Payment & Insurance



Insurance





Services may be covered in full or in part by your health insurance plan. We are in-network providers with the following insurance companies:



Blue Cross Blue Shield

Healthlink

Magellan

Cigna

Tricare

United Healthcare

Aetna

LIVE360

Health Alliance

WellFirst

Healthscope



EAP (Employee Assistance programs)





If you are using an EAP program, please call your EAP company to get authorization and a reference number before scheduling an appointment with Mascoutah Wellness Center.



Magellan EAP

Personal Assistance Services (PAS)

EAP Consultants, Inc.

Military One Source

Carelon Behavioral Health

Compsych

E4Health EAP

Ceridian

H&H Associates

Cambridge

ESPYR



I don't see my insurance listed. What should i do?





We send in applications often to become an in-network provider with different insurance companies. If your insurance company is not listed, please call the office to check with our office manager. Sometimes an insurance company will be listed under one of the umbrella companies above. You may also call your insurance company to see if you have out-of-network benefits.



Getting to know your insurance benefits





It is important to understand your insurance benefits. Please note that our services are not billed in the same manner as your doctor's office visits are. Your benefits may be different for mental health and/or substance abuse services.



Here are some questions you may want to ask when checking your insurance benefits:


- Do I have mental health and/or substance abuse insurance benefits?

- What is my deductible and has it been met?

- How many sessions per year does my health insurance cover?

- What is the coverage amount per therapy session?

- What coverage is offered for out-of-network providers?

- Is approval required from my primary care physician?



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, than 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 cost of items and services that are reasonably expected for your health care needs for an item of 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 mare 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 may ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bille, 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 prive 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 ger 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.



PAYMENT





Cash, checks, and most major credit cards are accepted for payment.







CANCELLATION POLICY





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 for the missed session.



PATIENT PORTAL





We offer a patient portal that allows you to see your bill and make payments directly on the portal. You can also schedule or reschedule appointments, as well as complete any required documentation.



Mascoutah Wellness Center



111 East State Street, Mascoutah, IL 62258


mascoutahwellnesscenter@gmail.com