Frequently Asked Questions - Billing

DO YOU TAKE INSURANCE?

Yes. We are in-network with TriCare West, Blue Cross Blue Shield, PEHP, GEHA, UofU, and Utah Medicaid.

Credit Card on File

DO I HAVE TO LEAVE MY CREDIT CARD INFORMATION TO BE A client AT THIS clinic?

Yes. This is our policy and it is a growing trend in the healthcare industry. Insurance reimbursements are declining and there has been a large increase in patient deductibles. In order to continue accepting insurance while continuing our high quality of service provision, we have decided to be more efficient in our billing and collections processes instead.

HOW MUCH AND WHEN WILL MONEY BE TAKEN FROM MY ACCOUNT?

The insurance companies on average take approximately 2 weeks to process submitted claims. Whatever the allowed amount is, your copay, coinsurance, and deductible are taken into consideration. Your individual policy dictates what you may owe. Once the insurance explanation of benefits is received and posted to your account, you will be sent a statement showing your responsibility. Your statement/invoice will have a processing date included.

HOW DO YOU SAFEGUARD THE CREDIT INFORMATION YOU KEEP ON FILE?

We use the same methods to guard your credit card information as we do for your medical information. The card information is securely protected by the credit card processing component of our HIPAA compliant electronic health record (EMR) system. This system stores the card information for future transactions using the same sort of technology that any online retailer would. We can’t see the entire card number and have no way to use the card outside of the billing system. There is no way to export the card information out of our system. The only way to use it is to process a payment in our EMR.

WHAT ARE THE BENEFITS?

Having a card on file saves time and money. It saves you time by eliminating the need to answer phone calls to confirm payments. It also drives our administrative costs down because our staff sends out fewer statements and spends less time taking credit card information over the phone or entering it from the billing slips sent in the mail, which are less secure methods than us storing the information. The extra time we’ll have can be spent providing therapy on your level!

I ALWAYS PAY MY BILLS ON TIME. WHY DO I HAVE TO DO THIS?

As stated above, the entire billing process is time consuming and can cost a lot of money. Reducing unnecessary costs are essential to allowing us to continue to be an in-network provider with most insurance companies. This policy does not impact what you owe.

WHAT IF THERE IS A PAYMENT DISCREPANCY OR I HAVE OTHER PAYMENT QUESTIONS?

Please contact our billing department directly to settle payment discrepancies or for other payment questions. This policy in no way compromises your ability to dispute a charge or question your insurance company’s explanation of benefits.

WILL I STILL RECEIVE A INVOICE BY EMAIL?

Yes. You will receive one invoice which will show what will be charged to your card by a certain date. If you prefer to pay by an alternative method, you may do so during that period. If you do not wish to make any payment method changes, just hold onto the statement for your records and your card will be charged.

No Surprises Act & Good Faith Estimates

What is “Balance Billing”?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network. “Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

What is “surprise billing”?

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed. If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections. You’re never required to give up your protections from balance billing. You also aren’trequired to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

• Your health plan generally must:

  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).

  • Cover emergency services by out-of-network providers.

  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

More information about your rights and protections 

Visit https://www.cms.gov/nosurprises  for more information about your rights under federal law.

Contact our Billing Department at 801.217.3390 to request a Good Faith Estimate or ask questions about your coverage.

Contact your insurance provider directly to understand your plan its coverages and limitations.