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.
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 firstname.lastname@example.org 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.
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.