Billing

Billing and Fees
Dr. Guerrieri believes that time and face-to-face interactions with her patients are important factors in the healing process and, therefore, Well-Minded, LLC, is a Fee-For-Service practice. This means that Dr. Guerrieri is not paneled with insurance companies and does not process or accept monies from insurance companies. Payment is due at time of service. However, patients can submit the receipts from Dr. Guerrieri’s services for reimbursement by their insurance companies.  Most of Dr. Guerrieri’s patients receive some reimbursement by their insurance plans, if they have “out-of-network” coverage. Patients are provided a comprehensive receipt after each appointment that they can submit to their insurance companies for reimbursement. New and existing patients are strongly encouraged to contact their insurance providers for coverage terms and single case agreements.  Payment is due at time of service and no refunds are issued for rendered services.

How do I find out if my insurance company will reimburse me for the appointments?
Insurance companies typically use two codes to determine what they will pay (or if they will pay) for a medical service: a billing (CPT) code and a diagnosis code (that starts with a letter of the alphabet).  Below is an example of a typical diagnostic and billing code pair used by Well-Minded, LLC, for provided services.  Contact your insurance company in advance of your appointment to find out how much they will reimburse you for the following billing (CPT) and diagnostic codes:

Sample diagnostic code:

  • F41.1 (generalized anxiety disorder)

Sample billing (CPT) codes:

  • Office outpatient (OP) New Patient Visit (NPV) codes (90-minutes): 99205 or 99215; G2212
  • Office OP evaluation and management (E/M) codes for established patients (55-minutes): 99214; 90838
  • Office OP E/M codes for established patients (25-minutes): 99213; 90833
  • Office OP E/M code for established patients (15-minutes): 99213

*NEW* Beginning 1/01/2022, Standard Notice of “Right to Receive a Good Faith Estimate of Expected Charges” Under the No Surprises Act, PART II, for all healthcare providers to share [(enacted as part of the Consolidated Appropriations Act, 2021 (Pub.L. 116-260)]:

  • You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. This is called a Good Faith Estimate (GFE)
  • You have the right to receive a Good Faith Estimate (GFE) for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a GFE in writing at least 1 business day before your medical service or item, if you do not plan to submit your receipts (or “super bill”) to your insurance company for reimbursement.
  • You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.
  • For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call this office (or your provider, if different) after you have scheduled an appointment or before your next scheduled appointment.
  • Understanding costs if you are uninsured or self-pay:  https://www.cms.gov/nosurprises/consumers/understanding-costs-in-advance
  • Fact Sheet of What you Need to Know about the Administration’s Actions to Prevent Surprise Billing:  https://www.cms.gov/newsroom/fact-sheets/what-you-need-know-about-biden-harris-administrations-actions-prevent-surprise-billing

Comments are closed.