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 service in your treatment plan, you will be responsible for the fee associated with the service. These services are called “Underinsured Services” because you have insurance, but it does not cover the service. These services may be available to you at a discount, if you qualify for discounted services under the Sliding Fee Discount Policy.

Medicare and Medicaid clients will be asked to complete an Advance Beneficiary Notice (ABN), which describes the service, the reason that the service is not a covered service, and the full fee for the service.

Questions about the sliding fee scale

To make a request for discounted services, please call 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?

All clients who come to Peak Wellness Center for behavior health services are assessed for eligibility for a Sliding Fee Discount unless they refuse.  We do this to ensure that if it is clinically appropriate for you to receive services that are not covered by insurance (underinsured services) that you can afford these services.  The Sliding Fee Discount is a “Payer of Last Resort” discount that is supported with a subsidy from the State of Wyoming Department of Health and follows Federal Poverty Guidelines of Income and Family size for this subsidy.

Clients with documented incomes at or below 100% of poverty will be charged a Minimum Fee on their services at Peak. This Minimum Fee is a substantial discount from the full fee for the service and is the greatest discount available based upon income and family size.  There are also 4 tiers of eligibility between 100% and 200% of Federal Poverty Guidelines, each with a related discount from full fee.  Federal Poverty Guidelines are updated during the first quarter of every calendar year.

To qualify for the Sliding Fee Discount, all alternative payment resources must be exhausted, including all third-party payment from insurance(s), Federal and State programs.  Peak cannot accept payment from any other payer (DFS, DVR, etc.) for any amounts due from clients which have been processed with the Sliding Fee Discount.

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

Payment for all services at Peak Wellness Center are due when the service is rendered.  This includes Minimum Fee services.   If you are experiencing a Financial Hardship, please speak with the front desk staff as soon as possible.  You may qualify for a Payment Plan or Financial Hardship discount.  A separate application is available for that process.

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?

Clients who wish to receive discounted services must provide written income documentation upon entry into service to qualify for the discounts.  The client/responsible party must complete the Sliding Fee Discount Program application in its entirety. Your Federal Tax Return is the best source of income documentation.  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.

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.

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