Written by: Shiloh McClelland

Hi, my name is Shiloh, and my job is to take care of the day to day billing operations of My Integrity Counseling so that our counselors can keep their minds on what is most important– you, their clients! When we were just a baby company, Phil, our founder, did contracting, billing, scheduling, and all of that by himself. As we grew, I took the billing and contracting portion off his shoulders, while Tony took the equally time-consuming portion of scheduling clients and getting the word out. Insurance can be confusing. A fun part of my job is to help you understand how it works so that you, too, can focus on your counseling journey. This article explains how insurance works and what information you should share with us to keep your mind on your counseling goals rather than paying for counseling.

Deductible

Before I started working in insurance,the most confusing aspect of insurance was the deductible–why would I pay monthly premium bills and still pay the doctor for healthcare? Isn’t that what I am paying them to do? While I still don’t have an easy answer for this question, what I can tell you is that each non-Medicaid or Medicare policy has an aspect of “cost-sharing.” Basically, this means that you agree you will pay a portion of your healthcare costs and your insurance company will pay the other portion. We do not get paid by your insurance company until after you have met your deductible. This is often the largest portion you will pay. If you are a person who does not go to the doctor all that much, it might make sense to pay lower premiums and a higher deductible. It’s like gambling that you will not need to pay your deductible, but you will be covered in case of a car accident or other catastrophe. For most of us, though, we will end up paying through our deductible the first few months of our policy. Therefore, we have to balance between paying for a lower deductible plan or just paying through the deductible until we get to the point that the insurance company begins helping out. Not being an insurance broker, I really can’t give out advice, but in my experience a lower premium may mean a higher deductible, which means you will be paying the bills out of your pocket for longer. Some policies do not apply deductible to certain services, like mental health counseling, which would be ideal for our clients. 

Copay versus Coinsurance

Another part of cost-sharing is copay or coinsurance, which is charged at the time of service. Most of the time you will pay a copay (flat rate per session) or coinsurance (a percentage of the allowed cost), though there are some policies that have a combination of both. We will do our best to tell you how much you can expect to pay per session based on your cost-sharing, but if you want to be certain, you will need to check your policy yourself, either by looking into your insurance policy information or simply by calling them. Remember– someone is already being paid to help you with any questions you may have; you might as well make them earn their paycheck! Each company has agreed a price to pay for your services with us, so your deductible amount and coinsurance payment will differ based on which company you are working with. 

What information do we need?

In order to minimize the amount of time you spend on billing and to maximize your focus on the benefits of counseling itself, you need to share certain information with us. Tony does his best to gather this information from you when scheduling you for counseling, but many people change their policies after they begin counseling, sometimes multiple times, and you will be the only one who knows when that happens. 

1. The front and back of your card (or digital equivalent): Often, the back of your card contains information we need in order to send your claims to the right place. Sometimes your mental health benefits are administered by a company other than the name that is on the front of the card. It’s important that we get as much information as possible.
2. Your birthdate and address: We can’t send claims for your session to be paid without this information.
3. Dates: The date your policy began and ended. 
4. Every policy you are on: Your claims will not be sent to two insurance companies unless we know about both of them. Claims will often be charged incorrectly without this information. We do our best, but if you do have a secondary policy, please email or text me directly.
5. Credit or Debit cards: If your credit or debit card is hacked, expires, or otherwise changes, please let me or your counselor know right away. I will email or text you if we are unable to charge your copay or coinsurance, but if I do not get a response, I will contact your counselor to communicate with you, and I know they’d rather be spending that time on your counseling goals.

Final Advice

The best thing I can tell you is that communication is key– both with us and with your insurance company. Also keep your policy’s termination date in mind (usually December 31 or May 31) so that you can set up a new policy before the old one expires. Please reach out to me if you need help. I am easiest to reach either by text (330) 227-2291 or by email (admin@myintegritycounseling.com). I would love to speak with you and answer any questions you may have.