Insurances
A Window To Wellness accepts all insurances, whether in- or out-of-network. Whether benefits and eligibility are obtained and verified, it is not a guarantee of payment, as in- or out-of-network factors may apply; details are subject to change per any insurance policy and guidelines. We do our best to verify client benefits and/or establish single case agreements, if necessary, to be apprised of the costs that our clients may have for their therapeutic services.
Insurance policies may include one or more cost-share factors to the client's responsibility per session, depending on the individual policy. A deductible, coinsurance, and/or copay are considered out-of-pocket costs to the client's cost-share responsibilities, per the contract agreement with the clients' insurance policy. Copays are expected as sessions are held, whereas coinsurances and deductibles are billable first to the carrier(s) and then payment is expected upon receipt of the explanation of benefits provided by the insurance(s) and/or our account statements.
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Copay, which is a flat fee paid for certain health care services.
Example: $15 per session -
Coinsurance, which is a percentage-based fee assessed for certain health care services.
Example: 10% of the allowable amount per billed session -
Deductible, which is a total amount assessed for certain health care services that must be paid and met before the insurance company begins contributing payment(s).
Example: $800 total out-of-pocket cost to be paid in a plan year, broken down and accumulated applied per session
If you have more than one insurance carrier that covers your services, it is the client's responsibility to have established the coordination of benefits (COB) to correctly provide which policy is primary, secondary, tertiary. When more than one insurance is involved, depending on each of the policy benefits, a secondary policy may not solely cover the balance left by the primary policy; or the secondary policy may still require a cost-share responsibility of the client for services to be covered. It is the client's responsibility to know what their benefits are with their insurance carrier(s) and to make prompt payments towards their financial responsibilities as directed by their explanation of benefits and/or our account statements.
In-Network Insurance Carriers
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AARP
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Aetna/Aetna Behavioral
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Amerihealth Caritas (DE Medicaid)
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Beacon Health Options/Value Options
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Blue Cross Blue Shield
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Cigna/Cigna Behavioral
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ComPsych
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Highmark Health Options (DE Medicaid)
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Humana
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Independence BCBS
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Keystone Health Plan East
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Medicare
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Magellan
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Optum/United Healthcare/United Behavioral
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Tricare Prime/East
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Various Medicare Supplement Policies
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Various EAP Policies
Listed are the major carriers, however, we have a multitude of other carriers that we are either in-network with or have single-case agreement arrangements in place with. Most other insurers are linked with one of the above insurers as their "sister-plan" and follow the billable allowances of the major carrier.
Clients are encouraged to contact their insurance company directly to confirm if the preferred therapist is in-network, or not. If your insurance is not on our list, please inquire directly with the office to see what can be done to be considered in-network with your carrier or if a single-case agreement can be established.
We do not remit to auto or workmen's comp insurances for therapeutic services.
Fee Schedule, as of 2/1/20
Insurance Billable:
Intake/First Session $200.00
Follow-up Sessions $105 to $150.00
Self-Pay Billable:
Intake/First Session $150.00
Follow-up Sessions $55 to $100.00
**The service fee ranges are calculated based on complexity and time spent. AWTW reserves the right to make changes to fees without notice.
If you self-pay for services as a result of no insurance, we do offer discounted services if there are financial circumstances that impact the client's ability to pay full price for services. The initial session would still be at the full rate, as we do not offer any additional discounts on this service. Contact our administrative staff to discuss this arrangement.
Account statements are not an expectation, but rather a courtesy reminder when provided since clients also receive notice of, or have access to, their explanation of benefits remittances from their insurances to provide such details, often 1-2 weeks prior to our office receiving the provider copy. It is the client's responsibility to communicate with the insurance company or the provider's office to verify if there are financial occurrences periodically, as advised in most insurance agreements and provider offices such as ours.
Clients are responsible for taking the initiative to process their copays/deductibles/coinsurances promptly through any means accepted by our office prior to, or shortly after each session to avoid accruing balances. Credit cards can be left on file for processing on client behalf if preferred, or payment agreements can be established if need. Speak with Christine if interested in either option.