Understanding Insurance & Billing at Healing Insight
A clear guide to how therapy insurance, copays, deductibles, and billing work at our Florida-based trauma-informed practice.
At Healing Insight Therapy & Wellness Collective, our highest priority is ensuring you have access to high-quality, trauma-informed, and culturally responsive mental health care.
Part of that commitment includes working with insurance companies whenever possible. We are in-network with several commercial insurance plans and serve clients throughout Florida. Insurance helps make therapy more accessible — but it also comes with complexity.
Our goal is to be:
- Transparent
- Ethical
- Proactive
- Collaborative
We will always provide the most accurate information available to us. We will also be honest about what is within our control — and what is determined by your insurance company.
If something ever feels confusing or surprising, please reach out. We review concerns carefully and walk through them with you.
How Insurance Verification Works for Therapy at Healing Insight
During your matching call, our Intake Coordinator:
- Matches you with a therapist
- Schedules your first appointment
- Collects your insurance information
- Attempts to verify your benefits
If real-time verification is unavailable, we complete a manual verification within 24–72 hours.
You will receive a written Benefits Verification Email outlining:
- Deductible
- Copay
- Coinsurance
- Our current understanding of your client responsibility
Important:
Insurance verification is an estimate based on what your insurance company tells us. The final authority is your Explanation of Benefits (EOB) once the claim is processed.
We strongly recommend calling the number on the back of your insurance card to verify your mental health benefits independently.
How Therapy Billing Works After Each Session
After your therapy session:
- Your card on file is charged for the estimated copay or client responsibility (same day or overnight).
- We submit the claim to your insurance company.
- Insurance processing can take anywhere from 2 days to 30–60 days.
When we receive the EOB:
- If the insurance payment matches our estimate → no change.
- If insurance pays more than expected → we refund or credit you.
- If insurance indicates you owe more → we adjust your invoice accordingly.
If there is a significant change, we will contact you to review the situation and create a plan forward.
Understanding Copays, Coinsurance & Deductibles
Deductibles are one of the most common sources of confusion in therapy billing.
Situations that can occur:
- Your deductible may apply to mental health services.
- Your deductible may not apply.
- Your deductible may reset (often January or July).
- Another provider may use part of your deductible without our knowledge.
- Insurance may initially indicate one thing and later apply something different.
Because we rely on information provided by your insurance company, adjustments may occur once your EOB is issued.
If we overcharge based on early information → we refund or credit you.
If we undercharge → we adjust and collect the difference.
We understand that unexpected billing changes can feel unsettling. If something looks unfamiliar, please contact us. We will review it thoroughly.
What Happens If Insurance Doesn’t Pay?
Occasionally, insurance may:
- Deny a claim
- Reverse a previously paid claim
- Apply a deductible unexpectedly
- Determine a service is not covered
When that happens:
- We review the claim and verify coding accuracy.
- We follow up with the insurance company when appropriate.
- We advocate for correct processing.
If insurance ultimately does not pay, the session becomes your financial responsibility.
Our contracted rate varies by insurance, but our standard self-pay rate is $150 per session.
If a denial creates financial hardship, we offer:
- Customized payment plans
- Sliding scale options (when appropriate and available)
Premium Lapses & Coverage Gaps
If insurance premiums are not paid, coverage may appear active before being retroactively denied.
Typically:
- Month 1 unpaid premium: Insurance often still pays for sessions that occur during that month.
- Month 2 unpaid premium: Insurance may appear to pay claims, but payment is tentative.
- Month 3 unpaid premium: Insurance often stops paying and may retroactively deny sessions from months 2 and 3.
This means a session that initially appeared covered may later be denied.
If coverage is retroactively denied due to unpaid premiums:
- You become responsible for those sessions at $150 per session.
- We will review the situation with you.
- Payment plans and sliding scale options may be discussed when appropriate.
If you anticipate difficulty paying your premium, please contact us proactively. Early communication allows us to prevent larger balances from accumulating.
If Your Insurance Changes
If your insurance plan changes:
- You must contact our administrative office directly.
- A new demographics form must be completed.
- Uploading a new insurance card alone does not update billing.
If sessions occur during a coverage gap:
- Those sessions temporarily reflect self-pay status.
- We attempt retroactive submission once coverage is confirmed.
- If insurance pays, we adjust and refund/credit accordingly.
If insurance ultimately denies coverage, you remain responsible for the session.
Balance Protection & Schedule Holds
To prevent unexpected debt accumulation, a schedule hold may occur if:
- Your balance exceeds $200,
- OR 3 sessions remain unpaid,
- OR 30 days pass without payment.
If an upcoming session would push your balance above $200:
- We charge the card on file same day.
- If payment cannot be processed, the session may be paused.
This policy protects both you and the practice from escalating balances.
Scheduling resumes once the balance falls below the threshold.
Late Cancellation & Missed Appointment Policy
We understand that life happens.
- Your first late cancellation or missed appointment per calendar year is waived.
- This waiver resets on January 1st each year.
After the first waived occurrence:
- A flat $80 late cancellation fee applies to cancellations with less than 24 hours notice or missed appointments.
- The fee is not billable to insurance.
- The fee applies even in the event of an emergency.
When appointments are cancelled without adequate notice, we are typically unable to fill that time. The $80 fee helps ensure clinicians are fairly compensated for reserved time.
If you are able to reschedule within the same calendar week and your clinician has availability, the fee may be waived. This depends on scheduling availability and is not guaranteed.
Our standard self-pay rate is $150 per session. We charge a reduced $80 fee to balance fairness and sustainability.
Sliding Scale & Payment Plans
Sliding scale availability:
- Typically offered in 12-week increments
- Reviewed quarterly
- Reset each calendar year
If you experience:
- A retroactive denial
- A deductible reset
- A coverage lapse
- Financial hardship
Please contact us. We are committed to working collaboratively while maintaining sustainable practice standards.
Automated Billing Adjustments
Parts of our billing system are automated.
When insurance sends updated information:
- Your invoice may automatically adjust.
- You may receive an updated statement reflecting that change.
If something looks unfamiliar:
- Contact us.
- We will review your account in detail.
- We will investigate discrepancies.
- We will correct errors if identified.
Unexpected changes are almost always tied to insurance determinations — not hidden decisions.
Superbills (Out-of-Network Therapy)
If you are out-of-network and need documentation for reimbursement:
- Contact our administrative team via secure portal message or phone.
- We will provide a superbill for submission.
Reimbursement timelines and approval are determined by your insurance company.
Collections Policy
If balances remain unpaid after multiple outreach attempts:
- We initiate a soft collections process.
- Accounts may eventually be referred to a third-party collections agency in accordance with applicable laws.
We always attempt communication and resolution first.
We Are Here to Partner With You
Insurance systems are complex.
We commit to:
- Accurate billing
- Ethical advocacy
- Transparent communication
- Compassion with boundaries
- Sustainable business practices
You support this partnership by:
- Keeping insurance information current
- Reviewing EOBs
- Communicating proactively
- Maintaining an active payment method
If you ever have questions about therapy billing, copays, deductibles, or insurance coverage, please contact our administrative team through your secure client portal or call 561-332-1812.
We are here to support you — clinically and administratively.
