111 East Church Street
Mascoutah, IL 62258
ph: (618) 566-3100
fax: (618) 615-4111
Mascouta
Services may be covered in full or in part by your health insurance or employee benefit plan. We are in-network provider for the following insurance companies:
EAP (Employee Assistance Programs)
We send in applications often to become an in-network provider with different insurance companies. If your insurance company is not on the list, please check back or consider out-of-network services. As we become a provider with different insurance companies, we will update the list above.
Out-of-Network insurers may also cover a portion of the cost. Please check your coverage carefully by asking the following questions:
Good Faith Estimate
Effective January 1, 2022, a ruling went into effect called the “No Surprise Act” which requires practitioners to provide a “Good Faith Estimate” about out-of-network care.
Under Section 2799B-6 of the Public Health Services Act (PHSA), health care providers and health care facilities are required to inform individuals who are not enrolled in an insurance plan or a Federal health care program, or not seeking to file a claim with their plan, that upon request they are entitled to receive (both orally and in writing) a “Good Faith Estimate” of expected charges.
Note: The PHSA and GFE does not currently apply to clients who are using insurance benefits, including “out of network benefits” (i.e., submitting superbills to insurance for reimbursement).
Good Faith Estimate Disclaimer
This Good Faith Estimate shows the costs of items and services that are reasonable expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate is created.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. If you are billed for more than this Good Faith Estimate, you have the right to dispute the bill. You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place.
Cash, checks, and most major credit cards are accepted for payment.
If you do not show up for your scheduled therapy appointment, and you have not notified us at least 24 hours in advance, you will be required to pay $75.00 for the missed session.
Copyright 2013 Mascoutah Wellness Center. All rights reserved.
111 East Church Street
Mascoutah, IL 62258
ph: (618) 566-3100
fax: (618) 615-4111
Mascouta