I got a call from PRA stating I have a Deductible and co-insurance, what does that mean?click to see answer
Here are some insurance terms with definitions that may help.
- Deductible: The amount you'll pay for covered services before your health insurance plan contributes that reset at the end of the insurance policy year or calendar year. Deductibles vary by insurance carrier. If there is both an individual and family deductible, mental health benefits may apply to both accumulations.
- Co-Pay: A pre-determined dollar amount you will pay a healthcare provider for a covered service at the time of the visit. Co-payments vary from plan to plan.
- In-Network vs Out-of-Network: In-network providers that are a part of a health insurance plan’s network will typically cost less than services outside-of-network. This cheaper, negotiated rate is due to a discount in exchange for insurance company referrals.
- Coinsurance: The percentage of covered services you’re responsible to pay, while your insurance covers the other percentage. For example, if your insurance covers 80%, you’ll be responsible for the remaining 20%.
- Maximum Out-of-Pocket: Your out-of-pocket maximum is the maximum amount of money you will pay for covered services during the course of a benefit period. The out-of-pocket maximum varies from plan to plan, but can include co-pays, deductibles and co-insurance. Once you’ve paid your full out-of-pocket maximum, your insurance will play 100% of the allowed amount for your covered healthcare expenses.
I see two different clinicians at PRA but when I log into the Patient Portal, I don’t see any balance, even though the front desk says I owe?click to see answer
What are the requirements for in-person sessions? Is my therapist or prescriber vaccinated?click to see answer
All of our therapists and prescribers have received the COVID-19 vaccine. We ask that clients coming for in-person sessions are also vaccinated or wear a mask during the session. Some therapists or prescribers, might ask that unvaccinated persons receive services via telehealth -- this is for the health and safety of our office and other clients and has the added benefit of us being able to see your facial expressions during your session.
What is the difference between a psychiatrist, psychologist, social worker or counselor?click to see answer
PRA Clinicians range in areas of expertise, education and professional style and work together to provide comprehensive treatment.
- Psychiatrists Psychiatrists are physicians/medical doctors (MD’s or DO’s) and their primary focus is to provide psychiatric evaluations and medication management for those individuals needing a biological approach to treatment along with therapy. DO’s are Doctors of Osteopathic Medicine – they are physicians but got their training through a program that focuses on holistic medicine and emphasis on achievement of normal body mechanics as central to maintaining good health. (see below for more info).
- Psychologists Psychologists have a doctorate degree in psychology and provide psychotherapy services which include but are not limited to individual, family, couples and group sessions. Some of our psychologists also specialize in providing psychological and neuro-psychological testing services to help define and differentiate between problem areas.
- Master level therapists Master level therapists consist of either LCPC’s which are Licensed Clinical Professional Counselors or LCSW’s which are Licensed Clinical Social Workers. Like psychologists, they provide counseling services to individuals, families, couples and groups. LCPC’s and LCSW’s are not trained in the area of psychological testing.
Differences between MD and DO
Today, the training of osteopathic physicians is virtually identical to that of M.D. physicians. Osteopathic physicians use all conventional methods of diagnosis and treatment but are trained to place additional emphasis on the achievement of normal body mechanics as central to maintaining good health. D.O. physicians receive training in Osteopathic Manipulative Medicine (OMM), a form of manual therapy shown to be of some benefit for patients with certain musculo-skeletal disorders.
What is the difference between the Telehealth Link box and Patient Portal? Can I do telehealth with my provider through the patient portal?click to see answer
You CANNOT access Telehealth link through the patient portal. You can only access telehealth link by pressing the yellow flashing link on our website - the Telehealth link is the same for every visit with your clinician. You just click the yellow flashing Telehealth link which takes you to the Telehealth tab. Find your clinician's name and click the link to the right of their name to enter their waiting room. Your clinical will start session when ready.
PORTAL - this requires an user name and password. The portal has information of when your next appointment is scheduled, they type of appointment that is scheduled (telehealth or In House/In person) and all billing/statements and financial information with that provider. **Please note - Each provider you see will have a different portal, they are not merged or the same. You can obtain different user names for each portal account by requesting it through the Contact Us page on our website. Make sure to include your email and clinician and patient name you want access to the portal for. A link will be sent to you with the user name for that provider.