Effective January 1, 2022, a ruling went into effect called the “No Surprises Act,” which requires mental health practitioners to provide a “Good Faith Estimate” (GFE) about out-of-network care to any patient who is uninsured or who is insured but does not plan to use their insurance benefits to pay for health care items and/ or services.
The Good Faith Estimate works to show the cost of items and services that are reasonably expected for your mental health care needs for an item or service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.
You are entitled to receive this “Good Faith Estimate” of what the charges could be for psychotherapy services provided to you. While it is not possible for a psychotherapist to know, in advance, how many psychotherapy sessions may be necessary or appropriate for a given person upon the initiation of psychotherapy, this form provides an estimate of the cost of services provided. Your total cost of services will depend upon the number of psychotherapy sessions you attend, your individual circumstances, and the type and amount of services that are provided to you. This estimate is not a contract and does not obligate you to obtain any services from the provider listed, nor does it include any services rendered to you that are not identified here.
Brittany Reinke, LLC is committed to ensuring that the billing and collection of medical debt is conducted in a manner that is respectful, ethical, and compliant with applicable laws. We aim to balance the need for financial sustainability with an understanding of our patients’ financial situations. If you have any questions about this policy, please contact us at 2 Second Avenue S. Suite 140, Sauk Rapids, MN 56379, Phone: 320-297-3610
Insurance
Brittany Reinke, LLC accepts many insurance plans but cannot guarantee that any particular plan will cover the services provided. Accordingly, please take note that you are responsible for verifying if your insurance plan provides coverage and for complying with any coverage-related requirements. If your insurance plan requires a referral for you to receive our health care services, you must get the required referral before you are seen by a provider. Failure to obtain the required referral could reduce your insurance benefit or leave you responsible for the total charges. If you are covered by an accepted insurance plan, Brittany Reinke, LLC will first bill your insurance plan for the health care services provided. If you do not have insurance coverage, we will discuss payment options with you. Additional information regarding how insurance is handled is set forth in more detail in the consent, policies, and agreement provided prior to services being rendered.
Co-Payments, Deductibles, and Other Amounts Not Covered by Insurance
You are responsible for any amounts not paid by insurance. This includes co-payments, deductibles, non-covered services, and any other amounts not covered by insurance. Co-payments are due at the time of your visit.
Statements and Payment Terms
We send billing statements by email or U.S. mail to the patient or responsible person monthly following the initial correspondence we receive from your insurance company. Billing statements include:
· Amount owed after insurance payments, if any.
· Description of services rendered.
· Contact information for inquiries.
After your insurance company has paid or identified its portion of the bill, any remaining balance is your responsibility and should be paid within thirty-days (30) of the statement date. If you are unable to pay the amount due by the due date, please contact our business office to set up a reasonable and acceptable payment plan.
Please also see the Billing and Fees portion of consent, policies and agreement offered before rendering services.
Billing Error Review
If you believe that your bill is not accurate, that a third party should pay the bill, or if you have other concerns about your bill, please contact our office to discuss the matter. If you notify us of a billing error, or we otherwise determine that there is a billing error, we will review the bill and correct any billing errors found. While the review is being conducted, we will not bill you for the health treatment or services that are the subject of the review for potential billing errors.
Within 30 days after we complete this review, we will notify you that the review is complete and explain in detail how any identified billing errors were corrected, or, if applicable, why we did not modify the bill as requested. We will also include applicable coding guidelines, references to health records, and other relevant information. We may resume billing you for the health treatment and services that were reviewed for potential billing errors only after:
· The review is complete
· Any billing errors are corrected; and
· A notice of completed review is transmitted to you
Medical Debt Owed and Collection
From time-to-time Brittany Reinke, LLC will send you statements identifying your remaining balance owed. If you are having difficulty paying your balance, we encourage you to contact our office about your account so that we may work with you on a payment plan and other reasonable options to help you pay your balance.
If after 45 days of the statement date there remains an outstanding balance and prior arrangements have not been made to resolve the matter, Brittany Reinke, LLC may attempt to reach the patient or responsible party through multiple communication methods as allowed by law. We may also provide at least one written notice of the outstanding debt that includes
· The amount due
· A statement that payment is expected
· Information about how to contact our office to discuss and arrange for a payment plan or financial assistance.
Referral to a Collection Agency or Law Firm
Please note that Brittany Reinke, LLC may use a collection agency or law firm in certain cases where the terms of a payment arrangement or terms of our billing and collection policy have not been met. If you have not paid the balance due within 90 days of the statement date and have not made acceptable payment arrangements with our office, or have not complied with agreed upon payment arrangements, Brittany Reinke, LLC may refer your account to a collection agency or law firm. Your medical debt will not be reported by us to a consumer reporting agency or credit bureau.
Ending Collection Activities
Brittany Reinke, LLC will review accounts periodically to confirm the status of any debts, and to identify uncollectible and satisfied debts. We will end collection activities once a debt is identified as satisfied or uncollectable, in accordance with our arrangement with the applicable collection agency or law firm. Our office will provide updates regarding the status of your account upon your request.
Outstanding Debt
Brittany Reinke, LLC will not deny medically necessary health treatment or services to you or any member of your family or household because of current or previous outstanding medical debt owed by you or any member of your family or household to us, regardless of whether the health treatment or service may be available from another health care provider.
As a condition of providing medically necessary health treatment or services when you or any member of your family or household has current or previous outstanding medical debt to us, we may require you to enroll in a payment plan for the outstanding medical debt owed to us. The payment plan will take into account any information you disclose to us regarding your ability to pay. If you are unable to make all or part of the agreed-upon installment payments under any such payment plan, you must communicate your situation to us and you must pay an amount you can afford. We may seek other legally permitted remedies in the event of your failure to abide by the payment plan terms.
Legal Requirements
When collecting medical debt, Brittany Reinke, LLC will comply with all applicable requirements of law (which may include the Minnesota Debt Fairness Act, the federal Fair Debt Collection Practices Act, HIPAA, and Minnesota state privacy laws).
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