Welcome
We are committed to providing you the best possible healthcare. If you have medical insurance, we will help you receive your maximum allowable benefits. Please review this policy. If you have any questions contact our Finance Department at 973-710-9140.

Payment for Services Rendered

Payments
Any out-of-pocket expenses such as a deductible, Advanced Beneficiary Notice (ABN) charge, Advance Written Notice Charge, and coinsurance/copayments must also be paid at the time of service. Although we collect information on your deductible and co-payments, it is your responsibility to verify if amounts charged to you are correct. You will be notified in advance of the approximate ABN/AWN charge and will be given an ABN/AWN agreement to accept and sign. ABN/AWN charges typically occur when you agree to receive a procedure knowing NCBI will be charging an amount for that procedure not paid for in part or full by your health insurance. We have a central billing and collection department and NCBI will apply payments to your credit card on file. We accept MasterCard, Visa, Discover and American Express. An SMS or email will be sent to you with the amount charged to your credit card. If you do not have a credit card on file with NCBI, you have to pay by other method at time of service. The finance department will text or email you a link to pay online. (Returned checks will be subject to a $35.00 service charge).

You will receive a 2% discount for any payments made prior to or at the time of service.

We participate in many insurance plans and in most cases; we will submit your claim to your insurance carrier for your reimbursement. If you have to make an upfront payment for any procedures, we will also submit that charge on your
behalf. If your healthcare insurance sends us reimbursement for those procedures that you already paid for, we will forward payment to you within 30 days of receiving it.

Non-covered Services
If your insurer does not cover, for whatever reason, the procedure you need; you can still undergo that procedure, but payment from you or your financially responsible party will be required prior to the procedure. If your insurer is responsible for payment for the procedure and they improperly deny or refuse to accept a properly coded procedure on a submitted claim, NCBI will bill the improperly ‘denied’ portion to you for payment upon receipt.

Open balances
If you have an open balance on your account, we will notify you including leaving you a voicemail, text or email of the amount to be applied to your credit card on file. If you do not have a credit card on file with NCBI, we will send you or your responsible financial party a Statement displaying the amount of money owed for procedures administered. Payment is due upon receipt of the statement. If for any reason you receive a payment from your healthcare insurance directly, DO NOT DEPOSIT the check; endorse the check and forward it with the accompanying explanation of benefits form to us at the address noted below. This will allow us to correctly update your record of payment. Your insurance carrier will inform us that you have received payment. If you do not turn over the check and explanation of benefits, you will be responsible for the entire bill. We will notify you prior to charging your credit card.

Please note, to avoid service interruption, you need to pay any open balance with NCBI within 60 calendar days. A 1.5% interest charge is added monthly to all balances greater than 30 days.

Health Insurance Coverage

Out-of-Network
Your insurance policy is a contract between you and your health insurance company/carrier. We must emphasize that as healthcare providers, our relationship is with you and not with your insurance company when a procedure is out-ofnetwork (OON). While the filing of insurance claim forms is a courtesy we extend to all our patients, you are ultimately responsible for submitting the claim and paying all charges at each visit. You are expected to know and follow all regulations or procedures of your insurance plan. We will assist you in obtaining precertification for services as needed.

Failure to obtain this information or to provide incorrect information (wrong insurance company, invalid policy number, etc.) may result in denial of your claim. Your insurance company may not cover certain tests considered necessary by NCBI’s healthcare provider. Under these circumstances, you will be financially responsible for the costs of such tests. Neuropsychological testing is typically reimbursed under the medical, not the mental health section of your healthcare insurance plan. Most healthcare plans will reimburse you a certain percentage for most diagnostic and treatment services rendered by an out-of-network provider. Please note however, the % of reimbursement is based on their fees and not the fee charged by NCBI. Typically, your insurance carrier fees are substantially lower. Our preauthorization division, within our accounting department, can assist you if necessary and let you know which services your insurance company will likely reimburse you for and how much they will reimburse.

Any co-insurance, co-payment for Out-of-Network procedures are calculated based on the current fee that NCBI charges for that procedure and not the allowed amount determined by the insurance carrier unless otherwise approved in writing by the NCBI.

Please be aware that some health insurance carriers, for example Cigna and UHC, have ‘carved-out’ behavioral health policies. This means that Cigna and UHC separate some procedures into medical and others into behavioral. A practitioner can only be in either the medical or behavioral -not both sides of a healthcare plan. NCBI as an institute has doctors and therapists listed on both sides, medical and behavioral. However, if you are receiving medical services from an NCBI practitioner that is only listed on the behavioral side (Cigna Behavioral or UBC) those services would be considered ‘outof-network’. For example, if you receive medical procedures such as functional brain mapping and that test is read by a doctor listed on the behavioral side as assigned by Cigna or UHC; the procedure will be reimbursed based on your OON coverage – if any.

In-Network
We participate in the government sponsored Medicare and Medicaid program and accept assignment of all Medicare and Medicaid charges. We also participate in many private insurance programs. If you are not sure if NCBI is an in-network provider with your healthcare plan – please check with your healthcare carrier.

If you belong to any restricted “HMO” (needing a referral from your Primary Care Physician), we cannot see you without a referral unless you pay for the visit yourself.

Canceled and Missed Appointments
Canceled appointments within 1 day of your scheduled appointment will result in charges unless you can reschedule your appointment within that same Monday-Saturday week. A $75 charge is billed for canceled treatment sessions and a $150 charge will be billed to you for payment for canceled diagnostic evaluation sessions.

Other Costs
Copies of medical records may be obtained with advanced notice. Costs are established in accordance with the New Jersey Annotated Code, currently $17.30 plus $.70 per page. You may have special forms that need to be completed by your physician. Please allow 3 to 5 working days for completion. There is a $3.00 fee for each form.

If you have questions regarding costs, financial arrangements or insurance concerns, please contact our accounting/finance department at 973-601-0100 option 5.