Billing & Insurance
We want all of our clients to have an exceptional experience by ensuring that our intake, billing, client relations processes are confidential, caring, and seamless so you (the client) may focus your entire attention towards your therapy.
To help achieve this goal, we want to ensure that we address your general questions about billing, insurance benefits, and payments for services.
Accepted Insurances & Finance Options
We are pleased to offer a wide range of options to cover the cost of your services. Please know that while we list many of these payment options, there are some instances where only a certain provider can accept a particular insurance or payment option.
Below is a list of our most common insurance payers. Please reach out to our front desk team for more information:
- Anthem and their affiliates (i.e. BCBS)
- Anthem EAP*
- Aetna EAP*
- Evernorth Behavioral Health (Cigna)
- Magellan of Virginia
- Magellan EAP*
- Molina Healthcare
- Piedmont Community Health Plan
- Humana (Tricare East Region)
- Optum Behavioral Health
- Optum EAP*
- United Healthcare
* EAP – Employee Assistance Program
Below is a list of our most common Medicaid payers. Please reach out to our front desk team for more information:
- Anthem HealthKeepers Plus
- Aetna Better Health of Virginia
- Magellan Behavioral Health
- Molina Complete Care
- Optima Health Community Care
- United Healthcare
- Virginia Premier
HOW TO PAY YOUR BILL
If you incur a future balance for past services, we will issue a billing statement and collect that amount at the beginning of each of your next appointment. If you receive a billing statement, you may pay it by any of the below payment options.
Please know that balances that are older than 60 days may be reported as a bad debt and sent to collections
If you would prefer to pay your bill in-person, you may do so by talking with a member of our front desk team at our Timberlake Rd. office.
We accept payments over the telephone via credit card free of charge. Please contact us at (434) 384-1594 to speak with a member of our team!
If you receive a billing statement, you may submit your payment in full along with a copy of the billing statement to 20564 Timberlake Rd., STE B, Lynchburg, VA 24502.
understanding key insurance terms
Insurance billing can be confusing so we want to help you navigate this complex terminology. You and your health insurance company pay for your health care expenses. Deductibles, coinsurance and copays are all examples of what you pay.
Understanding how each example works helps you know how much you pay.
A deductible is an amount you pay for health care services before your health insurance begins to pay.
How it works: If your plan’s deductible is $1,500, you’ll pay 100 percent of eligible health care expenses until the bills total $1,500. After that, you share the cost with your plan by paying coinsurance.
Coinsurance is your share of the costs of a health care service. It’s usually figured as a percentage (%) of the amount we are allowed to be charged for services. You start paying coinsurance after you’ve met your plan’s deductible.
How it works: You’ve paid $1,500 in health care expenses and met your deductible. When you go to the doctor, instead of paying all costs, you and your plan share the cost. For example, your plan pays 70 percent. The 30 percent you pay is your coinsurance.
A copay is a fixed amount you pay for a health care service, usually when you receive the service. The amount can vary by the type of service but will remain the same regardless if your session is 30 minutes or 60 minutes.
How it works: Your plan determines what your copay is for different types of services, and when you have one. You may have a copay before you’ve finished paying toward your deductible. You may also have a copay after you pay your deductible, and when you owe coinsurance.
Your insurance card may list copays for some visits but you can usually log in to your insurance account (or register for one) to see your plan’s estimated copays.
Explanation of Benefits
Your insurance company should send you a document explaining what they paid on charges submitted by your clinician. This form is referred to as the Explanation of Benefits, or “EOB” for short. Your Explanation of Benefits will tell you if your charges were applied to your deductible or denied for some reason.
They will also tell you how much was paid, how much was adjusted off due to the contractual agreement between your insurer and your provider, and how much is left for you to pay.
Most EOB’s show a breakdown of the charges under several headings which usually read from left to right. The most common headings are:
Date of Service – the date of the appointment or procedure.
Services – codes used by the provider to tell the insurance company what services were rendered to the client.
Amount Billed – the amount of charges submitted by the provider.
Approved Amount – the amount the insurance company approved for payment. Insurance companies often have pre-determined dollar amounts that they consider “usual and customary” for each medical service code. This pre-determined amount is often different than what your provider charges for that service. Depending on the contract or agreement between your insurance company and provider, or lack thereof, the difference between the Approved Amount and the billed amount may be adjusted (reduced to $0) or transferred to Patient Responsibility (see below).
Amount Paid – the amount the insurance company paid to the provider for the services rendered.
Applied to Deductible – the amount of charges that the insurance company has applied to the deductible. Most insurance plans require the patient to pay for a certain portion of their medical charges each plan year before the insurance coverage begins to pay. This is called the plan deductible and it comprises a portion of the total Patient Responsibility (see below).
Applied to Co-insurance – the amount of charges that the insurance company has applied to the co-insurance element of the plan. Some insurance plans require the patient to pay a percentage of the charges for each medical service. This is called co-insurance and it comprises a portion of the total Patient Responsibility (see below).
Patient Responsibility – the amount you owe. This is made up of the deductible, co-insurance, and any charges not covered by the insurance plan.
Denial Codes – Sometimes the insurance company will deny (refuse to pay) a charge for some reason. In this case, the EOB will contain alpha or numeric codes next to each procedure which indicates the reason for the denial. The explanation of these codes will often be found at the bottom of the page or on the reverse of the EOB. Some denial codes require the patient to contact the insurance carrier in order to resolve questions or other issues that are preventing payment from being made.
We recommend that you compare your insurance EOB’s to the the receipt and/or bill you received from Light Counseling. It is always a good idea to check if the payment was posted correctly and the amount owe or already paid matches the amount indicated on the EOB. Light Counseling makes this comparison easier by including detailed charge and payment information on all your billing statements. Any questions about your bill can be directed to our Client Account Representatives.