INSURANCE:

Insurances accepted include Kaiser Permanente, Regence, and Premera. As courtesy, our billing department will happily bill your insurance for your visit. However, it is your responsibility to be aware of your coverage and copay as well as any deductible and maximum benefits. There are hundreds of insurance plans and eligibility can be quite complicated. Please follow the steps below to help you find out about your benefits and eligibility:

1. Call the “member services” number on your insurance card. The phone number might also be listed as “benefits and eligibility.”
2. Go through the automated prompts to speak with a representative. You will want to say: “I would like to verify my benefits and eligibility for outpatient mental health and will be receiving telehealth services.”
3. Make sure you have current active coverage.
4. Ask if you need a referral or authorization for these services.
5. Make sure Deborah Crandall is in-network with your insurance. If needed, you can reference her National Provider Identification Number (NPI): 1154561272
6. Ask if your deductible applies to these services. If your deductible applies, you will be responsible to pay for the majority of the billed amount for the service until your deductible is met. (You can talk with our billing specialist more about this: rosalie@lifebridgetherapy.com)
7. If your deductible has been met, or it does not apply, ask what your copay will be. For some plans, you might be responsible for “coinsurance” rather than a copay, which is a percentage you will owe for the billed amount.
8. Ask if there are any limitations to how many times you can see Deborah.
9. Ask for the name of the representative you spoke with, and note the date and time in which you spoke to them.

Please note that your contract is between you and your insurance company. If your insurance company gives you inaccurate information, and does. not honor the benefits that were quoted, you are still responsible for your payment. You always have the option to file a complaint with the Washington State Insurance Commissioner if you feel your insurance company is not honoring your contract.

CANCELLATIONS:

If an appointment must be cancelled, 48 hours notice prior to the time of your appointment is required, or a fee of $100 will be charged to your account. Failure to appear within 10 minutes of the appointment will be considered a “no-show” cancellation and $100 will be charged to your account. This fee is not covered by insurance.

Good Faith Estimate:

Under Section 2799B-6 of the Public Health Service Act, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy of picture of your Good Faith Estimate.

For questions or more information regarding your Good Faith Estimate, visit http://www.cms.gov/nosurprises or call 1-800-985-3059.

What are my rights?

• I am not obligated to receive services from Life Bridge Therapy or any out-of-network provider.
• I can cancel services at any time by notifying my provider 48 business hours before the scheduled service date.
• I have a right to initiate a dispute resolution process if the actual billed charges are substantially in excess of the expected charges included in this Good Faith Estimate.
• I may start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). I understand that the dispute process must begin within 120 calendar days from the date of the original bill.
• There is a $25 fee to use the dispute process. If the agency reviewing my dispute agrees with me, I will have to pay the price on the Good Faith Estimate If the agency disagrees with me, I will pay the higher amount.
• I can contact the No Surprises Help Desk at 1-800-985-3059 or visit http://www.cms.gov/nosurprises at any time to start the dispute process or to get more information.

What else Do I need to know?

• Life Bridge Therapy is in-network with Kaiser Permanente, Premera Blue Cross Blue Shield, and Regence. However, it is important to note that some employer plans have third party payers in which the patient would need to check with their health insurance provider to make sure outpatient mental health services are covered as in-network.
• Information provided in a Good Faith Estimate is only an estimate of services reasonably expected to be furnished at the time the Estimate was provided. Actual items, services, or charges may differ from the Estimate.
• The Good Faith Estimate is not a contract.

Deborah Crandall | dc@lifebridgetherapy.com | 360.603.4212 | 360.603.4148 (fax)

2950 Newmarket St. Suite 101-168, Bellingham, WA 98226

*All services will be provided virtually through Telehealth*

If you would like to request an appointment, please fill out all of the boxes below.

If you are a current patient and have a question or concern, please fill out your name, email address, and your message.

For any billing/insurance related concerns, please email our office manager at rosalie@lifebridgetherapy.com