Luna collects your insurance information before scheduling appointments and verifies your benefits with your insurance company. Our team provides this information by accessing insurance portals specifically designed for providers to review your coverage and determine your eligibility for benefits. Luna then relays your deductibles, co-pay/co-insurance, and other relevant coverage information back to you.
Deductible - The amount a patient pays for health care services before their health insurance begins to pay for visits/services. This is typically reset annually, at the time of insurance renewal. A patient is responsible for the entire cost of health services received until the patient has paid the deductible amount for health services.
Example: If your deductible is $1000, you must pay $1000 for any health service covered by your plan before your insurance will begin to cover a portion of health service costs.
Co-pay - The fixed amount a patient pays for a health care service, determined by the insurance company for a specific service, paid for at the time of service.
Example: If your co-pay is listed as $25, you will pay $25 for your health service, after your deductible has been covered. Your insurance plan will pay the remaining balance of the bill.
Co-insurance - The percentage of a medical charge that a patient pays after a deductible has been met, with the rest paid by your health insurance plan.
Example: If your co-insurance is listed as 10%, you will pay 10% of the payment that has already been made by your insurance carrier for the claim, after your deductible has been covered.
Total treatment days allowed per calendar year - Some plans designate a fixed amount of physical therapy sessions that they will cover for a calendar year.
Your email contains the amounts verified by the Luna Concierge through your insurance carrier’s portal.
A benefits verification email contains the following information (amounts are for example only):
Deductible: $500
Co-pay: $25 (payable at each visit)
Co-insurance: 0%
Total Treatment Days Allowed Per Calendar Year: 30
For a patient who has not met their deductible, the patient is responsible for the entire cost of the session, which is determined by the treatment performed by the therapist. Luna relays information about your therapy sessions (dates and costs) to your insurance company, who then applies it to your deductible.
Once the patient has reached their deductible amount, the deductible has been met for the year. All future Luna sessions are then paid for by the insurance company and the patient pays either a co-pay for treatment (a fixed amount), co-insurance (a percentage of the cost of the care provided), or potentially nothing if you’ve met your maximum out-of-pocket amount.
Luna contracts with many insurance carriers. For all other insurance carriers, PPO patients are permitted to see providers that are considered out-of-network. Insurance carriers provide a schedule of fees for out-of-network providers to their PPO patients, that contain specified amounts for deductibles, copays, and co-insurances.
Insurance carriers typically renew with their customers annually and the benefits reset. Often coinciding with a new calendar year, deductibles reset to their original amount. Also, if you have recently changed insurance plans, Luna needs to be notified of your new insurance information and also verify your benefits at your new carrier.
If you have changed insurance carriers, please call Luna in advance of your next session. Luna will document and verify your new benefits and advise you of the new requirements under your new policy.
Luna recommends that patients familiarize themselves with their insurance plans and understand their benefits. To find out your benefits, please call the number on the back of your insurance card. Insurance carriers are well-equipped to answer all of your benefits questions.
We’re here to help! For detailed questions about your specific insurance benefits and claim status, our Billing team can be reached by email or by calling 866-806-3599 and following the prompt for Billing questions.
