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Paying for Services

We understand that healthcare billing can be confusing.  We are here to help you through the process. INcompass Healthcare will not deny access to services solely because of the inability to pay. Below are resources available to you online. Our Billing department is also available by calling (812) 537–1302.

Insurance & Billing

We strive to make the billing process as seamless as possible for our clients.  If you have questions at any time during the process, our Billing department is available to assist with any questions.  Below we have included responses to commonly asked questions.

In Person

You can make a payment in person at any of our office locations

Online

Click the ‘Pay Bill’ button for our convenient, online payment option

By Mail

Mail payments to: INcompass Healthcare
285 Bielby Rd
Lawrenceburg, IN 47025

By Phone

Calling the Billing department at              (812) 537 – 1302

COLLECTION ITEMS
In the case of non-payment after 90 days from the date of the billing statement, INcompass Healtchare will forward your financial account information to an independent letter service that will deliver up to seven reminders via mail and phone call regarding your balance. At that time, you can either pay your bill in full or make payment arrangements with our billing department. You can apply for financial assistance at that time as well, if you have not already done so. If no payment is received, or if payment arrangement is not established after completion of the letter service, your account will be forwarded to a collection agency.

Financial Assistance

FINANCIAL ASSISTANCE POLICY
INcompass Healthcare offers financial assistance for care provided to eligible individuals and families. As a nonprofit health care organization, INcompass Healthcare is dedicated to supporting the patients and communities we serve through better health and better health care. The Financial Assistance Policy covers all INcompass Healthcare providers delivering emergency or medically necessary care in the hospital facility or in an outpatient office.

All patients are treated with respect and fairness. You may be eligible for assistance if you show you have financial need and provide our staff with necessary information regarding your income. Discounts will be based on household income and size. Discounts under this policy do not apply to co-insurance, deductibles, and co-payments, except where specifically noted.

APPLYING FOR FINANCIAL ASSISTANCE
You may apply for financial assistance at any time – before, during or after your care – up to 240 days after the first billing statement date.

To apply for Financial Assistance

  • Fill out the Request for Financial Assistance Policy (FAP) Application form (Click here for the FAP Application Form)
  • Include the supporting documents listed on the form
  • Submit to the form and supporting documents to INcompass Healthcare staff who will determine your eligibility

If approved, financial assistance will be in effect for 12 months from the date of approval, or until your financial circumstances change, whichever comes first.

INCOME GUIDELINES FOR FINANCIAL ASSISTANCE
The amount of financial assistance you may receive is based upon Federal Poverty Level information established by U.S. government each year. In addition to your income, the discount will also consider your family size. (Click here for Subsidy Calculator)

Price Transparency

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • Any patient may request an estimate of the expected charges for non-emergency health care services that have been ordered, scheduled, or referred and health care providers and facilities are required provide you with an estimate of the expected bill for medical items and services within 5 business days of the request.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

Click here for additional information related to your rights and protections against surprise medical bills.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

If you would like to receive an estimate, please contact our Billing Department at (812) 537 – 1302.  Please be prepared to provide client name, date of birth, location of appointment, and specific service so that we are best able to estimate cost.

Charge Master

The Charge Master outlines the standard billable costs charged for services provided.  Charges are the same for all patients, but a patient’s responsibility and out-of-pocket expenses (i.e. deductible, co-insurance, copays, etc.) may vary based upon insurance coverage and/or qualification for financial assistance.  Patients can contact our Billing Department at (812) 537 – 1302 to determine whether they qualify for discounts.  Please understand that few patients will pay the full charge amount listed due to insurance coverage and/or financial assistance discounts in place.

To view a copy of the current Charge Master, click here

For a PDF version, click here

CODEDESCRIPTION
RATE
5CLINICAL ASSESSMENT
$286.88/HOUR
9INDIVIDUAL THERAPY
$286.88/HOUR
10MARITAL/COUPLES THERAPY$260.00/HOUR
11FAMILY THERAPY$260.00/HOUR
12FAMILY SUPPORT GROUP$25.00/EVENT
13FAMILY GROUP THERAPY$25.00/EVENT
14GROUP PSYCHOTHERAPY$136.40/EVENT
16PEER SUPPORT SERVICES$177.00/HOUR
171SUD GROUP$106.40/EVENT
175IOP GROUP$106.40/EVENT
18PSYCHOLOGICAL INTERVIEW/TESTING$120.00/HOUR
19ANGER MANAGEMENT GROUP$25.00/EVENT
20FAMILY W/O PATIENT PRESENT$260.00/HOUR
21EMERGENCY SERVICES/DAYTIME$100.00/HOUR
22EMERGENCY SERVICES/AFTER HOURS$200.00/HOUR
24DBT GROUP$136.40/EVENT
25COACHING DBTNO RATE
30SSA CHILD MSE$148.00/EVENT
31SSA ADULT MSE$148.00/EVENT
32SSA WAIS IV$125.00/EVENT
33SSA WISC IV$125.00/EVENT
34SSA BAYLEY$160.00/EVENT
35SSA STANFORD BINET V$140.00/EVENT
36SSA WPPSI$95.00/EVENT
37SSA WMS IV$200.00/EVENT
38SSA VINELAND ADAPT$160.00/EVENT
39AT RISK ASSESSMENT$65.00/HOUR
50HB FAM CENTERED THERAPY$98.40/HOUR
51DCS HOME BASED ASSESSMENT$80.00/HOUR
52DCS REPORT$78.76/HOUR
53PARENT EDUCATION GROUP$25.00/GROUP
54HOMEMAKER SERVICES$54.36/HOUR
55PARENT EDUCATION INDIVIDUAL$80.32/HOUR
56PARENTING/FAM FUNCT ASSESS$68.40/HOUR
57HB FAM CENTER CASEWK SUPER VISIT$79.32/HOUR
58VISIT FACILITAT P/C/S SUPERVISED VIS$54.36/HOUR
59COUNSELING SUPERVISED VISITATION$67.12/HOUR
60HOMEMAKER SUPERVISED VISITATION$54.36/HOUR
61HB FAM CASEWORK FACE TO FACE$79.32/HOUR
62HB FAM CEN THERAPY SUP VISITATION$98.36/HOUR
63CARE NETWORK$60.00/HOUR
64DCS COUNSELING TEAM MTG$64.00/HOUR
65DCS WRAPAROUND PER DIEM$965.49/EVENT
66COUNSELING THERAPY$68.40/HOUR
67RECOVERY COACH$80.00/HOUR
68PRESERVATION PER DIEM$113.47/EVENT
69PRESERVATION WEEKLY SAFETY CK$0.00
70PRESERVATION CONTACT TRACKING$0.00
71PRESERVATION CHILD PER DIEM$24.50/EVENT
72PRESERVATION MONTHLY MEETING$0.00
250WRAPAROUND FACILITATION$115.00/HOUR
251WRAPAROUND TECHNICIAN$104.56/HOUR
252HABILITATION$85.60/HOUR
253RESPITE CARE$16.00/HOUR
254CRISIS RESPITE$15.00/HOUR
255NON-MEDICAID TRANSPORATION$5.00/ONE WAY TRIP
256THERAPEUTIC SERVICES$90.00/HOUR
257TRAINING AND SUPPORT$60.00/HOUR
258FLEX FUNDS$ FOR $
331INITIAL HOSPITAL CONSULT$165.00/HOUR
336SUBSEQUENT HOSPITAL CONSULT$165.00/HOUR
361IPU PHYSICAL$125.00/EVENT
366IPU PHYSICAL FOLLOW UP$60.00/EVENT
381INITIAL IPU PHYSICIAN ROUND$85.00/EVENT
382INITIAL IPU PHYSICIAN ROUND$140.00/EVENT
383INITIAL IPU PHYSICIAN ROUND$190.00/EVENT
391SUBSEQUENT IPU PHYSICIAN ROUND$45.00/EVENT
392SUBSEQUENT IPU PHYSICIAN ROUND$75.00/EVENT
393SUBSEQUENT IPU PHYSICIAN ROUND$100.00/EVENT
41INPATIENT DAY OF CARE$1000.00/EVENT
42THERAPEUTIC LEAVE DAY$85.00/EVENT
43ISOLATION MONITORING$45.00/HOUR
490MEDICINAL SUPPLIESCOST*
491PHARMACY SERVICESCOST*
492LABORATORY SERVICESCOST*
493RADIOLOGY SERVICESCOST*
494ELECTROCARDIOLOGY SERVICESCOST*
495RESPIRATORY THERAPYCOST*
496PHYSICAL THERAPYCOST*
497NUCLEAR MEDICINE SERVICESCOST*
499OTHER HOSPITAL SERVICESCOST*
9500FACILITY CHG FOR SERVICE 05$146.88/EVENT
9501FACILITY CHG FOR SERVICE 09 1/2 HR$146.88/EVENT
9502FACILITY CHG FOR SERVICE 09 1 HR$146.88/EVENT
9503FACILITY CHG FOR SERVICE 09 1 1/2 HR$146.88/EVENT
9504FACILITY CHG FOR SERVICE 10$100.00/EVENT
9505FACILITY CHG FOR SERVICE 11$100.00/EVENT
9506FACILITY CHG FOR SERVICE 13$50.00/EVENT
9507FACILITY CHG FOR SERVICE 14$73.44/EVENT
9508FACILITY CHG FOR SERVICE 20$100.00/EVENT
9509FACILITY CHG FOR SERVICE 171/175$71.40/EVENT
9510FACILITY CHG FOR SERVICE 311$60.00/EVENT
9511FACILITY CHG FOR SERVICE 16$146.88/EVENT
9600FACILITY CHG FOR SERVICE 99201$146.88/EVENT
9601FACILITY CHG FOR SERVICE 99202$146.88/EVENT
9602FACILITY CHG FOR SERVICE 99203$146.88/EVENT
9603FACILITY CHG FOR SERVICE 99204$146.88/EVENT
9604FACILITY CHG FOR SERVIC E 99205$146.88/EVENT
9605FACILITY CHG FOR SERVICE 99211$146.88/EVENT
9606FACILITY CHG FOR SERVICE 99212$146.88/EVENT
9607FACILITY CHG FOR SERVICE 99213$146.88/EVENT
9608FACILITY CHG FOR SERVICE 99214$146.88/EVENT
9609FACILITY CHG FOR SERVICE 99215$146.88/EVENT
9610FACILITY CHG FOR SERVICE 99495$100.00/EVENT

 

 

* Actual charge for supplies/services received

 

 

CODEDESCRIPTIONRATE
100MRO LON DETERMINATION$77.72/EVENT
101MRO INDIVIDUAL COUNSELING$114.60/HOUR
102MRO GROUP COUNSELING$28.64/HOUR
103MRO FAMILY WITH CONSUMER$114.60/HOUR
104MRO FAMILY WITHOUT CONSUMER$114.60/HOUR
105MRO FAMILY GROUP WITH CONSUMER$28.64/HOUR
106MRO FAMILY GROUP W/O CONSUMER$28.64/HOUR
107MRO MED TRAINING AND SUPPORT$74.48/HOUR
108MRO MED TRAINING GROUP$13.40/HOUR
109MRO MED TRAINING FAMILY$74.48/HOUR
110MRO MED TRAIN FAM GRP W/O CON$13.40/HOUR
111MRO MED TRAIN FAM WITH CON$84.48/HOUR
112MRO MED TRAIN FAM GRP WITH CON$13.40/HOUR
113MRO SKILLS TRAINING AND DEV IND$104.56/HOUR
114MRO SKILLS TRAINING GROUP$18.84/HOUR
115MRO SKILLS TRAIN FAMILY W/O CON$104.56/HOUR
116MRO SKILLS TRAIN FAM GRP W/O CONS$18.84/HOUR
117MRO SKILLS TRAIN FAMILY WITH CON$104.56/HOUR
118MRO SKILLS TRAIN FAM GRP WITH CON$18.84/HOUR
119MRO CASE MANAGEMENT$58.12/HOUR
120MRO CRISIS INTERVENTION134.88/HOUR
121MRO PSYCH INTERVENT FACE TO FACE$122.48/HOUR
122MRO PSYCH INTERVENT NON FACE TO$73.48/HOUR
123MRO CAIRS$58.48/HOUR
124MRO AIRS$58.48/HOUR
125MRO INTENSIVE OUTPATIENT$174.96/3 HOUR
126MRO ADDICTION COUNSELING IND$58.32/HOUR
127MRO ADDICT FAMILY WITH CON$58.32/HOUR
128MRO ADDICT FAMILY W/O CON$14.58/HOUR
129MRO ADDICTION GROUP$14.58/HOUR
130MRO ADDICT FAM GROUP WITH CON$14.58/HOUR
131MRO ADDICT FAM GROUP W/O CON$14.58/HOUR
132MRO PEER RECOVERY SERVICES$34.20/HOUR
133MRO PSYCH INTERVENT – APN$122.48/HOUR
134MRO PSYCH INTERVENT – APN NON FTF$73.48/HOUR
135MRO SKILLS TRN SUPERVISED VISIT$104.56/HOUR
136BPHC Care Coordination$58.12/HOUR
142PRIME FOR LIFE260.00/EVENT
580SCREENING/PRE-VOCATIONAL REFERRAL$0.00
581DISCOVERY$42.00/HOUR
582WORK EXPERIENCE DEVELOPMENT$42.00/HOUR
583WORK EXPERIENCE A 1-5 HOURS/WEEK$200.00/WEEK
584WORK EXPERIENCE B 6-10 HOURS/WEEK$325.00/WEEK
585WORK EXPERIENCE C 11+ HOURS/WEEK$450.00/WEEK
586JOB READINESS TRAINING$42.00/HOUR
587JOB SEARCH AND PLACEMENT ASSISST$42.00/HOUR
588EMPLOYMENT MILESTONE 1$1300.00/EVENT
589EMPLOYMENT MILESTONE 2$1500.00/EVENT
590EMPLOYMENT MILESTONE 3$1300.00/EVENT
591ON THE JOB SUPPORTS SHORT TERM$42.00/HOUR
592SUPPORT EMPLOYMENT 1-5 HRS/MTH$176.00/MONTH
593SUPPORT EMPLOYMENT 6-10 HRS/MTH$352.00/MONTH
594SUPPORT EMPLOYMENT 11-15 HRS/MTH$528.00/MONTH
595SUPPORT EMPLOYMENT 16-20 HRS/MTH$720.00/MONTH
596SUPPORT EMPLOYMENT 21-25 HRS/MTH$920.00/MONTH
597SUPPORT EMPLOYMENT 26-30 HRS/MTH$1120.00/MTH
598SUPPORTED EMPLOYMENT HOURLY$42.00/HOUR
599BENEFITS ANALYSIS$500.00/EVENT
600LEVEL OF CARE CONSULTATION$100.00/HOUR
601COMPETENCY EVALUATION$100.00/HOUR
602ADHD EVALUATION$97.00/HOUR
603WALK IN CLINIC EVALUATION$240.00/HOUR
604BARIATRIC EVALUATION$100.00/HOUR
605MEDICAID DISABILITY EVALUATION$80.00/HOUR
606SOCIAL SECURITY DISABILITY EVAL$100.00/EVENT
607STERLING EVALUATION$93.48/HOUR
608PARENTING ASSESSMENT$97.00/HOUR
609JAIL CONSULTS$100.00/HOUR
610PASARR EVALUATION$100.00/HOUR
611DRUG AND ALCOHOL EVALUATION$100.00/EVENT
80TELEPHONE EMERGENCIES$0.00
83INTERN TRACKING$0.00
84TESTIMONY/DEPOSITION$200.00/EVENT
85BRIDGE DEVICE$800.00/EVENT
88INTERPRETER SERVICES$75.00/HOUR
89DRUG TESTING$15.00/EVENT
95INFORMATION/REFERRAL$0.00
96DOCUMENTATION ONLY$0.00
3410RN STAFF EDUCATION$0.00
3411RN MEDICATION AUDIT$0.00
3412RN CONSULTATION$0.00
3413RN TB TESTING$0.00
99201NEW PATIENT STRAIGHTFORWARD$178.88/EVENT
99202NEW PATIENT EXPANDED$200.88/EVENT
99203NEW PATIENT DETAILED$231.88/EVENT
99204NEW PATIENT COMPREHENSIVE$276.88/EVENT
99205NEW PATIENT HIGH COMPLEXITY$326.88/EVENT
99211ESTABLISHED PATIENT MINIMAL COMPLEX$162.88/EVENT
99212ESTABLISHED PATIENT STRAIGHTFORWARD$191.88/EVENT
99213ESTABLISHED PATIENT LOW COMPLEX$216.88/EVENT
99214ESTABLISHED PATIENT MODERATE$246.88/EVENT
99215ESTABLISHED PATIENT HIGH COMPLEX$286.88/EVENT
99216SMOKING CESSATION$15.00/EVENT
99495TRANSITIONAL CARE EVALUATION$262.80/EVENT
T9201TELEHEALTH NEW PT STRAIGHTFORWARD$178.88/EVENT
T9202TELEHEALTH NEW PT EXPANDED$200.88/EVENT
T9203TELEHEALTH NEW PT DETAILED$231.88/EVENT
T9204TELEHEALTH NEW PT COMPREHENSIVE$276.88/EVENT
T9205TELEHEALTH NEW PT HIGH COMPLEXITY$326.88/EVENT
T9211TELEHEALTH ESTAB PT MINIMAL COMPLEX$162.88/EVENT
T9212TELEHEALTH ESTAB PT STRAIGHTFORWARD$191.88/EVENT
T9213TELEHEALTH ESTAB PT LOW COMPLEX$216.88/EVENT
T9214TELEHEALTH ESTAB PT MODERATE$246.88/EVENT
T9215TELEHEALTH ESTAB PT HIGH COMPLEXITY$286.88/EVENT
T3014TELEHEALTH SPOKE SITE$35.00/EVENT
69290EAR IRRIGATION$15.00/EVENT
82948GLUCOSE$15.00/EVENT
96372IM INJECTION$25.00/EVENT
87804RAPID FLU SWAB$20.00/EVENT
87880RAPID STREP$20.00/EVENT
81025URINE PREGNANCY$10.00/EVENT
99364VENIPUNCTURE$10.00/EVENT

 

FAQ’s

What forms of payment are accepted?

We accept cash, personal checks, money orders, FSA, HRA, HSA, debit card, as well as VISA, MasterCard, Discover, and American Express.

Will you accept my insurance plan?

We accept the majority of the insurance providers in our area including Medicaid, Healthy Indiana Plan (HIP), and Medicare; however, please contact your insurance provider to see if we are in your network. On the front or the back of your insurance card you will find a phone number that will allow you to contact your insurance provider directly to determine if we are in or out of network.

Will any of my services not be covered by insurance?

It is your primary responsibility to contact your insurance provider to make sure the services you are receiving will be covered by insurance. You will want to make sure both the service and the provider you are seeing are covered by your insurance plan.

What if I don’t have insurance?

We will evaluate and treat anyone who is experiencing a medical emergency, regardless of your ability to pay. For clients without insurance, we will assist you with obtaining coverage, if eligible. At the first visit, we can assist you with applying for presumptive eligibility.  If approved, this will provide temporary coverage.  We can also assist with the full application to receive Medicaid benefits.   

Do you offer any form of financial assistance?

We have a Finance Assistance program to help individuals in need of service who are not otherwise able to afford care.

When or will I receive a statement for services?

We process client statements monthly. Typically, you will receive a statement by the middle of the month for the previous months’ services if an amount is due. If you have insurance coverage, you will receive a statement after the claim has been processed with your insurance provider.  The amount of time for processing varies by provider.  You will continue to receive a monthly statement until your balance paid in full.  If not paid in full after 3 statements or arrangements have not been made with Billing department, the account is referred to outside vendor for collections.