Your Opening Email From the Billing Team and What It Means
Once your kiddo has had their initial evaluation at WPT, you’ll be sent a few important emails about their upcoming appointments. One of those emails will come from the billing team to explain just how your insurance plan will cover your child’s therapy services. We have basic access to your plan’s specific coverage, but we can’t see every detail. If you ever have questions about your plan’s coverage, then we highly recommend reaching out to your insurance plan directly. With that in mind, here are some things we will go over in your welcome email!
Does your plan require authorization?
We will let you know if your plan requires authorization and we will submit to your insurance all necessary documents in order to obtain one if required.
Is there a visit limit?
Many plans only allow for a certain amount of therapy visits per plan year. Most plans run January-December, but not all so it’s a good idea to know when your plan restarts each year. There are some plans that allow for 20, 25, 45, or even 120 visits to be used within a plan year. And some don’t have a visit limit at all! That means your child could come to therapy as many times as needed and never have to worry about their insurance covering them. If your plan does have a visit limit, then we will let you know in the opening email what that number is. Some plans will allow us to request a few additional visits after the limit has been reached. But, unfortunately, many plans will have what they call a “hard max.” This means that once your child has used all of the allotted visits, then your plan will not approve any more until your plan year restarts. If this happens, your child’s visits would need to switch to our private pay rates in order to continue therapy.
Although we do our very best to keep track of your kiddo’s visits, it is ultimately the responsibility of the member to know how many visits they have used. This is especially important if your child has attended therapy at another clinic in the same plan year. The visit limit shown to us does not always accurately show how many have been used. So if any visits have been used before coming to WPT, then there could be a discrepancy in what we see and what is actually available.
How will we charge you for your child’s visits?
If your insurance requires payment (copay or deductible), then we will charge the card you submitted with your kiddo’s opening paperwork. If you would like to change the card on file, then you can do so at any time! Just shoot us a text and we will send you a new form to fill out that will allow for your e-signature. If your child has a copay, then we will charge that amount on the date of each appointment. If your plan requires payment toward a deductible, then we will charge your card one appointment behind. This gives claims time to generate and process so we know exactly what your insurance says that you owe.
Is there a processing fee for card transactions?
There is currently a $3 fee for all card transactions. This is what we are charged by our financial institution in order to have your payment securely processed.
Do I have to pay with a card?
It is a requirement that you have a valid debit/credit card on file. However, you do not have to use that card for payment. We do not accept personal checks, but we can take cash if you wish to pay that way. Just bring any payment to the window BEFORE your child’s appointment begins. If you pay in cash, then we will not need to use your card. The card will simply be there to charge in case you forget to bring cash. It is important to know that we do not keep change on hand. If you give us more money than your child’s appointment will cost, then any extra will act as a credit on their account toward their next visit. You may also pay for several visits at one time so you don’t have to remember to bring cash to every appointment.
What happens if I miss an appointment with little to no notice?
We do have a no-show policy in place should this happen. We ask that you let us know at least an hour before your child’s appointment is set to begin if you cannot make it. Less than an hour notice or no notice at all is considered a no-show and is subject to an $80 fee. We do understand that there are emergencies and unforeseen circumstances that may occur and we will take these into consideration before applying the fee.
Everyone’s time is valuable! If you know that you cannot make it for an appointment, then we ask that you let us know as soon as possible. The same rule applies to us! If your child’s therapist is unexpectedly out of the office, then we will let you know as soon as we can in order to get your child rescheduled.
These are just the basics that we will send to you before your child’s first treatment session. We will gladly answer any questions that we can about your child’s insurance requirements, but we will always direct you to speak with them firsthand to officially verify your benefits. You can respond to the email you are sent or call/text us at 859-475-4305 with any questions or concerns you may have.
