We are thrilled that you have chosen Prosperity Eating Disorders and Wellness Center. We strive to provide comprehensive care and customer service to our clients and families. Prosperity has recently hired a biller to work with insurance in an effort to ease the burden and confusion associated with claims and payment. While we are currently out of network with insurance, we are happy to check benefits/coverage and attempt to establish a single case agreement with your insurance company.
A single case agreement means that services provided by Prosperity would be treated as “in network” and you would have coverage per your insurance plan. While we cannot guarantee the single case agreement (SCA) would be approved, we are happy to try to arrange this.
Payment for services is as follows:
If we bill through your insurance the cost per day of IOP (three groups included, an hour of individual therapy and 30 minutes of nutrition) is $430.00. Ideally insurance will cover the full amount. If insurance does not cover the full amount, you are responsible for covering the remaining fee.
- For example – if insurance is willing to cover $100.00 per night, you are responsible for paying the remainder of $330.00.
If your insurance does not allow a single case agreement, we will work with you on a fee for service arrangement. Like many medical and service offices, we understand that insurance has limitations and it is our desire to make services affordable for those who need them.
Frequently Asked Questions
- How do we get this started?
- The provider will need the name(s) of the insured, a copy of the insurance card, birthday, phone number, and address to call the insurance company and determine available benefits.
- The family/individual is then informed of the benefit information and coverage of services by the medical billing specialist or individual therapist.
- What happens once I know my benefits information?
- The client would then complete an assessment with the clinical provider to identify diagnoses, treatment plan, medical records, and coordinate with the interdisciplinary team as needed. Recommendations for treatment are provided to the client. Payment for services are expected on the date of service.
- The clinician then calls the insurance to obtain authorization and/or establish a Single Case Agreement, if available through the plan
- How is this processed after services are received?
- Dates of service are captured by the individual providers and sent to the medical billing specialist.
- The medical billing specialist then sends the records of services to the insurance company for payment and/or reimbursement
- Will I receive an invoice?
- If you are paying up-front for services you will receive an invoice each week with the record of payment
- When can I anticipate repayment from insurance?
- All insurance companies are different but typically reimbursement is received within 6-12 weeks from the date of submission.
- What else do I need to know?
- If you pay in full up front, the refund will be sent to Prosperity, we will send you the refunded amount as quickly as possible once it is received.