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Charging client amount after insurance

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  • Ayelette

    Hi Debra,

    When you are in network with an insurance provider, you are bound by your contract with them. Therefore, you can charge a client the amount that the payer determines is the client's responsibility, i.e. their copay or their deductible amount, as outlined in the EOB for the relevant appointment.

    When you are out of network with an insurance provider, you aren’t bound by a contract with the insurance company so you don’t have to adjust your rate and you can charge your client any amount that you wish.

    I also recommend reaching out to your local clinical authority for more detailed guidance.

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