Insurance FAQs

Patient FAQ section will help front desk staff confidently address common concerns, while also improving transparency and trust with patients

What does “out-of-network” mean?

It means our provider does not have a contract with your insurance company. While you can still receive care here, your insurance may cover less of the cost, and you may be responsible for a larger portion of the bill. But don’t worry — you can still be seen here! We’ll walk you through your options and help you understand what your plan might cover.

Can I still use my insurance if you're out-of-network?

Yes, if your plan includes out-of-network benefits. We will verify your benefits and, if eligible, submit the claim on your behalf. You may still owe a deductible, coinsurance, and any balance not covered by your plan.

What is a GAP exception, and how does it help me?

A GAP exception is a special approval from your insurance that allows you to receive in-network coverage at an out-of-network provider. This is typically granted when no in-network providers are available nearby. If approved, your costs may be significantly reduced.

Why do I have to pay the full amount up front?

Because we are out-of-network, your insurance may send payment directly to you instead of us. To avoid delays or non-payment, we collect the full billed amount at the time of service. If your insurance pays us directly, we’ll apply that to your account and refund any overpayment.

What happens if I overpay?

If your insurance pays more than expected or you paid more than your final responsibility, we will:

Apply the credit to any outstanding balance
Leave it on your account for future visits
Or issue a refund, based on your preference

Will I get a bill after my appointment?

Possibly. If your insurance pays less than expected or denies part of the claim, you may receive a bill for the remaining balance. We’ll always provide an estimate up front, but final responsibility depends on how your insurance processes the claim.

Can I choose not to use my insurance and just pay cash?

Yes. If you prefer not to involve your insurance, you can opt for our cash-pay option. We’ll provide an estimate and collect payment at the time of service. No claim will be submitted to your insurance.

How do I know what my insurance will cover?

We submit a Verification of Benefits (VOB) request before your appointment. This helps us understand your coverage and estimate your out-of-pocket costs. However, coverage is ultimately determined by your insurance when they process the claim.