Billing & Insurance
Serenity will be happy to bill your insurance as a courtesy. Please remember that your insurance coverage is a contract between you and your insurance company. We do not determine the specifics of your benefits and a benefit quote is not a guarantee of payment. YOU ARE ULTIMATELY RESPONSIBLE FOR THE PAYMENT OF YOUR ACCOUNT.
Medical insurance coverage can be confusing. As difficult as it may seem, however, it is important that you take the time to understand your own insurance. Whether you are a member of an employer-sponsored medical plan or an individual medical plan, you may end up paying more out of your own pocket by not understanding the details of your insurance.
Our goal at Serenity Spa & Natural Health Clinic is to help you maximize the benefits of your insurance plan and minimize your out-of-pocket payments. We encourage you to call the number on the back of your card to verify your benefits prior to your visit with us.
Co-payments, co-insurance and deductibles are patient responsibilities and will be collected at time of service. KNOW YOUR COVERAGE AND COME PREPARED TO PAY YOUR PORTION. If your coverage cannot be verified, the minimum due will be $30 for a Medical Massage and $50 for an Acupuncture and Physical Therapy treatments. If you are not prepared to pay, we may be required to reschedule your visit.
Patients that do not have coverage or who have an insurance we are not contracted with will be required to pay in full at time of service. Each of our providers is credentialed individually with specific insurance companies. Some insurance companies have closed their network and do not allow any new providers to be added. We do not bill out-of-network but we are happy to provide an itemized bill so you may self-submit the medical claim for possible reimbursement.
Do I need a referral to get my treatment covered by insurance?
A referral from a doctor is required for all medical massage treatment. Some insurance companies do not require a referral; however, all claims require an ICD-10 diagnosis code and it is outside of the scope of practice for massage therapists to diagnose.
Can i receive treatment for injuries sustained in an auto accident?
We provide a variety of treatment options for injuries associated with motor vehicle accidents. In order for us to bill insurance for injury treatment you must have an open and active claim. We do not bill third party insurance (the other driver's insurance) so you will need to confirm that you have Personal Injury Protection (PIP) on your policy. If you do not have coverage under your own auto insurance, we can sometimes bill your private health insurance or you can pay at the time of service and we will provide you with a superbill to get reimbursed when your claim settles. Some health insurance companies have limitations when it comes to covering treatment for injuries caused by motor vehicle accidents. Please contact your health insurance carrier to determine what services are covered by your plan.
what is a co-payment?
Your insurance may require a co-payment for your visits. A co-payment is usually a fixed dollar amount that you are required to pay (and we are contractually required to collect) at the time of your visit.
What is a co-insurance?
Once you have personally paid for your medical services up to your annual deductible amount, your insurance plan will begin paying. If your plan has a co-insurance, it will require you to pay that percentage amount for those services you have received in excess of your deductible. For example, your plan has a $1,000 deductible and a 20% co-insurance. You receive an MRI scan costing $1,500 at the beginning of the year. Your plan would require that you pay the first $1,000, plus your co-insurance of $100 (20% of the amount over the deductible, i.e., 20% of $500).
what is a deductible?
Your insurance plan may require you to personally pay for medical services you receive, starting at the beginning of each calendar year, up to a certain dollar amount. This amount is called your “annual deductible.” For example, if your plan has a $1,000 annual deductible, you are required to pay the first $1,000 each year for medical services you receive, after which your plan begins paying. The deductible is applied once each year for all medical services, including specialist visits, out-patient services, durable medical equipment, etc. It may also include primary care visits depending on your coverage.