Insurance and Client Billing
The PRN for Families System is committed to providing the highest quality therapeutic care as well as outstanding service concerning insurance and client billing. This page will provide you with basic information about insurance plan participation, and authorizations, covered vs. non-covered services and balances that are your responsibility to pay. PRN for Families has a designated customer service agent to help you with questions or concerns you have about insurance billing or the amount you owe.
Insurance Plan Participation
PRN for Families accepts selected insurance plans contingent on the respective company and applicable benefits. Based on experience most insurance companies reimburse between 40 - 60% of services provided.
If we have a contract with your insurance plan, we will provide you with an insurance bill as a courtesy which you may forward to your insurance company. You are, however, still responsible for all out-of-pocket costs and settlement of your bill in full. Any reimbursements made by your insurance company will be credited to your account. Insurance contracts change periodically, and we recommend that you speak with your insurance plan to see if they include us in their network.
If your insurance plan does not have a contract with us, we will still provide you with an insurance bill as a courtesy which you may forward to your insurance company. You are still responsible for all out-of-pocket costs and settlement of your bill in full. If we are not a participating provider, you may want to ask your insurance plan if they would consider enrolling PRN for Families as a provider in order to minimize your out-of-pocket costs.
Also be aware that a DSM IVR diagnosis may need to be assigned. Certain diagnosis may not be eligible for reimbursement. Please consult with your insurance representative for more details.
Regardless of your insurance benefits, all payment is required in full at time of service and in accordance with your Agreement for Services.
Referrals and Authorizations
Many insurance plans require referrals and/or pre-authorizations in order for services to be covered. A referral is permission from your primary care provider and your health plan to see a particular provider or to have specific services provided. If your plan requires a referral, your primary care provider must submit the referral prior to services being rendered. If you arrive for services without a referral in place, you may be asked to sign a waiver that holds you financially responsible for the services you receive.
The PRN for Families System (PRN), which includes our therapists and liaisons, welcomes clients with all types of insurance. We recommend that you contact your health plan if you have questions regarding your benefit coverage or how your services will be covered at PRN. We also suggest that you contact your health plan before scheduling an appointment at PRN to determine plan participation.
We know that insurance rules are sometimes confusing and we make every effort to assist our clients and families. However, as a member of a health plan, you have a responsibility to understand how your plan works and what you must do to maximize your benefits and minimize your costs. We encourage you to become familiar with your health plan benefits before you need them. Please contact your employer benefits office and/or health plan representatives for assistance.