READ ALL OF THIS INFORMATION!! THIS IS IMPORTANT!! 

Billing and Insurance Information:

Complete all intake forms accurately. If a client does not complete the WS Billing Registration Form correctly then WS is not responsible for any billing-related problems or concerns that result from the client’s failure to provide the information correctly. 

Take personal responsibility for your own insurance eligibility, benefits, and claims information. Clients are responsible to know their own insurance benefits. Clients who make the active decision to be willfully ignorant of their own outpatient mental health eligibility, benefits, claims, or the network status of the provider are still financially responsible for their benefits and patient responsibilities for treatment. 

Patient account information & receipts for services. WS provides receipts via email every time a client’s credit card on file is charged. Clients are also provided with an account summary at the end of every month via email if there is a balance on the account. Clients can check their patient portal 24/7/365 for information on the balance on their client account. 

Credit Card Charges to the Client Account. If a client opts for sliding scale or to pay the full fee for services and submit his or her own claims to their out-of-network insurance then the client’s credit card on file is charged the patient responsibility for services the day of the appointment. Payment for services rendered is due at the time of service. If the client uses their in-network insurance then the client’s credit card on file will be charged the patient responsibility for services when the claim for each date of service completes the insurance adjudication process. Any other fees for services are charged to the client’s credit card on file as the client incurs these fees. Clients with credit cards that are declined will receive a $25.00 charge assigned to their existing balance. 

Clients are responsible to know their own insurance benefits. Clients pay their insurance company to manage their benefits, answer their questions about their benefits, and keep track of their claims information. If clients have questions regarding their insurance then the client should contact their insurance company to obtain this information. WS is not responsible for knowing a client’s insurance benefits better than the client. Clients who have questions about their insurance or complaints about their insurance should direct those questions and complaints to the appropriate party - their insurance company. This is the client’s responsibility. Taking responsibility, ownership, and accountability for one’s own healthcare journey includes financial responsibility.

Clients are responsible for obtaining Employee Assistance Plan (EAP) authorizations if they would like to access that benefit. WS accepts a limited number of EAP insurance benefits. If a client wants to access his or her EAP benefits then the client is responsible for calling their insurance company, obtaining the EAP Authorization Number, and the exact number of authorized sessions. The client will be asked to provide this information in the WS Billing Registration Form. WS does not contact insurance companies or EAP programs to obtain authorization numbers and the number of sessions covered. WS will submit EAP claims for clients for one treatment series only. Clients who have EAP benefits that can be renewed can only use those benefits with WS once. WS will not bill for repeated EAP series. Clients are responsible for calling their insurance company to obtain BOTH the EAP Authorization Number AND the number of authorized sessions to utilize and access this benefit. 
 

Clients are responsible for knowing if they have a mental health carve out of their benefits. Many clients have insurance benefits that include a mental health carve-out. A mental health carve-out is when the client’s mental and behavioral health benefits are managed by a different insurance company than the client’s medical benefits. This means that the client’s medical insurance is managed with one company and their mental health benefits are managed with a different company. The name of the mental health carve-out insurance company is usually NOT listed on the client’s insurance card. This can be confusing and complicated because if the client is not informed about his or her mental health carve out then the client will provide insufficient information to WS regarding their insurance. This causes problems with insurance claims being rejected or denied. This also causes problems because in many situations the mental health carve-out insurance company is out of network. Clients may choose WS thinking that WS is in-network with their insurance only to learn that is not the case because the client did not check to see who manages their mental and behavioral health insurance benefits. In this situation, the client will provide WS with the medical insurance company information and the mental and behavioral health benefits are with a completely different company. The only way for a client to know if they have a mental health carve-out is to check their outpatient mental health benefits. It is the client’s responsibility to know his or her outpatient mental health benefits. It is the client’s responsibility to inform WS if the client has a mental health carve-out. If the client has a mental health carve out the client is responsible for informing WS of the managed care company’s information so WS can bill the client’s insurance correctly.  

Clients Without Insurance or Clients With Out of Network Insurance- Payment Options. If a client does not have insurance or only has out-of-network benefits then WS provides two possible payment plan options. Option 1: The client can pay the full fee for services and then submit claims to their out-of-network insurance. WS will provide the client with a “superbill” which is required for the client to submit his or her claims to the out of network insurance. (Please see below for additional information). OR Option 2: The client can pay the sliding scale discounted fee for services. This is for clients who would not be able to access care or the cost of accessing care is prohibitive so WS provides a compassionate discount. This is an either-or option. You cannot do both. This is not a WS rule, this is the law. A client can change his or her mind at any time. No, we will not backdate to accommodate when a client changes his or her mind. The change will take place currently and moving forward. If a client chooses a sliding scale then the fees paid for services will not go towards his or her out-of-network deductible or out of pocket. WS does not submit claims to out-of-network insurance. WS also does not check insurance eligibility, benefits, or claims for out-of-network services.   

Super Bill Documentation Information. If a client opts to pay for the full fee for service and submit claims to his or her out-of-network insurance then WS will provide the required “superbill” documentation. The superbill will be provided no more than once per month, at the beginning of each month, and will be for the sessions in the previous month. There is a fee of $25.00 for WS to compile the information for each superbill. To request the superbill documentation go to the WS website - Click on Current Client Portal & Self-Service Forms - Click on the WS Documentation Self-Service Request Form - then complete the form. To receive the superbill the client must request the documentation each month. If a client misses a month then WS will not provide a superbill for the month missed. WS will not process documentation requests made without completing the WS Documentation Self-Service Request Form. It is the client’s responsibility to stay on top of the required information and documentation that he or she requires to submit their out-of-network claims to insurance. 

Additional billing-related documentation requests. If a client would like any additional documentation regarding billing, such as, extra receipts then he or she needs to submit the request by going to the WS website - Click on Current Client Portal & Self-Service Forms - Click on the WS Documentation Self-Service Request Form - then complete the form. All billing documentation requests, outside from what WS already provides, will incur a $25.00 fee. Depending on the nature of the documentation request additional fees, such as case management fees may also apply. WS will not process requests made without completing the WS Documentation Self-Service Request Form.

WS Reserves the Right to Refrain from Business with Insurance Providers. WS does not submit claims to open access self-funded indemnity plans or similar insurance plans and benefits. WS reserves the right to refrain from insurance and claims submissions to companies or third-party benefit administrators who do not provide adequate support to providers for insurance eligibility and benefits checks, claims follow up, electronic claims submissions, electronic remittance advice, or electronic funds transfers. WS reserves the right to refrain from insurance and claims submissions for companies who do not use the WS clearinghouse. 

Communication Expectations & Turnaround Times. WS reviews client communication in the order in which they are received and then screens the communications based on risk and safety concerns. 

The WS Billing & Insurance Turnaround Time Expectations are As Follows:
Billing & Insurance Texts: 3-4 Business Days
Billing & Insurance Emails: 3-4 Business Days
Billing & Insurance Patient Portal Messages: 3-4 Business Days
Billing & Insurance Phone Calls & VM: 4-5 Business Days
Billing & Insurance Documentation Requestions: 10-14 Days*
*Once the client submits the WS Documentation Self-Service Request Form

*Most general insurance and billing questions can be answered by reviewing the information provided on the WS website. This includes how to check your insurance eligibility, benefits, and claims information. The communication turnaround times are the WS goal and may vary based on staffing and other variables.