At Lotus Behavioral Health, we know that understanding insurance can be overwhelming. We aim to make the process as simple as possible so you can focus on what matters most – your child’s well-being. Below, we break down key terms and what to expect regarding coverage and costs.
Patient Financial Responsibility
Each family’s financial responsibility varies depending on their insurance plan. We will verify your benefits and explain your coverage in clear terms. Our team is here to help you navigate costs and payment options.
Key Insurance Terms
Deductible
The amount you must pay out of pocket before your insurance starts covering costs.
Out-of-Pocket Maximum
The most you’ll have to pay in a year for covered services. Once reached, insurance covers eligible costs at 100%.
Admission Fee
Some insurance plans require an upfront cost when entering a treatment program. We will confirm if this applies to you.
Copay
A fixed amount you pay for each visit or service, as determined by your insurance policy.
Authorizations & Insurance Approvals
Most insurance plans require authorization for behavioral health services. Our team works directly with your insurance provider to secure the highest number of approved days based on medical necessity. However, insurance companies may choose to limit coverage at any point. If they deny further services, you may choose to continue treatment at your own cost, as long as it remains clinically appropriate.
Continuing Care Beyond Insurance Coverage
If additional care is needed beyond what your insurance approves, you have the option to continue treatment privately. We will discuss all financial details upfront to ensure transparency and will work with you to explore flexible payment options.
Financial Assistance & Payment Plans
We are committed to helping families manage costs and will work with you to create a feasible payment plan if needed. We can also refer you to healthcare loan providers for additional financial assistance.
If you have any questions about your insurance coverage, financial responsibilities, or payment options, our team is here to guide you every step of the way.
Contact us today to learn more!
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