Dill-Standiford Psychological Asscociates, Incorporated

January 27, 2017Dear [redacted],Dill-Standiford Psychological Associates has been providing mental health assessment and treatment services to individuals and families in Bucks County and surrounding areas for almost 20 years. A primary goal of our practice is to make psychological assessment and...

treatment accessible to as many individuals in our community as possible. As such, we accept a number of insurance plans. In fact, we remain one of the few established psychological practices in the community that will bill and accept payment directly from insurance companies. As a courtesy to our patients, a member of our office staff makes contact with a representative of each patient's insurance company to obtain information regarding the patient's coverage with our office. We also encourage our patients to call their insurance carrier as well, because their health insurance belongs to them and it is ultimately their responsibility to know what services their plan covers, as well as the out of pocket costs associated with these services. All deductibles, co-pays and co-insurance amounts are part of the patient's agreement with their insurance company and are the patient's responsibility. Unfortunately, there are times when the information provided to our office is incorrect. We do not become aware of this until the services we provide are submitted to the insurance company and payment is ultimately received. This can take several weeks or months, depending upon the carrier. At this point, both the patient and the provider receive an explanation of benefits from the insurance carrier. This document indicates the fees that were paid by the insurance company for each service provided, and the fees that remain the responsibility of the patient. The charges associated with each type of service are set by the insurance company, not the provider. If a provider charges a patient less than what the insurance company determines to be the patient's financial responsibility, it is considered insurance fraud and is punishable by law. It was unfortunate that our office staff was given inaccurate information by the insurance representative in the case in question, but we cannot change the patient's financial responsibility. This is determined solely by the insurance company. The patient has access to the same explanation of benefits document sent to the provider, and this document indicates the exact amount that was paid to the provider by the insurance company and the exact amount to be paid by the patient. In the case in question, the insurance company determined that the patient's responsibility totaled $1,221.00. The patient in this case paid a total of $900.00 to our office. Thus, $321.00 is actually still owed by the patient to our office.A copy of DSPA's financial policy guide, which is provided to every patient on the first date of service, is included with this letter for reference. Every patient seen in our practice is given a copy of this financial policy guide, as well as information on the fees associated with each service to be provided, and they sign a document indicating that they have read and understand the information before services are rendered.I trust that this explanation will clarify the concerns and questions of all parties. If this is not the case, please address any further questions in writing to Dr. Dill-Standiford.Respectfully submitted,Teresa D. Ph.D. Founder and Clinical Director