financial hardship, you can apply for assistance. Normally, hardship applications are completed and approved before services are rendered, however, we do understand circumstances may change. Hardship applications follow CMS and federal poverty guidelines. Our PPS Billing Team will be happy to work with you to complete the application.
Who do I contact if I have questions or concerns regarding my account and/or billing or if I have additional questions?
The PPS Billing Team will be happy to assist you with any questions or concerns. Please feel free to contact us at: 714-277-3047 or via email at ppsbilling@discoverybh.com.
