Insurance and Billing

Insurance and Billing2020-08-27T15:10:51+00:00

Our Commitment to Our Patients

At Compass Health Center, we believe in patient education and patient advocacy.  The following are commitments we will make to you:

  • Act as a liaison between you and your insurance company
  • Communicate updates with you throughout the revenue cycle process
  • Answer your questions
  • Be upfront and honest with you regarding your coverage, eligibility and self pay responsibilities
  • Follow the revenue cycle process with integrity and treat our patients with respect and compassion

We take pride in doing this, as we know that knowledge is power and will help reduce possible anxiety.  We also feel it’s important to be open around any possible patient financial liabilities and options you may have in that regard.

Support and Next Steps

During and after the intake process, we will be happy to contact your insurance to verify your benefits and communicate back to you.  We will make this process as easy to understand as possible, but we also ask that you contact your employer or insurance as well.  Some plans are considered, “self funded” and follow different rules and regulations then “fully insured” policies.  There are also a few things to remember as we verify your eligibility and benefits:

  • This is the best and most up to date information given to us from your insurance.
  • Please remember the insurance holds the ultimate decision making and may quote us the wrong information or incorrect benefits. Therefore, we recommend you confirm the information that we are told
  • Getting a quote from Compass Health Center does not obligate you or bind you to coming here for treatment.
  • If you have any revenue cycle (billing, benefit, or eligibility) questions, please feel free to call us at 773-739-5600.

Insurance Process

The insurance process can be complicated and confusing and can also be time consuming.  We at Compass Health Center would like to partner with you in these situations and discussions.  Our goal is to make the process as smooth as possible and remove some of the burdens from you.

However, there are various situations and scenarios where your insurance will only take certain information from you.  The process of seeking care and submitting claims does involve patient or parental involvement and engagement.  But don’t worry, we will walk through this with you and make sure you are not navigating on your own.

Network and Out of Network Coverages

While we attempt to work with all major managed care organizations, we, unfortunately, aren’t in-network with all of them.  What does this mean?

  • In-network plans received a contractual obligation discount off our service charge. That means they have an agreed upon maximum rate that is lower than our average daily charge.  For in-network plans, managed care organizations often pay a higher coinsurance and usually have a lower deductible.
  • For out of network coverages, there is no contractual adjustments or discounts. Out of Network plans will pay what they consider the “usual and customary” charge.  You will pay the difference between that amount UP TO our full bill charge.  Unfortunately, we don’t know what the insurance will consider usual and customary.
  • We will bill your insurance, regardless of in or out of network status, and after claim adjudication will bill you for any patient responsibility on the back end.
  • Compass Health Center is in-network with BCBS, HMOI, Humana, Cigna, ComPsych, Aetna, and University of Chicago for Compass Health Center Programs.
  • Our Utilization Review (Insurance) Department works with all insurance companies to prove medical necessity and obtain pre-authorization.
  • Please email billing@compasshealthcenter.net with any questions regarding bills received.

Other Things to Consider:

Before and during your treatment at Compass Health Center, our Utilization Review (UR) team will be in contact with your insurance to get authorization for services.  Most often, insurance companies authorize 3-5 days at a time, so our exceptional UR team will be sending clinical data to prove “medical necessity”.  If at any point your insurance and Compass Health Center do not agree on your treatment programs, we will notify you or your family and inform them of the next steps.

If you receive any denials or denial letters from your insurance, either while in treatment or after discharge, please know we received a copy as well. We are already working on it on our end.  Please know that a denial from your insurance company IS NOT a request for payment nor is it considered a bill.  If the denial is something we need your help on (coordination of benefits, premium payments, etc) we will contact you.

Financing Options

In the event that you are out of network, or your insurance does not cover your care at Compass, we will work with you on potential financing options.  We will take your financial situation into consideration and do our best to meet you at a financial solution allowing you or your family to seek care at Compass Health Center.  Please note that these scenarios will only be considered after we have exhausted all efforts to work with your insurance plan and have appealed all denials.

Contact Info for Billing

Email: Billing@compasshealthcenter.net

Phone: 773-739-5560

When will Compass bill my insurance?2020-08-06T12:10:30+00:00

Claims will be submitted on Mondays for the prior week of treatment.

Please note that if you step down for PHP to IOP, 2 different bills will be submitted. For example: Patient start a PHP program on the 17th of the month. On the 31st, patient is still in program. A claim for payment will be submitted to patient’s insurance at the end of the month. In the following month, patient ends PHP treatment on the 8th and steps down to an IOP program. A claim will be submitted to insurance for PHP (1st-8th) and then also for IOP services performed after the 9th and before the 16th.

What happens after my insurance processes claims from Compass?2020-08-07T20:16:48+00:00

After we receive an explanation of benefits (EOB) from your insurance carrier, Compass will generate a self-pay statement to the address and guarantor (financially responsible person) on file. If there are no changes or questions regarding your bill, Compass will bill your credit card on file after 14 days.

How do I pay my bill?2020-06-13T13:14:08+00:00

You may log into our website after you get a statement, click on “PAY MY BILL” and pay through the Compass website.

What if a claim is denied by my insurance?2020-06-13T13:14:41+00:00

Please note that we will make every and all efforts to appeal any denials we received from your insurance. We at Compass do not want these scenarios to cause undue stress to you during treatment. If we are unable to get a denial overturned, we will work with you on payment arrangements and options.

What can I do to better understand my insurance coverage and out-of-pocket expenses?2020-07-17T13:47:49+00:00

Many times, mental health benefits are carved out or administered by a third party managed care company. Please review the back of your insurance card to see if your mental health benefits are serviced or paid differently then your major medical coverage.
 
Please review your medical plan documents for coverage levels and benefits. We will work with you to understand these, but feel it’s prudent for the patient or family to review as well. These are often given to you by your employer, or whoever issues your insurance coverage.

Insurance processing times2020-07-17T12:14:10+00:00

In general, please give your insurance 30-45 days to process a claim. Some payors process it sooner, but some will take longer.

It’s strongly encouraged and recommended that you open an online account with your insurance company. Then you can see what has been submitted, accepted and processed. It will even show you the EOBs (explanation of benefits) regarding how your claims were paid.

Why wasn’t this claim paid?2020-07-17T12:14:55+00:00

Again, please refer back to your online insurance portal to review the claim.  It may have been processed, but your insurance is saying it was part of your deductible, co insurance or copay.  Please note that any denial you received, we have also received and will be reviewing for possible appeal.

The bill came via an email or text. Is this a legit bill?2020-07-17T12:15:54+00:00

Most likely yes.  Our current 3rd party billing company uses paperless billing.  So instead of getting a paper bill in the mail, you will get either an email or text from Compass Health Center/ML Billing.  Again, please confirm the amount you are asked to pay matches what your insurance states is your responsibility for that particular date of service.

Can I get a paper statement/invoice?2020-07-17T12:16:18+00:00

Please call ML Billing and ask for them to send you a statement.  Because most invoices are done paperless they will be able to email this to you.  If you require one send through the mail, please note there may be a delay, as all staff is currently working from home during the COVID-19 pandemic.

I mailed a payment, but it’s still not showing as paid.2020-07-17T12:16:38+00:00

Because the staff at ML is working remotely, they are only collecting mail and checks on a weekly basis.  Therefore, there will be a delay in getting your payment processed and applied.

Why are different charges and dates of service different prices?2020-07-17T12:17:07+00:00

Providers (physicians, nurse practitioners) charge for different services.  Often times, a provider will charge for an E/M (evaluation and management) code when they see a patient.  However, on certain days, they may also charge for psychotherapy or other services.  That is why you may see different rates on different days.  Also, the first time your doctor sees you in PHP or IOP, that E/M code is higher priced because that is a longer visit and more complex.  Follow up visits (subsequent) are priced less.

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