Member Financial Policy
Welcome to Lyn! Our goal is to provide you with the care you need to help you reach your goals. As we work together to reach your goals, we may offer you additional care that may result in a cost to you. This policy identifies the services that are provided to you at no cost and the services that will result in a cost. Please read and sign this policy. If you have any questions, please let us know.
1. Our Care Model. Lyn provides two categories of services: Core Services and Additional Services. Lyn’s Core Services, which includes care management, care coordination, and healthcare navigation services are provided to you at no cost. Additional Services include virtual urgent care, mental health therapy visits, or doctor visits, which are subject to the fees outlined by your insurance provider.
2. Insurance. Because we partner with your employer, Lyn participates with your insurance plan. Lyn is considered an in-network provider. Lyn will bill your insurance provider for the Core Services and the Additional Services. Your Care Partner will collect your insurance information at the start of your first visit.
We must collect your insurance information found on your insurance card as proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the cost of the service.
3. Coverage changes. If you change jobs and your insurance changes, this may result in a change of coverage. Please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. This will help ensure you are not paying more than you need to pay. If you do not notify us of the change and we do not participate in your new insurance plan, then you will be billed directly for the full amount for all services provided to you within 30 days of the visit(s).
4. Member Cost Share. There are certain costs for healthcare services that are covered by insurance that you pay out of your own pocket. You and your insurance company share in the cost of the covered healthcare services. Your share of the costs generally includes deductibles, coinsurance, and copayments (copay).
Deductible: the amount you pay during the plan year for covered healthcare services before your health plan starts to pay through coinsurance.
Coinsurance: the percentage you pay for covered healthcare services after your deductible has been met.
Copayments or copay: the fixed amount you pay to your healthcare provider for a covered healthcare service. The dollar amount can vary by the type of service (doctor office visit vs. ER visit).
After receiving care, your share of the cost must be paid within 30 days of your visit. Failure on our part to collect your share of the cost can be considered insurance fraud. Please help us uphold the law by paying your cost share within 30 days of each visit. If you are having difficulty paying your cost share, please let us know as we can discuss a plan to assist you.
Note: Preventive services such as annual visits and the associated preventive screenings are generally not subject to cost share.
5. Non-covered services. Some of the Lyn Additional Services may not be covered by your insurance plan. However, we will tell you if the service is not covered by your insurance, before providing the service to you. If you choose to receive the non-covered service, you will be billed directly for the full amount for all services provided to you within 30 days of the visit(s).
6. Claims submission. We will submit your claims for the Core Services and the Additional Services to your insurance company, and will assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request.
7. Nonpayment. If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.
8. Good Faith Estimate. If you are uninsured or self-pay (ie. do not use insurance to pay for your services), you have the right to receive a “Good Faith Estimate” that explains how much your medical care will cost. Based on our record of your insurance status, or by request within 2 business days, we will provide you with a written Good Faith Estimate at least 1 business day before your visit. Make sure to save a copy or picture of your Good Faith Estimate. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
Thank you for understanding our financial policy. Please let us know if you have any questions or concerns.