Life Stone Counseling Centers

INSURANCE & BILLING

Life Stone Counseling Centers accepts all in-network insurances. There is much to understand about pre-authorization of services, your deductible, co-payments, co-insurance, etc. We provide free verification of your mental health benefits and will help you understand what they mean. For individuals with out-of-network insurance, we are happy to supply you with a receipt for services that you may submit to your insurance for reimbursement.

Life Stone is also happy to accept payments from clergy, State Victims Reparation and many others. We also offer $80.00 low-cost sessions with Master's Level Interns for individuals who are uninsured or may have difficulty affording treatment. Please call us with any questions regarding your insurance benefits or self-pay rates at (801) 984-1717.

UNDERSTANDING THE BASICS OF

HOW INSURANCE BILLING WORKS

We believe that understanding insurance billing can empower clients to navigate their expenses, advocate for their rights and make informed decisions about their care. Here is an overview of the process:

Insurance Verification: Before scheduling an appointment, mental health clients should verify their insurance coverage for mental health services. This involves checking whether their insurance plan covers mental health treatment, the types of services covered, and any limitations. Life Stone is happy to verify benefits via our online databases, however sometimes these benefits can be vague or can omit important details, so they are always an estimate.

Contracted Rates: Many mental health providers, including Life Stone, have contracts with insurance companies that outline negotiated rates for services. These contracted rates establish the amount the provider will be reimbursed by the insurance company for specific services. Clients should be aware of these rates as they may affect their out-of-pocket expenses.

Payment at Time of Service: Life Stone requires payment for the 'estimated client responsibility' at the time of service, rather than after insurance processes claims. This helps avoid clients from accruing a large or unexpected balance from services.

Claim Submission: After each session or service, Life Stone submits a claim to the insurance company for reimbursement. The claim includes details such as the type of service provided, the duration of the session, the provider's information, and any applicable diagnoses and procedure codes.

Adjudication: The insurance company reviews the claim to determine its eligibility for reimbursement based on the client's insurance policy and the provider's contract. This process includes verifying the client's coverage, applying any contractual rates, and assessing any copays, deductibles, or coinsurances.

Payment or Denial: Once the claim is adjudicated, the insurance company will either approve the claim and provide payment to Life Stone or deny the claim for reasons such as lack of coverage, incorrect coding, or failure to meet policy requirements, etc. Life Stone has a dedicated team that works to resolve any denials quickly. If the denial cannot be resolved, the cost of services will default to the provider’s self-pay rate.

Application of Contracted Rates / Write-Offs: Our clinic compares the contracted rates negotiated with the insurance company to the total charges billed for the services rendered. Any difference between the billed amount and the contracted rate represents a contractual adjustment or write-off. This adjustment reflects the portion of the charges that Life Stone agrees not to pursue for payment from the client.

Patient Responsibility: Once the claim is approved, the client may be responsible for paying a portion of the cost as determined by their insurance plan (such as copays, deductibles, or coinsurance).

If you have any questions about this process or a statement you have received, please reach out to our 3rd-party billing dept, Consulmed at (801) 296-2113 or reach us via email at billing@lifestonecenter.com.

PLEASE NOTE, Life Stone is OUT-OF-NETWORK with the following insurances: Medicaid, Medicare, CHIP, United Healthcare, Optum, SelectHealth Share Community Advantage, DMBA

This list is not an exhaustive list- please submit your information for verification on in-network coverage.

INSURANCE VERIFICATION

Life Stone is happy to help verify client benefits via our online databases and through resources made available to us by insurance companies, however sometimes these benefits can be vague or can omit important details. Due to this, any benefit details given by us are always an estimate.

Client Full Name

Phone Number and/or Email Address

Client Date of Birth

Insurance Carrier

Insurance ID Number

Insurance Customer Service Number

What location(s) are you interested in?

Midvale
American Fork
West Jordan
Virtual

What services are you interested in receiving?

COMMON INSURANCE TERMS

DEDUCTIBLE:
A deductible is the amount a member must pay out-of-pocket before insurance benefits kick-in. Deductibles are often listed annually, by individual and family. In other words, if you have a $300/$900 deductible, it means that $300 must be paid for an individual member OR $900 for the combined family before insurance will begin paying for services. Deductibles correspond to your plan's policy year (e.g. calendar or fiscal).

CO-PAYMENT/CO-INSURANCE:
A co-payment is the portion of the charge for the appointment that the member is responsible for. This amount may be a specific dollar amount, a percentage for the total charge, or a combination of the two.

IN-NETWORK BENEFITS:
Many insurance plans have provider panels (professionals that are contracted with your insurance company), which are the professionals whose services the plan will pay the maximum benefit for.

OUT-OF-NETWORK BENEFITS:
Some plans allow members to "swing-out" of the panel and see any provider they choose. The main disadvantage of going outside your network is you may have to pay a higher deductible and/or copay than if you use a provider who is considered in-network.

$80.00 LOW COST-SESSIONS

Life Stone offers $80.00 low-cost sessions with Master's Level Interns for individuals who are uninsured or may have difficulty affording treatment. SCHEDULE NOW