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Billing and Payment

Paired is a private pay provider, meaning you will be expected to pay directly for the services you or your child receives. However, you can still use your insurance to cover costs accrued for services at Paired. Superbills are available to all clients. These can be used to for claiming out-of-network benefits from your insurance provider so that you get access to the coverage you deserve.

Understanding Superbills

A Guide for Parents

The world of healthcare billing can be overwhelming - let’s take a moment to explain what a Superbill is and how it can benefit your family. In simple terms, a Superbill is a document that includes all the information about a medical visit that you might need in order to submit a claim to your insurance company. This includes the date of the visit, the name of the provider, and the services that were provided.

 

But why is this important for you? Well, you may have to visit providers on a regular basis. Keeping track of all these visits can be a challenge, but having a Superbill can make the process much easier. By providing your insurance company with a Superbill, you can ensure that you are getting reimbursed for all the services that are covered under your plan. This can help you save money and avoid any confusion or disputes with your insurance company.

By keeping track of all your visits and submitting Superbills to your insurance company, you can ensure that you are getting the care you need for your child without breaking the bank.

Examples of Payment Options

Let’s take a look at two examples: private pay vs. out-of-network reimbursement

Scenario #1: Private Pay

Let’s say the your health insurance does not cover ABA therapy at all, but you know your child needs such visits so they go to direct therapy two times per week. After each session, or on the agreed upon cadence, you would pay the due balance via cash, debit, or credit card. And… thats it! Your payment is complete and you have no other actions needed.

 

Scenario #2: Insurance Reimbursement

Now, let’s say that you know your health insurance offers both in-network and out-of-network coverage for services, but you haven’t been satisfied with the in-network options or have been waitlisted time and time again. Now, you opt for a personalized approach and go out-of-network with Paired. You will still pay for each session via cash, debit, or credit card, however every month Paired will supply you a superbill that summarizes all of the services that you received and paid for for the month. If the superbill shows $1000 of services, and your insurance covers 70% of out-of-network costs, then you should expect a $700 reimbursement from insurance, leaving you with only $300 of coverage!

Additional Resources

The Case for Out-of-Network Reimbursement

This article argues for the value of out-of-network reimbursement for patients seeking medical care. It cites several reasons why patients may choose out-of-network providers, including a lack of available in-network providers, dissatisfaction with in-network providers, and a desire for more personalized care. The article also notes that out-of-network providers often have higher costs, which can be a burden for patients. However, the author argues that out-of-network reimbursement can help offset these costs and provide patients with more flexibility and choice in their care. The article suggests that patients should advocate for out-of-network reimbursement and work with their insurance providers to ensure that they are receiving the best possible care.

 

Your own insurance benefits summary!

Be sure to review the health insurance benefits that your family has available. We are happy to work with you to determine possible reimbursements that you could expect for our services. 

Schedule a free consultation with us.

We are happy to talk through payment options and estimated costs for desired services. Our initial consultation is free of charge, so we encourage you to reach out if you would like to discuss this further. 

Disclaimer: Please note that any guidance we provide on insurance reimbursement is offered to the best of our ability and based on our understanding of the relevant regulations and guidelines. However, we cannot guarantee the accuracy or completeness of this information, and we cannot be held responsible for any outcomes or decisions resulting from its use. It is always advisable to consult with a qualified insurance professional or legal advisor for specific advice on insurance reimbursement matters. By using our services, you agree to hold us harmless from any claims or liabilities arising from your use of this information.

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