Payment & Insurance

Keeping excellent mental health care affordable for everyone

All clients seeking services at Peak Wellness Center will be served, regardless of ability to pay.

We work with many insurance carriers, and we’re happy to set up payment plans as needed. We also offer a sliding fee scale for clients at or below the federal poverty guidelines. (To learn more about the sliding fee scale, see our “Questions About Sliding Fee Scale” section below.)

Using your health insurance at Peak

We participate with the following insurance carriers:

  • Blue Cross Blue Shield (BCBS), including Federal BCBS and Kid Care CHIP
  • CIGNA (formerly Great West)
  • Medicare*
  • TRICARE*
  • RR Medicare*
  • Wyoming Medicaid

* If you are using Medicare or RR Medicare, you must see a Medicare-authorized LCSW, MD, DO, or Nurse Practitioner in order for Medicare/RR Medicare to pay. Please let us know if you’re using Medicare or RR Medicare when you make your appointment.
* If you are using TRICARE, you must be active duty and have a referral. They will only pay for visits to eligible providers, so please let us know you’re using TRICARE when you make your appointment.

What questions should I ask my insurance provider before I come in?

Before making your first appointment with us, you may want to contact your insurance provider and get the answers to these common questions:

  • Is Peak Wellness Center considered an “in-network” provider on your insurance plan?
  • Are there any authorizations required or steps you need to follow to make sure your insurance covers your care with us?
  • Are there any specific limitations on the type of provider you must see in order for insurance to cover the cost of your appointments at Peak?
  • What are your insurance benefits on your plan? (For example, are there limitations in the number of counseling appointments insurance will cover? Does your insurance cover prescription medications?)

What if my insurance requires me to see an “eligible provider?”

Some insurance companies will only reimburse for selected, eligible providers. For example, sometimes insurance will cover appointments with a psychiatrist, doctor, nurse practitioner or licensed clinical social worker, but the plan might not cover the cost of a parenting class or case management services.

When you make your appointment with us, we will make every effort to assign you to an eligible provider; however, we can’t guarantee the provider you see will be eligible for reimbursement by your insurance company. Should you choose to see an ineligible provider, you will be responsible for all uncovered charges incurred for the provider by whom you are seen.

What if my insurance doesn’t cover a specific Peak provider or service?

If your insurance doesn’t cover a specific Peak care provider or service in your treatment plan, we will then look at adjusting fees for our services, based on your income, to make sure they remain affordable for you.

Questions about the sliding fee scale

To make a request for discounted services, please visit the front desk of your local Peak Wellness Center office. Our friendly and helpful staff can answer any questions you might have, as well as assist you in filling out the required applications and paperwork.

How do I know if I qualify for the sliding fee scale?

Clients with incomes at or below 100% of poverty will receive a full 100% discount on their services at Peak. Those with incomes above 100% of poverty, but at or below 200% of poverty, will be charged according to the sliding fee scale. The sliding fee scale is updated during the first quarter of every calendar year with the latest federal poverty guidelines.

To qualify for the sliding fee scale, all alternative payment resources must be exhausted, including all third-party payment from insurance(s), Federal and State programs.

If I qualify for sliding scale, do I still need to pay for my visits to Peak?

Clients receiving a full discount will be assessed a $7 nominal fee per visit. However, clients will not be denied services due to an inability to pay. The nominal fee is not a threshold for receiving care and thus, is not a minimum fee or co-payment.

Can I qualify for the sliding fee scale if I have insurance coverage?

Under federal regulations, clients with insurance coverage do not qualify for the sliding fee scale.

 

Questions about the Sliding Fee Discount application process

We make discount mental health and substance abuse services available to all clients in need through a Sliding Fee Discount Application process. (Click here to download the application.)

The Sliding Fee Discount is based upon the annually published Federal Poverty Guidelines, establishing income and family size parameters for the Discount from full fee.

How does the Sliding Fee Discount Program work?

The Sliding Fee Discount Program procedure will be administered through the Chief Financial Officer or his/her designee. Information about the Sliding Fee Discount Program policy and procedure will be provided and assistance offered for completion of the application. Dignity and confidentiality will be respected for all who seek and/or are provided charitable services.

How do I apply for the Sliding Fee Discount Program?

The client/responsible party must complete the Sliding Fee Discount Program application in its entirety. By signing the Sliding Fee Discount Program application, persons authorize Peak Wellness Center access in confirming income as disclosed on the application form. Providing false information on a Sliding Fee Discount Program application will result in all Sliding Fee Discount Program discounts being revoked, and the full balance of the account(s) restored and payable immediately.

If an applicant is unable to be processed due to the need for additional information, the applicant has two weeks from the date of notification (date applicant notified PWC of need to apply for Program) to supply the necessary information without having the date on the application adjusted. If a client does not provide the requested information within the two-week time period, their application will be re-dated to the date on which they supply the requested information, and charges incurred in the interim period will be at the regular fee. Any accounts turned over for collection as a result of the client’s delay in providing information will not be considered for the Sliding Fee Discount Program.

How do I provide proof of income?

For income verification, applicants must provide one of the following:

  • Prior year tax return
  • W-2
  • Three most recent pay stubs
  • Letter from employer
  • Form 4506-T (if W-2 not filed)

Self-employed individuals will be required to submit detail of the most recent three months of income and expenses for the business. Adequate information must be made available to determine eligibility for the program. Self-declaration of income may only be used in special circumstances. Specific examples include participants who are homeless.

Clients who are unable to provide written verification must provide a signed statement of income, and why (s)he is unable to provide independent verification. This statement will be presented to Peak Wellness Center’s Chief Financial Officer or his/her designee for review and final determination as to the sliding fee percentage. Self-declared clients will be responsible for 100% of their charges until management determines the appropriate category.

If approved, how is my sliding fee scale discount decided upon?

Discounts will be based on income and family size only. Peak Wellness Center uses the Census Bureau definitions of each:

  • Income includes earnings, unemployment compensation, workers compensation, Social Security, Supplemental Security Income, public assistance, veterans’ payments, survivor benefits, pension or retirement income, interest, dividends, rents, royalties, income from estates, trusts, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Noncash benefits (such as food stamps and housing subsidies) do not count.
  • Family is defined as a group of two people or more (one of whom is the householder) related by birth, marriage, or adoption and residing together; all such people (including related subfamily members) are considered as members of one family.

 

Downloadable financial documents

 

Still have questions about payment and insurance for Peak services?

Contact your local Peak office