Understanding Your Mental Health Benefits: A Guide to Billing at Body and Mindfully Healthy
- Melissa Londry, LPC
- 2 days ago
- 4 min read
Seeking mental health care is an investment in yourself, and we believe understanding your financial responsibility shouldn't be overwhelming. One of the most common concerns we hear from clients is, "I don't understand my insurance benefits." The good news is that you don't have to navigate them alone.
Our billing department is here to help answer your questions, explain your benefits as best we can, and support you throughout your counseling journey.
Our Goal: Make Billing as Stress-Free as Possible
At Body and Mindfully Healthy, our billing team works behind the scenes every day to ensure your insurance claims are submitted accurately and efficiently. While your therapist focuses on your mental health, our billing specialists focus on helping you understand the financial side of your care.
We know insurance can be confusing. Terms like copay, deductible, and coinsurance are often used interchangeably, even though they mean very different things. We're here to help explain those differences.
What Does Our Billing Department Do?
Our billing department is responsible for much more than sending statements.
We:
Verify insurance eligibility before services begin whenever possible.
Submit insurance claims after each appointment.
Post insurance payments and adjustments.
Help explain your insurance benefits.
Answer questions about balances and statements.
Assist with payment plans when appropriate.
Correct billing errors if they occur.
Communicate with insurance companies regarding claim issues.
Help clients understand Explanation of Benefits (EOBs).
Process self-pay payments and receipts.
Work to ensure your account remains accurate and up to date.
Our goal is to advocate for accurate billing while helping you understand what your insurance company has determined is your responsibility.
Understanding Your Copay
A copay is a fixed dollar amount you pay each time you receive a service.
For example:
$20 therapy copay
$35 specialist copay
$50 psychiatric visit copay
If your insurance plan includes a copay for outpatient mental health services, you'll generally pay that amount at the time of your appointment. A copay is determined by your insurance plan, not by your therapist or our practice.
What Is a Deductible?
A deductible is the amount you must pay out of pocket before your insurance begins paying for covered services.
For example:
Your annual deductible is $2,000.
If you've only paid $400 toward that deductible this year, your insurance company may require you to pay the remaining cost of therapy sessions until your deductible has been met.
Many clients are surprised when insurance "covers therapy" but they still receive a bill. Often, this is because the deductible has not yet been satisfied. Your deductible resets according to your insurance plan, often every calendar year, but not always.
What Is Coinsurance?
Some insurance plans require coinsurance instead of (or in addition to) a copay.
Coinsurance means you pay a percentage of the allowed amount after your deductible has been met.
For example:
Insurance pays 80%
You pay 20%
If your insurance company's allowed amount for a therapy session is $120, your portion would be $24.
Why Did My Insurance Not Pay?
There are several reasons an insurance company may deny or reduce payment.
Common reasons include:
Your deductible has not been met.
Your insurance policy has terminated.
Your insurance company requires prior authorization.
The service is not covered under your plan.
Coordination of benefits needs to be updated.
Your insurance company processed the claim incorrectly.
Another insurance company should be billed first.
If something doesn't seem right, please let us know. We are happy to review the claim and determine whether additional information needs to be submitted.
Why Can't My Therapist Tell Me What I Will Owe?
This is one of the questions we hear most often.
Unfortunately, therapists do not receive real-time information from insurance companies.
Insurance companies make payment decisions after reviewing each submitted claim.
They determine:
Whether services are covered
Whether your deductible applies
Your copay or coinsurance
Whether prior authorization was required
Any contractual adjustments
Because these decisions are made by your insurance company, not your therapist, there are times when your financial responsibility changes after the claim has been processed.
We Verify Benefits... But Insurance Makes the Final Decision
Before beginning services, we make every effort to verify your insurance benefits.
However, insurance companies typically include a disclaimer stating that benefit verification is not a guarantee of payment.
Ultimately, the insurance company determines:
Coverage
Medical necessity
Payment
Patient responsibility
While we strive to provide accurate estimates based on the information available to us, final claim processing always rests with your insurance carrier.
Understanding Your Explanation of Benefits (EOB)
After your insurance processes a claim, you'll usually receive an Explanation of Benefits (EOB). An EOB is not a bill.
Instead, it explains:
What service was billed
What your insurance paid
Any contractual discount
What portion may be your responsibility
Comparing your EOB with your statement from Body and Mindfully Healthy can often answer many billing questions.
What If I Receive a Bill I Don't Understand?
Please don't ignore it. Many billing questions have simple explanations. If something doesn't make sense, reach out to us.
Our billing department is happy to:
Explain your statement
Review insurance payments
Clarify your deductible
Discuss payment options
Investigate claim issues
Answer general billing questions
We would much rather answer your questions early than have confusion create additional stress.
Helping You Make the Most of Your Insurance
There are a few things you can do to help prevent billing surprises:
Notify us if your insurance changes.
Bring updated insurance cards to appointments.
Inform us if your employer changes insurance plans.
Review your EOBs.
Ask questions if something doesn't make sense.
Contact your insurance company if you have questions about your specific plan benefits.
Keeping your insurance information current helps claims process more quickly and accurately.
We're Here to Help
At Body and Mindfully Healthy, we understand that financial concerns can add stress during an already difficult time. Our goal is to make the billing process as transparent, accurate, and supportive as possible so you can focus on what matters most, which is your mental health.
If you have questions about your account, insurance benefits, copays, deductibles, or statements, please don't hesitate to contact our billing department. We are here to help explain the process, answer your questions, and work with you whenever possible.
Healing is challenging enough. Understanding your bill shouldn't be.
Need Billing Assistance?
Body and Mindfully Healthy
📞 276-601-2749
Comments