Patient Billing & Insurance Guide
From understanding potential billing issues and making payments to navigating deductibles and deciphering changes in costs, it’s important to understand your benefits.
From understanding potential billing issues and making payments to navigating deductibles and deciphering changes in costs, it’s important to understand your benefits.
In late February, Change Healthcare, which manages billing and processes claims for approximately one-third of all healthcare provider groups in the United States, including LifeStance, experienced an outage because of a cyberattack. As a result, the ability for those provider groups across the country to submit billing to insurance companies was halted for over two weeks.
Our team has been working hard to limit the impact of this outage on our patients. While you may experience delays in receiving your bills or seeing them reflected on your patient portal, we are committed to processing them as quickly and accurately as possible. Thank you for your understanding and patience.
We encourage you to register for our patient portal. There you will have access to health record information, as well as the ability to send and receive messages with your LifeStance Care Team. You can also upload insurance cards, photo ID, and other documents.
For your initial login, you’ll locate the email sent by our Intake Team when you scheduled your appointment.
Access Patient PortalA set amount that a patient pays to their provider when services are rendered.
A percentage of charge (contract rate) a patient will pay AFTER they have met their deductible.
A set amount a patient must pay each year toward their healthcare before insurance starts to share the costs of services.
The maximum amount a patient will pay for in-network services in a given plan year. Once met, the insurance will cover 100%.
EOB stands for Explanation of Benefits. It is a statement sent from the insurance company. It is not a bill; it explains what services were paid by the insurer.
AOC stands for Add-On Codes. These are healthcare procedure codes describing services performed in addition to a primary service by the same provider.
TPA stands for Third Party Administrator. TPAs process claims and manage employee benefits under contract for insurance or self-insured companies.
Carve out refers to the elimination of coverage for a specific category of services from a standard insurance plan, requiring separate payment or insurance.
Depending upon your insurance, some providers will be in-network, while others are out-of-network. This status impacts how much you’ll pay for care.
A provider who is contracted with your insurance is considered in-network. This means that patients may pay lower cost-sharing.
When a provider is not contracted with your insurance, they are out-of-network. The provider is not contracted with the health insurance plan to accept negotiated rates.
If you have questions about your coverage or financial responsibility, please contact your insurance plan administrator directly. Insurance customer service phone numbers can typically be found on the back of your insurance card.
You are financially responsible for the cost of the mental health services provided to you or your dependent(s) and for any portion of the fees not reimbursed or covered by your health insurance, including late cancellations and missed appointments.
Please call your local office or the billing call center to discuss any charges set to charge in 5 days.
Note: If patients have a balance on their account 30 days after an appointment date, that balance will be subject to Payment Assurance.
Payment Assurance is an automated process that will send an email (and if a patient opts in, a text) to all patients that meet this balance criteria.
Patients can schedule their own payment plans for up to 2, 3, or 4 month durations. For more customized options, please contact the billing department directly.