Square One Specialists in Child and Adolescent Development does not have contracts with any insurance companies and does not file claims to insurance companies; however, you may submit a claim directly to your insurance company for possible reimbursement through out-of-network benefits after you have paid fees for our services. We provide the necessary information for your claim, including our federal tax identification number, diagnosis (ICD) codes, and procedure (CPT) codes. Our doctors will provide signatures or other documentation on a requested basis. Be advised that if you do opt to file a claim for reimbursement, it may be necessary to contact your insurance company prior to your appointment to complete pre-authorization requirements.
Payment is due at the time of service. Accepted forms of payment include Health Savings Account (HSA) and Flexible Spending Account (FSA) funds, most major credit cards, checks (up to $125), and cash. The receipt Square One will provide to you at every appointment details the necessary information for filing your claim with your insurance company for reimbursement according to your plan’s out-of-network benefits. Information from the American Psychological Association regarding mental healthcare benefits: http://www.apa.org/helpcenter/parity-guide.aspx.
The CMS 1500 Insurance Claim for is available for download here: https://squareonemd.com/wp-content/uploads/2017/09/CMS-1500-Insurance-Claim-Form.pdf
At Square One, your family’s treatment is our primary concern. Unfortunately, insurance companies often dictate allowable, or financially covered, providers and services which limits the comprehensive evaluation and treatment of patients; this conflicts directly with the mission at Square One. In addition, insurance companies routinely pay only a portion of doctors’ fees. Many doctors’ offices resort to multi-booking appointments or increasing service fees in order to compensate for the reduced payment schedule from insurance companies – the balance that the insurance companies do not pay may then be passed on to the patient, in most cases.
As an out-of-network provider, Square One may keep out-of-pocket evaluation costs lower than providers who process claims to insurance companies. In fact, some of our patients have reported paying more out-of-pocket for evaluation services elsewhere after their insurance coverage was applied, often without the benefit of a team-based assessment. Furthermore, our doctors do not book multiple patients for the same appointment slot: your appointment time is uniquely for you. We provide you the services best suited to your needs, regardless of insurance coverage.
Instead of practicing under health insurance companies’ guidelines, our doctors focus on their mission to support families and to help develop realistic and comprehensive care options.