Thank you for choosing Momentum Counseling for your behavioral health needs. To streamline our billing and payment system and to provide a seamless, convenient way for patients to pay their bills, effective October 1st, 2020, Momentum Counseling will require all patients keep an active credit card on file with us. We will bill your insurance company first and upon their determination of benefits, we will only charge your credit card when they inform us of patient responsibility. Circumstances when your card would be charged include but are not limited to: missed or canceled sessions without 24 hour notice, missed copayments, deductible and coinsurance, any non-covered services and/or denial of services, as well as any current balance on your account.
Once your insurance has processed your claims, they will send an Explanation of Benefits (EOB) to both you and our office showing the amount of your total patient responsibility. You will typically receive the EOB before we do, so if you disagree with the patient responsibility balance owed, it is your responsibility to contact your insurance carrier immediately.
When we receive the EOB, we will enter all pertinent payment information into our system. At that time, any remaining balance owed by you will be charged to your credit card and a copy of the charge will be sent to you.
If the credit card we have on file for you changes, please notify us immediately by completing this form with the new card details. It is not uncommon for people to change or cancel their credit cards for various reasons, including when a credit card expires.
If there is a problem with your bill/claim and it is brought to our attention after your credit card payment processes, we will investigate it and if we owe you the money, we will refund it to the same card in a timely manner. We understand that there are legitimate reasons that you may not have a credit card. If this is the case, you are welcome to leave an HSA (Health Savings Account) or Flex Plan Card on File.