Insurance wasn't applied to my bill. What do I do next?
My bill is more than I expected. Why?
We want care to be as affordable as possible. So when a bill is more expensive than you anticipated or visits aren’t covered the way you thought they would be, it can be frustrating. If something seems wrong with your bill, here are the most common reasons why, and what you can do about it.
How deductibles might affect your bill
The most common reasons patients get unexpected bills is because their plan has a deductible.
A deductible is the amount of money you need to pay out of pocket before your insurance will start helping you cover the costs of your medical visits or procedures. It’s set in advance and usually resets annually.
For example, if you have a $1,000 deductible, and you receive a bill for $250, you will be responsible for paying that $250. Once you have spent $1,000 on eligible care, then your insurance will start to share the costs of your care.
If you have reached your deductible for the year, in most cases you are then responsible for a co-pay or coinsurance.
What to do: Contact your insurer directly through their website, or using the phone number on your insurance card. They’ll be able to tell you about your deductible and how much of it is left, so you can make informed choices about your care.
Have more than one insurance plan (primary vs. secondary insurance)?
Some patients have more than one insurance plan. One will be listed as the primary insurance (this is who we bill first). The other is listed as secondary insurance (we bill your secondary insurance for any costs your primary insurer doesn’t cover). Sometimes insurance companies will deny claims due to “coordination of benefits.” This just means that the insurance we have on file isn’t your primary insurance.
What to do:
- Call your insurance company using the number on the back of your insurance card.
- Let them know you want to update your "coordination of benefits" and make them your “primary insurance” company. Note the name of the representative that you spoke with and ask for a call reference number.
- Send an email to firstname.lastname@example.org with the representative name and call reference number.
If the insurer that denied the claim is your secondary insurance and we don’t have your primary insurance on file:
- Email email@example.com with pictures of the front and back of your primary insurance card. We will then update your account and charges.
Do you need to update the insurance we have on file?
New jobs, new plans—there are plenty of reasons your insurance coverage can change. If you have a new insurance plan (or had secondary insurance) and didn’t update the information before your visit, don’t worry. Just send a picture of the front and back of your card to insurancecard@Talkiatry.com. We’ll resubmit the claims and make sure they go to the right place.
What if the Explanation of Benefits (EOB) my insurance company sent me doesn’t match your bill?
If the EOB from your insurance doesn’t match our bill or if the EOB shows a denial of your claim, please reach out to our billing team at firstname.lastname@example.org. We’ll resubmit the claim to make sure it’s processed correctly. Depending on how responsive your insurer is, this could take between 30-45 days.
Does your insurance plan cover specialists and primary care doctors at different rates?
Regular visits with a mental healthcare professional are a crucial part of treatment. Most insurance plans classify psychiatrists as ‘specialists.’ The cost of visits and the level of coverage may be different than for preventative care or visits with a primary care doctor.
Could it just be a mistake?
It happens. We’re humans, too. If none of the above apply to you, get in touch with our Patient Billing Support Center at 833-351-8255 or send an email to email@example.com and we’ll make sure to correct any errors...and apologize for the inconvenience.