We want to make your experience as clear and smooth as possible. These answers to common questions should help you navigate the billing process. If you don’t see what you’re looking for, or need further assistance, feel free to reach out and we’ll work with you to find a solution.
How does LynLake handle billing?
- First, your therapist (or, for Nurse Practitioners, their area manager) will send you a few documents to fill out online, including documents regarding your insurance and payment information.
- Therapists do check your benefits, but the insurance carriers do not fully stand behind the information they provide us. It is always a good idea to give your insurance a quick call to make sure you are cleared to be seen at LynLake and to check on what your likely client responsibility will be (deductible, coinsurance, or copay – two standard service codes to check are 90791 and 90837).
- Next, your therapist will bill your insurance (or bill you if you are paying privately) following each of your services (this is called sending a claim). And then we wait for insurance to process your claim (generally 1-6 weeks after billing) and determine your responsibility. Private pay billings are charged at the end of each week.
- Finally, there is the matter of paying for your portion of the service (deductible, coinsurance, copay).
How does LynLake handle client payments?
Clients have two options for paying their portion of the service.
- They can either pay their clinician in session with cash or check AT THE TIME OF SERVICE (some, but not all, clinicians accept payment. Nurse Practitioners never accept payment), or…
- They can opt for what the vast majority of clients choose – autocharge. AUTOCHARGE IS THE DEFAULT OPTION AT LLPW.
When you are on autocharge, we bill insurance (should you have insurance) and once insurance determines your responsibility (generally 1-6 weeks after billing) your credit card on file is charged with a credit card fee (2.1%, except for Debit and HSA/FSA cards). With autocharge, there will never be a balance or a credit on your account, you never have to remember cash or checks, and you never have to take up valuable session time paying for your service. Simple and elegant.
NOTE: LynLake does not send regular invoices for services EXCEPT in the case of a Third Party paying for your service (like a parent paying for the child/adult child).
*Clients who wish to create a custom charging plan can do so in conversation with their clinicians.*
What happens when I have a question about a charge, need a receipt for insurance, or I need to do something like update my address, insurance, or credit card on file?
Please contact your clinician directly (therapist, dietitian, psychologist, etc.) right away. They will be able to help you or direct your question to the appropriate person at the practice. Psychiatry clients should contact their Psychiatric Assistant.
Why am I sometimes charged different amounts at different times?
There are many reasons you may be charged different amounts at different times.
- You may have been charged for more than one date of service at one time (see “How do I read my receipt?” below). This is because insurance processed more than one date of service at one time.
- Your deductible may have been exhausted and now you only have a smaller copay or coinsurance. Similarly, your insurance plan year may have restarted and NOW you’ve switched from a copay/coinsurance back to a higher deductible.
- You may have a coinsurance. A copay is a flat fee while a coinsurance is a percentage of the service. So, depending on the code your therapist bills that best corresponds to the service you received, you may have a different coinsurance percentage owed.
- Your therapist billed a complexity code because the service you received involved more complex communication than services usually entail. Please discuss this further with your therapist.
Why do you have my credit card on file?
The vast majority of clients at LynLake pay for their services (private pay or client responsibility after insurance has processed a claim) by autocharge. AUTOCHARGE IS THE DEFAULT PAYMENT METHOD AT LYNLAKE. Autocharge works like this: after insurance processes your claims, we charge your card on file for the portion of the service that insurance has determined is your responsibility – this could be your deductible, copay or coinsurance.
With autocharge, there will never be a balance or a credit on your account, you never have to remember cash or checks, and you never have to take up valuable session time paying for your service. Simple and elegant.
Even if a client chooses to pay with cash or check at time of service, s/he is still required to have a card in file in case s/he forgets a payment, incurs a late cancel fee, or discontinues therapy with a remaining balance.
There is a 2.1% fee for Credit Card payments. This fee is not charged to Debit cards or HSA/FSA payments.
PLEASE DISCUSS THESE POLICIES AND YOUR OPTIONS WITH YOUR CLINICIAN.
Why do you charge a fee of 2.1% to credit cards?
Our credit card processing system charges us a percentage (2.1%) for each payment we run. Additionally, the practice pays for a professional to process insurance payments and client payments. The practice covers the cost of the professional to process insurance payments and client payments and the client covers the percentage for each credit card payment.
Again, no fees can be charged to HSA/FSA or Debit cards.
If I pay with my HSA/FSA card by autocharge, why do I also need to have a regular, non-HSA/FSA card on file?
Most charges you incur at LynLake can be covered by your HSA/FSA funds. However, late cancel and no show fees cannot be charged to HSA/FSA cards. Additionally, most HSA/FSA cards eventually run out of funds and, when that happens, your regular card will be charged for your service so there is no delay in payment to your clinician.
How do I read my receipt?
Each time you are charged for your portion of your service, you will receive a Square receipt. That receipt will list not only the amount you are being charged, but also your first name, last initial, and the date of service for which you are being charged. See the example receipt below.
This is all very helpful information because we only charge you for your portion of insurance after insurance processes your claim – about 1-6 weeks after billing for your service.
Do you accept health insurance?
We accept most major insurance plans, including commercial and state plans. We also offer self-pay and a standardized sliding-fee scale based on the Federal Poverty Guidelines.
However, not every provider/clinician is in-network with every plan, and your plan may or may not cover particular services. Our Referrals Specialists will work with you to match you with a clinician who meets your needs. Your clinician will also talk with you about how to check your benefits prior to beginning services.
What do you mean by “deductible,” “copay,” and “coinsurance”?
Most, but not all, insurance plans generally start with a fixed deductible that you will need to exhaust each insurance year (12 months from the start of your insurance) BEFORE insurance will cover services. This deductible could be $100 or several thousand dollars. If you have a deductible, insurance will process your claim and your responsibility will be the full contracted rate for the service. For example, if we have a contract with your insurance that we will be paid $125 for a service and you have a deductible, you will be responsible for the full $125.
COPAY and COINSURANCE
Usually after you exhaust your deductible in each insurance year, you may have a copay or a coinsurance. A copay is a fixed amount you will pay each session, like $20 or $50. Insurance will cover the rest of our contracted rate.
A coinsurance is a percentage you pay for each session, like 20% or 30% of the contracted rate. For example, if our contract rate with your insurance is $125 and you have a 30% coinsurance, you would be responsible for $37.50 ($125 x .30 = $37.50). Insurance will cover the rest of our contracted rate.
Sometimes insurance begins to cover the ENTIRE cost of your services. That’s because you have reached your “out-of-pocket” maximum, which is the maximum amount you and/or your family are required to pay out-of-pocket for deductibles and copays/coinsurances each insurance year.
Please know this information is for educational purposes only and may not accurately describe how your specific insurance functions. It is the responsibility of each client of Lyn-Lake Psychotherapy and Wellness to be aware of her/his/their insurance benefits. However, we hope this is a helpful guide to some terminology that you may encounter in your research.
Will my health insurance cover Telehealth?
According to the Minnesota Psychological Association: All insurance plans in Minnesota need to treat telehealth as equivalent to in-person therapy for purposes of billing and regulation. There cannot be different pay rates or limits on service that are not mirrored in current policy for in person therapy.
“In Minnesota” is not to be taken as the person lives in Minnesota. Medicare is not a Minnesota-based insurer, and telehealth has its own Medicare coverage rules that are federally regulated, not state-regulated. Also, some insurance plans associated with Minnesota-based companies (such as 3M or Medtronic) that self-insure (ERISA model) are not subject to state rules, but rather federal ones. Whenever you are preparing for an intake, confirmation of benefits is a key step. In telehealth it is even more important. Confirm the benefits in advance to avoid a later problem.
What if I leave the State of Minnesota? Can I still see my LynLake provider via Telehealth?
Your provider’s ability to provide professional mental health services when you are outside the State of Minnesota depends primarily on whether or not the provider (therapist, psychiatric nurse practitioner, dietitian) is licensed in the jurisdiction (location) where you are at the time of service. This essentially means “it depends” on the provider, their particular type of professional license, where you are, and where they are currently licensed to practice. You will want to check with your provider as well as your specific insurance plan for information on benefits and limitations.