Insurance Fees
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Insurance / Fees
Prana Wellness, LLC proudly accepts most major insurance plans. However, coverage can vary widely between plans. The following list is not exhaustive and should not be used to determine whether your insurance is accepted in-network. For accurate information on in-network acceptance, please contact our practice directly. Additionally, we strongly recommend reaching out to your insurance provider to fully understand the mental health benefits offered by your specific plan and any financial responsibilities you may have. While we can provide estimates, the final determination of your out-of-pocket costs is subject to the insurance company’s final payment.
For your convenience, when inquiring about costs to your insurance company here is a list of some of the common CPT codes used for mental health visits:
NEW Patients: 99205, 99204, 99203, 90792
ESTABLISHED Patients: 99215, 99214, 99213
Therapy Codes: 90833, 90836
Less commonly used codes: 99417, 96132, 90785
*This list does not include all codes, only the most commonly used.
Codes chosen for a visit are determined by complexity of care, medical decision making or time spent.
Prana Wellness will also verify your benefits with your insurance provider prior to your initial appointment. It is the patients responsibility to notify the practice immediately if you have any changes to your insurance or loss of insurance. If your insurance is not listed as in-network, it may simply mean our list has not been updated. Therefore, we still encourage you to call our office, and we will be happy to check your eligibility but we will need to collect your insurance information at the time of the call so please be prepared to share that information.
Our practice collaborates with Grow Therapy, Headway and Alma for some of our billing services. We also utilize RLN Billing Services.
Have Insurance but We Are Not In-Network?
If we are not in-network with your insurance provider, you can still be seen at our self-pay rate or out of network but coverages and patient financial responsibility in these situations vary greatly.
If you have insurance but choose not to utilize your benefits you must notify the office PRIOR to receiving care and complete the election to opt out of using insurance benefits. Those individuals with Medicaid cannot opt out of insurance. Currently, this practice is not in-network with Medicaid therefore we cannot accept any patients enrolled in Medicaid.
Upon request, for those patients seen out of network, we will provide an invoice (also know as a superbill) that you may use to request reimbursement from your insurance provider. Please note that Prana Wellness, LLC cannot guarantee reimbursement, and there are no refunds if your insurance company declines to reimburse you for any or all out of pocket expenses. Please feel free to reach out to our office if you have any questions about this or you are trying to decide how to proceed and we will be happy to assist!
Please contact your insurance provider if you have questions about the implications of seeing an out-of-network provider or making the decision to opt out of using insurance benefits. We are also here to help any questions you may have!
Self-Pay Rates:
- Initial Evaluation (50-55 Minutes): $275
- Follow-Ups (20-25 Minutes): $150
Payments are due on or before the date of service, prior to the start of the appointment, and can be made by credit card or exact cash (if being seen in person). There are no exceptions to the payment policy and no refunds under any circumstances.
Insurance Company List
We do attempt to keep this list updated however if your insurance is not listed below it may simply mean that our list has not been updated recently. We encourage you to call or text our office and we will be happy to verify your benefits. Additionally, we recommend that you call your insurance company directly to confirm your benefits and coverage limits. It is ultimately the patients responsibility to know and understand their insurance benefits.
Insurance Companies
- Aetna
- Allied
- All Savers
- Avmed
- BIND
- Blue Cross Blue Shield
- Boon-Chapman
- Carelon Behavioral Health
- Cigna
- Coventry
- Evernorth
- Florida Blue
- GEHA
- Golden Rule
- Humana
- Medicare
- Meritain
- Nippon Life Benefits
- Optum
- Optum Health Complex Medical Conditions
- Oscar
- Providence Health Plan
- United Health/Optum
- United Medical Resources UMR
- United Healthcare Life Insurance
- United Healthcare Shared Services
- United Healthcare Student Resources
- US Health Group
- 1199SEIU Funds
- 90 Degree Benefits-Caprock
Billing Services
Prana Wellness uses third-party billers: Alma, Headway, Grow Therapy and RLN Billing
Many practices use billing companies to process their insurance payments. In order to maximize our exposure to a variety of insurance companies thereby allowing us to provide mental health services to those in need who choose to use their insurance, we utilize the billing services of 3 companies, Alma, Headway and Grow Therapy.
You may have found your providers profile using one of these platforms or you may be directed to one of these platforms for insurance verification and payment when you make an appointment with Prana Wellness, LLC.
Links to Our Billing Platforms Alma, Grow Therapy and Headway
Want to do a FREE 15 minute consultation with the provider prior to making an appointment?
You may use this link below labeled ‘ALMA‘ to book a FREE 15-minute consultation with a Prana Wellness provider and if you would like to proceed with scheduling an appointment with that provider you may do so at the time of your consultation call.
Prana Wellness, LLC uses ALMA as a biller for insurance plans: United Healthcare/Optum, Aetna and Cigna
If you are an Alma client and you have billing questions, please reach out to Alma at support@helloalma.com
If you are using any BCBS , Florida Blue or Medicare insurance plan, you may use this link labeled below ‘GROW THERAPY’ below to make an appointment with a Prana Wellness provider and have insurance benefits verified simultaneously.
If you are a Grow Therapy Client and you have billing questions, please reach out to Grow Therapy billing directly at: https://growtherapy.com/wp/contact-us/
Your Link to Grow Therapy, for verifying insurance and direct booking:
Prana Wellness uses Headway as a billing option as well. You may use the link below labeled ‘HEADWAY‘ to make an appointment with a Prana Wellness provider and have your insurance verified simultaneously. Insurances accepted using Headway include Aetna, UHC/Optum and Cigna.
If you are an active patient with Headway and you have questions about billing or your account, please use https://headway.co/contact for assistance.