FAQs

A deductible is the initial dollar amount one must pay before insurance plans begin to pay for the bills. Typically, a deductible is a flat dollar amount. Not all clients will have a deductible, and some plans may waive a deductible. A copayment is a fixed flat fee paid for each visit to a provider. Copayments may vary depending on the visit. Coinsurance is the percentage of the total cost of the health service that you must pay until you have reached your out‐of‐pocket maximum. Instead of a copayment, some plans clients will pay a percentage of the provider's fee, and insurance pays the rest of the amount owed for the session. 

A surprise bill is an unexpected medical bill. The No Surprises Act was enacted to protect clients from these surprise bills. One section of this act states that as of January 1st 2022, healthcare providers are required to offer “Good Faith Estimates.” Good faith estimates show a list of expected charges. 

Payments are due at the time of service. Depending on your provider, co-pays may vary. Our standard rate for out-of-pocket payment ranges from $230 for the initial intake appointment and $50-$205 for individual sessions depending on the length of session. If you are under-insured, uninsured, or, if co pays are a financial burden to your family, we have financial assistance available.  You may find more information on our financial assistance page, or contact School Mental Health Services Program Coordinator. 

We're happy to help! Contact Jen Pollock 402-597-4891 or email at jpollock@esu3.org

We work with several insurance and managed care organizations (MCOs). They each have their own unique requirements for authorizing treatments and each plan has different benefits and coverage. It is your responsibility to notify and provide us with any updates to your coverage. 

As a courtesy, we will attempt to contact your insurance company to better understand your coverage and benefits, however, it is the policy holder’s responsibility to know and understand the benefits and limitations of your policy. This includes information such as your co-pay amount, your annual deductible amount, your lifetime benefit, whether or not pre-certification for service is required, and if your coverage limits the maximum number of therapy sessions each year. 

Additionally, you are responsible for any required updates for Coordination of Benefits, as outlined by your insurance company. A Coordination of Benefits (COB) is the framework for medical insurance companies to establish the order and amount of coverage or services, especially when more than one insurance company is providing coverage for a client. Coordination of Benefits is commonly required in the following situations:

• Where there is more than one insurance or a coverage plan is added or removed

• When changes occur to the policy holder’s or client’s demographics or dependent status (i.e. change of mailing address, birth of a child, etc.) 

• When a major medical event occurs

• Annually

To learn more about Coordination of Benefits, reach out to your insurance company to find out what is expected of you as part of your patient responsibilities.  

Financial assistance is available for those who qualify for financial support. If you have questions, or need financial assistance please call Jen Pollock, SMHS Program Coordinator,  at 402-597-4891.

If you are not insured with one of our in-network companies, there are additional options available. These options include utilizing any out of network benefits your provider may have,  accessing our our financial assistance, options including a nominal fee option. Please see our financial assistance page for more detailed information. 

Active participation at the onset of therapeutic services, including the intake interview is critical to our SMHS process. Parent/Guardian attendance and participation in a child’s intake appointment is required. Your input and engagement is important to therapeutic outcomes! We will do our best to accommodate your schedule and communicate with you throughout the therapeutic process. If you do not attend your child’s scheduled intake, we will reschedule one time. After that, we may need to discharge your child from services or refer them out to community based services.

Your child’s attendance and engagement in the therapeutic process is also very important. If your child misses more than 3 consecutive sessions for reasons other than illness, we may need to discharge your child from services. This decision is made on a case by case basis at the professional discretion of your child’s SMHS Therapist. 

We will not submit claims or bill families for no-shows, however, consistent lack of attendance to services may result in a discharge from services. 

Provided we have your insurance information twenty four hours prior to your intake meeting, we will make a courtesy call to your insurance provider to check in-network status, if pre-authorization is required, and where you're at with your benefits (co pay, deductibles, etc.). While we offer this as a courtesy, it is ultimately your responsibility to understand your benefits. Insurance benefits can change, so it's always a good idea to double check your benefits. 

An EOB is a statement from your insurance company that explains how they processed a claim. Review it carefully to ensure that the services and charges are accurate. If you have questions or disagree with any information, feel free to contact your insurance company or contact SMHS Program Coordinator, at ESU#3 for clarification.

If you've paid for a medical service upfront and need to seek reimbursement, contact your insurance company for their specific claim submission process. You may need to fill out a claim form and provide itemized bills from the healthcare provider.

A copayment (or copay) is a fixed amount you're required to pay for certain medical services, as specified in your insurance plan. You typically pay this directly to the healthcare provider at the time of the visit. It's separate from insurance billing but contributes to your overall healthcare costs. You may contact your insurance provider at any time to better understand your benefits and responsibilities related to any co-payment required. 

If a claim is denied, contact your insurance company to understand the reason for the denial. It could be due to various factors, such as incomplete information or services not covered by your plan. You can work with the provider and the insurance company to appeal the decision if necessary. Please also reach out to your child's SMH Therapist or the SMHS Program Coordinator for support or access to financial assistance if needed.

Yes! Please use the financial assistance request form on this website to begin the process. Additionally, you can find information on our website about our financial assistance process and continuum of supports from nominal fee schedules to waivers, if you qualify.