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 the administrative agent). Please be aware that it is your responsibility to know your benefits, rules and regulations. You should be knowledgeable of any deductibles, co-payments, co-insurance, annual visit maximus and prior authorization requirements. If you are not clear about your current health insurance policy benefits you should review your plan’s details on your insurers web portal or speak with your employer to learn about your benefits and responsibilities.
Therapy Solutions is in-network with the following:
- Anthem Blue Cross Blue Shield
- United Healthcare
- IN Medicaid
- Children’s Special Health
- MDWISE Hoosier Healthwise
- Managed Health Services (MHS)
As an in-network patient, it is your responsibility to notify us of any change in insurance eligibility or any additional insurance plans. The failure to do so can result in the pausing of services and direct patient financial responsibility.
If you are not in-network with one of the insurers above, Therapy Solutions may still be able to use your insurance as an out-of-network provider if your plan has out-of-network benefits. However, this means we cannot negotiate or guarantee the payment of claims for you. The insurance company will pay you directly. Therapy Solutions will send you an invoice for payment. It is very important that you are familiar with any deductibles, co-payments, co-insurance, annual visit maximums, and any prior authorization requirements, as we cannot perform insurance benefit eligibility for services.
Good Faith Estimate
A good faith estimate will be prepared to the best of our ability when requested. Insurance companies will not typically give us an exact amount that will be covered before service begins. This estimate is based on your insurance type and historical reimbursement rates from that insurer. This is an estimate only and not a guaranteed price.
Primary Insurance with Secondary Insurance
If you have a primary insurance plan with a secondary insurance (typically Medicaid) we are required to first file a claim with your primary insurance. Once your primary insurance has completed that claim we can then file the remaining patient responsibility to the secondary insurance.
If you are using out-of-network benefits through your insurer we may request and require your support in providing us with copies of the Explanation of Benefits for each claim no later than 14 days of the claim processing. You also agree to pay Therapy Solutions all primary claim funds that are directly reimbursed to the policy holder no later than 14 days after receiving payment from the insurance company. Any delay in this process may result in the pausing of services and direct patient financial responsibility.
New or Updated Insurance
You are responsible for contacting our office as soon as possible whenever you have new insurance or become aware of any updates or changes to your existing insurance plan. Any delay in notification may result in the pausing of services and direct patient financial responsibility. You must either call the Clinic Coordinator at 765-423-7988 ext 1 and/or present a copy of your new insurance card(front and back) in person before your next appointment.
Courtesy Insurance Filing
Therapy Solutions will file a claim with your insurance on your behalf. We will start submitting claims from the date that you provide your insurance information.
Payment is due at the time of service. This applies to any co-payments, co-insurance or deductible amounts and all other costs for treatment/service not covered by insurance. An active credit/debit card is required to be kept on file to be charged after each visit. If you are paying with an HSA card we will require you to provide a second backup card to be used in the event of the HSA card not being approved.