INSURANCE & BILLING INFORMATION
Key Insurance Terms
Understanding health insurance can be overwhelming, especially when it comes to mental health services. Although we cannot eliminate all insurance barriers, we aim to clarify some of the terminology and explore alternative coverage options if needed.
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This page can help give some insight on your plan, along with information on Rust Wellness Group's billing processes.
Deductibles
A health insurance deductible is the amount of money you have pay out of pocket before your insurance kicks in. For, example, if you have a $1,000 deductible and it is $150 per session - you would be responsible for paying the first the session fee ($150) until you hit $1,000. Once that amount is reached, your insurance will begin covering services. Deductibles can vary depending on your plan.
Coinsurance
Coinsurance amounts indicate the portion of the claim that you are accountable for paying. For instance, if your plan has a "20% coinsurance" clause and your session fee is $150, you will be liable for $30 per session, while your insurance will cover the remaining $ (80%). The deductible requirement before your coinsurance takes effect may differ for each policy.
Copay
Usually, a copay is a set fee that you pay for each visit, which can differ depending on the type of service provided. For instance, the copay for Mental Health treatment in a hospital may be higher than that for Outpatient Therapy.
Out of Network Providers & Superbills
While Rust Wellness Group accepts various commercial insurance plans, we unfortunately may not be "In-Network" with others. If we do not take your particular insurance, you may have "Out of Network" benefits.
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For example, you will pay out of pocket per session. At the end of the month (or in whatever frequency you would like), we will send you a "SuperBill". This SuperBill can be submitted to your insurance company for reimbursement. If your insurance policy covers 75% of Out of Network Mental Health Services, and you spent a total of $450 that month on Therapy Sessions - your insurance will reimburse you $337.50 (75%).