Frequently Asked Questions about Billing
Our expectation always is that you pay on the day that services are rendered. However, there are circumstances that necessitate sending a bill; when there is a balance due, for example. Below are frequently asked questions regarding bills.
Does this bill contain only amounts that I owe?
Yes, this bill contains only the charges that you personally owe Rasi Associates, Inc. for services rendered. If you are using your insurance, then these charges are referred to as a “co-payment,” “deductible,” or ”short notice cancellation.” If your insurance plan denies coverage for reasons that are not of our making and they inform us that you are responsible for payment, that charge will appear in your bill as well.
What is a co-pay?
A co-pay is what you personally owe for a particular service rendered. Your insurance sets this amount.
Is my co-pay always the same?
This depends on your policy. Some policies require a lower co-payment for the first number of sessions and then charge larger co-payments after those sessions. For other policies the co-payment remains the same for all mental health services. It is also possible that at the time that your policy comes up for renewal your employer changes to a plan with a higher out of pocket co-payment. This can be true even with the same insurance carrier and even when your benefits do not change. If this happens and you need further clarification you should speak with your employer.
What is a deductible?
A deductible is the amount that you owe before your mental health benefit “kicks in.” Your insurance company sets this amount. Often, but not always, the deductible covers both medical and mental health benefits. In the past couple of years we have been seeing more policies with deductibles, and also higher deductibles. These amounts are set by the insurance company and depend on the particular plan you have. You should bring your concerns about this to your employer.
Why am I being charged a deductible on this bill?
There are three possible answers. The first is simply because your particular insurance plan includes a deductible. Second, your therapist may be an “out of network provider” and a deductible needs to be paid by you before benefits “kick in.” Third, when you or we verified your benefits the insurance company may have given us the wrong information.
I thought I would be charged a certain amount but now I’m being charged a different amount. Why?
Your insurance company sets the amount that you are required to pay out of pocket. When insurance companies pay us, sometimes they specify a different amount for you to pay than what they indicated when you or we originally verified your benefits.
What is a short notice cancellation charge?
When you began therapy you signed an agreement that you would be responsible for any missed session or a cancellation under 24 business hours. Missed sessions cannot be charged to your insurance company. Therefore, you are responsible for payment of the full fee for that particular session.
How do I know what the limit of my yearly benefits is? What happens then?
The limit of your benefits is determined by your insurance plan. It is important that since this is your benefit that you become familiar with it and manage it. When your benefits end for the year, we are unable to charge the insurance for your sessions. You should speak with your therapist about becoming a self pay client if you are continuing with your sessions. You will still be expected to pay on the day the service is rendered.
What are parity benefits?
The parity law of the state of MA determines that behavioral health services be covered similarly to all other medical illnesses. In order to have “parity benefits” two things need to happen: your insurance plan needs to include “parity benefits” (and there are exceptions); and you must have a “biologically-based diagnosis.” The law defines “biologically- based” as a condition that can be shown to have a medical origin, for example, major depression, panic disorder, bipolar disorder, schizophrenia. In that case, your benefits change to “unlimited sessions.” For more clarification speak with your therapist or call your insurance plan.
I am an insurance client. What should I do if I think that my bill is wrong?
First, consult the Explanation of Benefits (EOB) you receive from the insurance company. This is the document that the insurance company issues directly to you and to us when they send us a payment. This document explains what we have charged them, what they paid us, and what you owe.
Second, if you believe that the insurance part of your bill (co-pay or deductible) is wrong, call your insurance company. A customer representative at the insurance company should be able to answer your questions, or correct any mistakes they might have made. Unfortunately, we are unable to do this for you.
If the insurance corrects any mistakes, the adjustment will be reflected in a future bill once we have received notification from them
Please let us know what you think the problem is and inform us of what steps you have already taken to remedy the situation so that we can keep on top of it.
I am a private pay client. What should I do if I think that my bill is wrong?
Contact Rasi Associates, Inc.’s billing office by calling our main number. If you get voicemail, leave a message at extension 120. The billing manager will contact you within 24 business hours.