Financial Policy & Insurance
The staff at Lee Side Wellness, LLC (LSW) are committed to providing caring and professional mental health care to all of our patients. As part of the delivery of services, we have established a financial policy that provides payment policies and option to all patients. Your insurance policy, if any, is a contract between you and the insurance company; we are not part of the contract with you and your insurance company.
LSW will bill your insurance or provide you with a statement and claim form for you to submit to other third-party payers but cannot guarantee such benefits or the amounts covered. In some cases, insurance companies or other third-party payers may consider certain services as not reasonable or necessary or may determine that services are not covered. Patients are responsible for payments regardless of any insurance company’s determination of usual and customary rates. LSW will assure that a visit is billed properly but cannot guarantee payment by insurance.
The Person Responsible for Payment will be financially responsible for payment of such services. The Person Responsible for Payment is financially responsible for paying funds whether they are reimbursable by insurance companies or third-party payers.
Effective January 1, 2019
Insurance deductibles, co-payments and other payment plans are due at the time of service. This includes the full fee of the visit/service provided at your scheduled appointment. LSW will bill the patient at the beginning of the visit for the allowed amount for their specific insurance. Once the patients' deductible is met for the year their co-insurance will be charged until all patient out of pocket expenses have been paid. Once the patient has reached his or her maximum out of pocket, the insurance company should cover their claims at the percentage specified in the patient’s insurance contract. If the insurance reimburses LSW for a service that the patient has already paid for, the patient will be reimbursed for the service. It is at the provider’s discretion to continue clinical services if a patient has outstanding charges.
Payment methods include check, cash, or the following charge cards: Visa, Amex, MasterCard, Discover and HSA cards.
Questions regarding the financial policies can be answered by the Office Manager.
Lee Side Wellness is currently contracted with many insurance companies but not all. In the interim, if your insurance company does provide out-of-network benefits, you may elect to file your own claims for reimbursement. These claims will be paid directly to you. We recommend that you contact your insurance company directly for specific information regarding your out-of-network coverage for mental health services. The staff of Lee Side Wellness is happy to discuss service fees at the time your initial appointment is made, addressing any questions or concerns prior to your first session.
- Patients are responsible for being aware of current insurance coverage. This includes the details of:
- Out of network benefits
- Deductible and/or "out-of-pocket"
- Need for pre-certification
- Current coverage and co-payment
- Maximum annual visits
- Current visits remaining
- Any changes in coverage
- If you have exceeded your benefits covered, you are responsible for the full payment for any uncovered sessions.
- Your mental health coverage may be "carved out" to other managed care companies. We are considered out-of-network with those companies.
- Please note that your insurance may place limits on the number of visits allowed per calendar year. This may not be sufficient to cover the clinically appropriate level of care determined by your provider.