Highland Springs is in-network with most major insurance providers and we can often work with other insurers on an out-of-network basis. We encourage you to call us to confirm the status of your insurance company.
Verifying Benefits & Coverage
Please contact your insurance provider and verify your coverage for specific services.
Here are some questions you should ask your insurance provider:
Do I have mental health benefits?
Will you cover the programs that Highland Springs provides?
How much is my deductible?
How many visits per year are covered?
Please call 216-302-3070 if you have any questions about your insurance coverage.
Payment & Billing
Those who visit us should be able to concentrate on getting better. That’s why we have a trained financial counselor to walk you through your insurance coverage and what other options are available for you. If you have any questions about your account, please call 216-302-3070 and ask for the Business Office.
It is our intent with this website to provide uninsured patients with information related to financial obligations for healthcare services. View our detailed price list for more information.
The pricing information provided is strictly an estimate of prices, and Highland Springs cannot guarantee the accuracy of any estimates. The amount that patients pay is determined by their health insurance coverage. This price list does not apply to patients with some form of insurance, including Governmental coverage such as Medicare or Medicaid. Pricing is for specific services listed, and does not include complicating factors or services provided by independent practitioners.
Patient Rights and Protections
Against Surprise Medical Bills Disclosure Notice
Patients who receive emergency care or treatment by an out-of-network provider at an in-network hospital or ambulatory surgical center, are protected from surprise billing or balance billing.
These Rights and Protections generally apply to items and services provided to individuals enrolled in group health plans, group or individual health insurance coverage and Federal Employees Health Benefits plans. These Rights and Protections do not apply to individuals through programs like Medicare, Medicaid, Indiana Health Services, Veterans Affairs Health Care or TRICARE. These programs have other protections against high medical bills.
What is balance billing?
When you see a physician or other health care provider, you may owe certain out-of-pocket costs, such as a co-payment, co-insurance and/or a deductible. You may also have other costs or have to pay the entire bill if you see a health care provider or visit a health care facility that isn’t in your health care plan’s network.
Out-of-Network describes health care providers and facilities that haven’t signed a contract with your health insurance plan. Out-of-network health care providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count towards your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you cannot control who is involved in your care – – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network health care provider.
You are protected from balance billing for:
Emergency Services
If you have an emergency medical condition and get emergency services from an out-of-network health care provider or facility, the most that the health care provider or facility may bill you is your plan’s in-network cost-sharing amount, such as co-payments and co-insurance. You cannot be balance billed for these emergency services. This included services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain health care providers at these facilities may be out-of-network. In these cases, the most that these providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These health care providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you receive other services at these in-network facilities, out-of-network providers cannot balance bill you, unless you give written consent and give up your protections.
You are not required to give up your protections from balance billing. You are also not required to receive care out-of-network. You may choose a provider or a facility in your plan’s network.
When balance billing isn’t allowed, you have the following protections:
You are only responsible for paying your share of the cost, such as co-payments, co-insurance, and deductibles that you would pay if the provider or facility was in-network. Your health insurance plan will pay out-of-network providers and facilities directly.
Your health insurance plan generally must:
Cover emergency services without requiring you to get approval for services in advance (Prior authorization);
Cover emergency services by out-of-network providers;
Base what you owe the health care provider or facility (cost-sharing) on what it would pay an in-network health care provider or facility and show that amount in your explanation of benefits;
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you have been wrongly billed, you may contact Springstone’s Compliance Department at Compliance@spsh.com or the U.S. Department for Health and Human Services at 800/985-3059. You may also visit www.cms.gov/nosurprises for more information regarding the No Surprise Act and payment disputes.
