Welcome
We are committed to providing you the best possible healthcare. If you have medical / mental health insurance, we will help you receive your maximum allowable benefits. Please review this policy. If you have any questions, contact our finance department at the number listed below.

Payment for Services Rendered

In-Network Provider
We participate in the government sponsored Medicare and Medicaid programs and accept assignment of all Medicare and Medicaid charges. We also participate in many private healthcare insurance programs. If you are not sure if NCBI is an ‘in-network’ provider with the patient’s healthcare plan – please check with the patient’s healthcare carrier or call the Finance Department at NCBI and speak to a representative that manages the patient’s healthcare insurance.  In-network providers are contracted with health insurers to provide services at a contracted rate. If the patient needs a referral from the patient’s Primary Care Physician, please submit that if required.

If you are using healthcare insurance, NCBI will submit to the patient’s insurance company the claims for the procedures the patient will receive as part of the evaluation and/or any treatment services provided. 

Payments
Copayments are due at the time of service.  If the patient has a coinsurance plan, that portion of the payment will be calculated and is due at the time of the service.

Deductible information: If the patient's healthcare insurance deductible has not been fully met, you will be responsible for payment to NCBI for any non-covered portions of the services due to an open balance on the patient's deductible.  Although we collect information on the patient's deductible and co-payments, it is your responsibility to verify if amounts charged to you are correct.

Advance Beneficiary Notice (ABN) and Advanced Written Notice (AWN)
An Advance Beneficiary Notice (ABN) (Form CMS-R-131) is a specific, standardized Medicare form used to notify beneficiaries that Medicare likely will not pay for a service, shifting financial liability to the patient.  "Advance written notice" is a broader, generic term for informing patients of potential costs before care.

You will be given an ABN/AWN agreement to accept and sign if NCBI knows that that procedure is not part of the contracted procedure between NCBI and your health insurance.  We use a sliding fee scale, sliding down to the allowed Medicare rate in your state for any procedures that are not in our contract with your insurer.

Any out-of-pocket expenses such as a deductible, ABN/AWN charge, and coninsurance/copayments must also be paid prior or at the time of service.

We accept multiple methods of payments include:

Credit Card	Zelle (recipient email: gt@neuroci.com)
Online payments at neuroci.com via InstaMed	InstaMed (enter your patient ID on your statement along with your last name and zip code)
Paywoot (enter your patient ID on your statement)	Check (mailing address below)
Paypal including Apple Pay and Venmo: Recipient - The NeuroCognitive Institute or mrellosa@neuroci.com	Care Credit (3rd party healthcare financing)

When making online payments, please email the confirmation payment receipts to: finance@neuroci.com 

Returned checks will be subject to a $35.00 service charge.

Non-covered Services
Even if we are in-network with the patient's healthcare insurance plan and contracted to provide the specific procedure at the contracted rate, the patient's healthcare insurer can still deny the claim.  You are responsible for payment from that procedure or those procedures at the contracted rate and payment is due 10 days from the procedure.  You are responsible for appealing the denied claim or claims.  If you need help submitting the appeal, please contact the Finance Department at NCBI and they will help you or submit the denial for you on your behalf.  However, payment for the procedures is still due 10 days from the procedure. If your healthcare insurance reimburses NCBI for the denied procedures after the appeal, we will forward payment to you within 10 days of receiving it.

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 the 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; please 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 30 calendar days. A 1.5% interest charge is added monthly to all balances greater than 30 days.

Out-of-Network Health

Insurance Coverage
The patient’s insurance policy is a contract between the patient and the health insurance company/carrier. We must emphasize that as healthcare providers, our relationship is with you and not the patient’s insurance company when a procedure is out-of-network (OON). While the filing of insurance claim forms is a courtesy we extend to all our patients, you are ultimately responsible for 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.

Carved-out Policies
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, mediacl 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 "out-of-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.

Canceled and Missed Appointments
Canceled appointments if not rescheduled by the end of that week of the patient’s scheduled appointment will result in charges unless you can reschedule your appointment within that same Monday-Saturday week. A $75 charge is billed for each canceled treatment session and a $150 charge will be billed to you for payment for canceled diagnostic evaluation sessions.  These charges will be billed to your credit card after notifying you.

If you have questions regarding costs, financial arrangements or insurance concerns, please contact our Accounting/Finance Department at 973-601-0100 or email finance@neuroci.com.

Note: It is the guarantor’s responsibility of knowing the deductible and copayment fees charged by their own insurance plan. Fees charged by NCBI against the deductible or for co-payment will be texted or emailed to the guarantor.