While we're contracted with the insurance plans listed below, having one of these plans doesn't guarantee coverage for your specific services. Coverage can vary depending on the details of your individual plan.
It is your responsibility to contact your insurance provider, give them our clinic name, and ask whether your plan covers services with us.
Insurance 101
How does health insurance work?
Health insurance can be obtained in three main ways:
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Through your employer
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Through the healthcare exchange (marketplace)
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Through the Department of Human Services (DHS) for state-funded programs
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When you enroll in a plan, you enter into a contract with an insurance company. As a member of the plan, you’ll receive an insurance card and documents outlining your coverage.
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Most people have one insurance plan, but some have secondary insurance—an additional plan that helps cover costs not paid by the primary plan.
Your Responsibilities as a Client
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Provide accurate insurance information
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Let us know if your coverage changes
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Tell us if you have more than one insurance plan
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Sign the Insurance Authorization Form (included in your intake packet and required again if your insurance changes)
Cost Sharing:
Some plans share the cost of coverage with their members. This is called cost sharing. There are a few types of cost sharing:
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Deductible:
This is the amount you must pay out of pocket at the beginning of your coverage year before your insurance starts helping with costs. -
Co-insurance:
After your deductible is met, some plans require you to pay a percentage of the cost for certain services. Your insurance pays the rest. -
Co-payment (Copay):
This is a set amount you pay at each visit. The amount is decided by your insurance and is due at the time of your appointment. -
Out-of-Pocket Maximum:
This is the most you’ll have to pay in a year for covered services. It includes your deductible, coinsurance, and copays. After reaching this amount, your insurance covers 100% of additional costs (except your monthly premium).
In Network
Clinics that have contracts with your insurance company are called in-network providers. Choosing in-network providers usually helps you save money on your care.
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The Luminous Mind is in-network with these insurance companies:
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Aetna
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Blue Cross Blue Shield
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HealthPartners
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Medicaid
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Medicare Part B
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Tricare (Triwest)
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Ucare
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Important:
Having one of these insurance plans does not guarantee that your services will be covered. Coverage depends on the details of your individual plan. To confirm whether your services at The Luminous Mind will be covered, please call your insurance company directly. They may ask for our NPI (National Provider Identifier) number: 1588015168
Out of Network
Out-of-network providers are clinics or clinicians who do not have a contract with your insurance company. Practically, this often means you’ll pay more (or all) of the cost, may face higher deductibles, and might need to submit your own claims—so always check your plan’s out-of-network benefits first.
Explanation of Benefits (EOB)
This is a statement generated by a health insurance plan after they process claims submitted by your provider. They are sent directly to the member describing what costs it will cover for the specific services received.
Coordination of Benefits (COB)
Sometimes, your insurance company will ask you to call them to provide COB information. This simply means they want to know if you have more than one insurance plan. If you do, they use this information to figure out which plan should pay first when both are responsible for the same bill.
Prior Authorization
Some insurance plans require your provider to get approval in advance before certain services can be given. If your plan requires prior authorization (sometimes called a pre-authorization), it must be approved before the service takes place—otherwise, your insurance may not cover the cost.
If We're Out-of-Network with Your Plan, Here Are Your Options:
Find an In-Network Provider
You can contact your insurance company to ask for a list of in-network providers who offer the same type of services you’re looking for.
Request a Single Case Agreement (SCA)
An SCA is a special contract between your insurance company and an out-of-network provider. It allows you to receive care from that provider for a specific service and time period at an agreed-upon rate. Each insurance company has its own process for requesting SCAs, so be sure to contact them directly to ask about their requirements.
Utilize Out-of-Network Benefits
Some clients choose to use their out-of-network benefits after speaking with their insurance provider. If you choose this option, we’re happy to provide you with superbills (invoices you can submit to your insurance).
Before services can begin, two federally required forms must be signed:
A. Surprise Billing Protection Notice and Waiver
B. Good Faith Estimate
Pay Out of Pocket
Some clients choose to pay privately—either because they don’t have insurance or prefer not to use their out-of-network benefits.
If you choose this option, you may complete a Sliding Fee Application to help reduce the financial cost of services. If you receive a reduced rate through the Sliding Fee Application, you will not be eligible to receive a superbill for out-of-network reimbursement.
Before starting services, two federally required forms must also be completed:
A. Surprise Billing Protection Notice and Waiver
B. Good Faith Estimate
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Please Note: If you choose not to use your insurance and decide to pay out of pocket for services, we will not retroactively bill (back bill) your insurance for any sessions that have already been paid for.