WS Billing Information

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Wellness Solutions understands choosing to begin the treatment journey is courageous. There are many challenges including finding a provider you feel comfortable confiding in and who also provides the services you are searching for, accepts your insurance, and has schedule availability consistent with your schedule availability. There are many barriers that present themselves and it is understandable how you can become overwhelmed, frustrated, and want to quit before getting started.

If that were not enough discomfort most clients express significant concern and confusion regarding the cost of treatment and how to access insurance benefits. Most clients struggle to understand the benefits and eligibility that they pay for and how to utilize those resources to access affordable healthcare. We understand insurance can be both confusing and frustrating. For clients who do not have insurance the availability of treatment providers and options is extremely limited.

We are here to help. Wellness Solutions offers several billing and payment options for you to choose from based on your financial situation and resources. The information below is included to educate, explain, and demystify the complexity of insurance benefits and our payment options for those who do not have insurance. We hope this information will empower you to make informed and confident decisions.

We hope you will discover the Wellness Solutions billing and payment options offer realistic, fair, and flexible choices with transparency. Our goal is to facilitate a positive healing environment throughout the delivery of care in treatment. We believe that our commitment to inspiring and compassionate care is demonstrated in every contact and every point of service. We aspire to your Wellness Solutions experience should be seamless, consistent, individualized, customized, and empathetic.

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WS Billing Information Basics:

  • Wellness Solutions and our clinical associates accept most private insurance.

  • Wellness Solutions does not accept or submit claims to insurance for out of network services.

  • Wellness Solutions does not accept or submit claims for public insurance, such as, Medicaid, Medicare, or TriCare.

  • Established clinical associates are credentialed to be in network providers with most major insurance companies.

  • New clinical associates begin the process of credentialing with insurance when they are hired. The insurance credentialing process takes between 90-180 days approximately. New clinical associates are out of network providers until they complete the insurance credentialing process. (These are insurance rules that all outpatient mental health professionals are required to follow.)

  • In situations where Wellness Solutions is credentialed as an in network group practice AND the Wellness Solutions Clinical Associate has not completed the insurance credentialing process (which means the clinical associate is out of network) than the service is considered out of network.

  • Insurance rules do not allow for back-dating for services received prior to the clinical associate completing the credentialing process.

  • Once a clinical associate is in network with an insurance panel the client may use his or her insurance benefits and Wellness Solutions will submit claims for the client.

  • Wellness Solutions offers sliding scale discounted rates for clinical services to assist clients access affordable healthcare when they have out of network insurance or do not have insurance benefits.

  • Wellness Solutions does not require any form of verification or qualification of income to qualify for sliding scale services. We believe in an honors system where if a client reports that he or she has the need to access services with discounted rates than we appreciate positive healthy assertive communication and want to support self-care. If a client has out of network insurance or does not have insurance then he or she may request a sliding scale agreement. We allow each person to make his or her own decisions with regard to the appropriateness of sliding scale agreements to their individual situation.

  • If a client has in network insurance benefits AND wants to use a sliding scale agreement than unfortunately we are unable to accommodate that request. Insurance credentialing contractual agreements and insurance law does not allow in network providers to renegotiate established fees in this manner.

  • We strive to make our services accessible, transparent, and flexible to your individual needs and preferences. We offer flexible billing options to try and simplify your experience.

WS Billing Options for Clients Receiving Services from Out of Network Clinical Associates:

  • Choose to pay the full rate for services provided until the clinical associate completes the insurance credentialing process and is an in network provider.

  • Choose to pay the full rate for services provided and request to receive a "super bill receipt" for services so that the client can submit out of network claims himself/herself to one's insurance until the clinical associate completes the insurance credentialing process and is an in network provider.

  • Choose to pay the sliding scale rates for services until the clinical associate completes the insurance credentialing process and is an in network provider.

WS Billing Options for Clients Receiving Services from In Network Clinical Associates:

  • Choose to pay the full rate for services provided and do not use insurance benefits.

  • Choose to pay the full rate for services provided and request to receive a "super bill receipt" for services so that the client can submit claims himself/herself to one's insurance.

  • Choose to have use one’s insurance and have WS check eligibility and benefits, submit claims to insurance, and follow up with insurance regarding claims. Clients pay rates based on his or her insurance policy and plan provisions for deductibles, copays, coinsurance, and out of pocket benefits.

WS Billing Options for Clients That Do Not Have Insurance:

  • Choose to pay the full rate for services provided.

  • Choose to pay the sliding scale rates for services.

WS Insurance Information:

  • WS will check eligibility and benefits, submit claims, and follow up on claims for in network insurance only. We do not offer this service for out of network insurance.

  • Insurance does not permit for dates of service to be backdated. Therefore, we are not able to submit claims for dates of service prior to a clinical associate completing the credentialing process.

  • WS does not submit claim for out of network insurance companies.

  • WS does not submit claims to secondary insurance companies. If a client has secondary insurance WS will not check benefits or submit claims to a secondary insurance.

  • WS does not submit claims to public insurance, such as, Medicaid, Medicare, or TriCare.

WS Sliding Scale Information:

  • WS offers sliding scale rates to clients who request assistance to pay for needed services that they would otherwise not be able to receive.

  • Sliding scale rates are available for some but not all fees for services.

  • Sliding scale rates are available for clients who report that they have a need to receive said rate discounts based on their individual financial situations and who would not be able to receive care otherwise.

  • WS offers sliding scale rates on a case by case basis.

  • Insurance contractual agreements do not allow us to offer sliding scale fees to clients with in network insurance benefits. We can only offer sliding scale rates for clients who have out of network insurance and clients who do not have insurance benefits.

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