Mountain Mental Health PLLC currently accepts Premera Blue Cross, Regence Blue Shield, Lifewise insurance plans. Payments of cash, check, credit card, and debit card will be made directly to Mountain Mental Health PLLC IF WE DO NOT accept your insurance. If you would like to submit your charges to your insurance company for reimbursement, we will generate a “Super bill” or statement of charges at your request. It is the patient’s responsibility to settle any claims submitted to his/her insurance company for reimbursement. It is the patient’s responsibility to check with his/her insurance company to determine if insurance will reimburse for “Out of Network” charges.
No Surprise Billing
Patients who are not enrolled in a health insurance plan or are not filing claims for services to their insurance plans have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost out-of-pocket.
A Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for a service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.
Services at Mountain Mental Health cost between $180-$400 depending on the code and complexity of the appointment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
If you are billed over $400 more than this Good Faith Estimate, you have the right to dispute the bill. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about four months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate.
If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059.
Please note that a Good Faith Estimate does not include no-shows and late cancellation fees.
No Surprise Billing
Patients who are not enrolled in a health insurance plan or are not filing claims for services to their insurance plans have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost out-of-pocket.
A Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for a service. The estimate is based on information known at the time the estimate was created. The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment.
Services at Mountain Mental Health cost between $180-$400 depending on the code and complexity of the appointment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
If you are billed over $400 more than this Good Faith Estimate, you have the right to dispute the bill. You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about four months) of the date on the original bill. There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate.
If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059.
Please note that a Good Faith Estimate does not include no-shows and late cancellation fees.