Member financial policy

Welcome to Bend Health! We are happy you have chosen us as your Care Provider. Our mission is to provide the highest quality professional medical care and member satisfaction. To avoid confusion and meet our mission goals, Bend Health wants to make member financial responsibility clear and easy to understand.‍

Payment responsibility

‍Members or their legal representatives are responsible for charges for services rendered. Payment is expected at the time of service for all charges incurred for the current visit as well as any outstanding balances. For Insurance Plans that do not provide immediate member responsibility information, settlement of your outstanding balance can be accomplished via the credit card you have placed on file in your member account. We will charge your credit card on file for the outstanding balance you owe as soon as your Insurance Plan confirms your member responsibility. If the credit card on file is not able to satisfy your member responsibility with Bend Health, an invoice with the outstanding balance will be sent to you. Payment will be due upon receipt of the invoice.

Assignment of benefits

I authorize and request payment of all Health Plan benefits directly to Bend Health and authorize Bend Health to submit claims and pursue all appeal rights of any claim denials, reductions, and other adverse determinations on my behalf. I further authorize and assign to Bend Health the right to obtain all benefits and other relief available under my Health Plan(s) or Employment Retirement Income Security Act of 1974 (“ERISA”), including without limitation the right to obtain information on my Health Plan(s) and the basis for claim determinations

Release of Information

I authorize Bend Health to release to all Health Plans the medical information necessary to obtain approval for payment for my care and/or to process my claims. “Health Plan(s)” includes Centers for Medicare and Medicaid Services or its carriers or fiscal intermediaries, employee benefit plans, managed care plans, insurance companies, third-party payors, or Medicare or Medical Assistance and their agents or review agencies. The term “medical information” includes, but is not limited to, information related to psychological, psychiatric, HIV/AIDS, communicable diseases, and alcohol and drug abuse diagnosis and treatment.‍

Type of member payments

‍Insurance plans vary from member to member and service to service. Bend Health makes every attempt to verify member responsibility so that you are aware of out-of-pocket costs before being seen. Your insurance contract is between you and your insurance plan. Therefore, Bend Health cannot be held liable for unexpected member costs dictated by your insurance plan’s contract with you. If you have any questions regarding your contractual payment obligations, please contact your insurance plan directly.

Co-pays, co-insurance, and deductible for Bend services are based on your individual coverage. Bend Health services include case management, coaching, and may include therapy and psychiatry services based on clinical need. Your health insurance plan may not cover all services offered by Bend Health. For detailed benefits information, please contact your health plan.

To help you understand the types of charges you may see from Bend Health, we have provided definitions and examples of different types of member payment scenarios. All numbers used in these scenarios are examples, not actual amounts.

‍Co-payments‍

This is a specific dollar amount set by your insurance plan which you are required to pay for each visit with your Bend Health Care Provider. Payment inmost cases should be made prior to seeing your Provider.

Example: Your health plan allows $100 for your visit with us; you have a $30 copay as set by your insurance plan. You would pay Bend Health your $30 copay and your insurance plan would cover the remaining $70 (payable to Bend Health) to equal the $100 allowed amount

‍Deductibles

‍This is the amount a member needs to pay out-of-pocket before their insurance company covers any expenses.

Example: A member has a $1,000 deductible as set forth by your insurance plan. Your insurance plan allows $100 for your visit with us. You as the member would be responsible for paying that $100 for every visit until you have reached your $1000 deductible

NOTE: Deductibles are met through any services covered by your Insurance Plan, not just the services with BendHealth.

‍Co-insurance

‍This is a cost share agreement with your insurance company, which usually goes into effect after your deductible has been met, but before you have satisfied your out-of-pocket maximum. Some insurance plans do not have an out of pocket maximum and will always have a co-insurance agreement with you.

Example: You have an 80/20 co-insurance policy with your insurance company. This means they agree to pay 80% of allowed charges and expect you to pay the remaining 20%. Your health plan allows $100 for your visit with us, your insurance plan would pay Bend Health $80 and you would pay Bend Health $20.

‍Out-of-pocket maximum

‍This is set by your insurance plan. It is the maximum amount you would spend out-of-pocket to pay for co-payments, deductibles, and co-insurance before your insurance plan covers all costs.  

If you have a flexible spending account (FSA) or health saving account (HSA), you can use those pre-tax funds to pay for sessions with Bend Health.

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Non-covered services advanced notice

I acknowledge and agree that I am responsible for all charges for services provided to me that are not covered by my Plan or for which I am responsible for payment under my Plan. For example, I acknowledge that Bend Health Coaching and Case Management Services  may not be a covered service under my Plan. To the extent coverage is not available, or is limited, under my Plan, I acknowledge that I am responsible to Provider for all of the Provider's charges for services furnished, and I agree to pay Provider all charges not covered by my Plan.

Bend Health behavioral care services include Coaching and Care Management to ensure timely access to care and coordination with our internal care teams and your outside providers. Your health plan may not cover all Bend services and may consider the following as non-covered services or your responsibility:

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In cases where your health plan does not cover these services, these services will be charged to you as your responsibility. Bend Health will always attempt to bill your health plan first. Please check with your health insurance plan if you have any questions about your coverage.

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If you need further clarification or would like to speak with someone regarding the information provided above, please contact us at Billing@Bendhealth.com.