Payment/Insurance

Billing Information:

We are the safety net for our communities, delivering compassionate, dignified, and exceptional quality behavioral healthcare to individuals who are on Medicaid or uninsured. We also recognize there are limited treatment options for people on Medicare or who are privately insured, and strive to serve these individuals based on available capacity. Thanks to support through Colorado Crisis Services, a program of the Colorado Behavioral Health Administration, we are able to provide 24/7 mobile crisis response to everyone in our communities, regardless of insurance coverage.

Our goal is to provide our clients with information to help them make the best-informed decisions about their care. The information on this page is provided to help you understand billing and client responsibilities.  Billing representatives are available Monday through Friday (8 am to 5 pm) at 719-276-5475. They can help set up financial arrangements, explain insurance benefits, address any billing concerns, and/or answer any questions about billing.

 

No Surprise Billing/Know Your Rights:

What is surprise billing?  If you are seen by a provider or use services in a facility or agency that is not in your health insurance plan’s provider network, referred to as “out-of-network,” you may receive a bill for additional costs associated with that care. Out-of-network facilities or agencies often bill you the difference between what your insurer decides is the eligible charge and what the out-of-network provider bills as the total charge.  Under Colorado law this is defined as balanced billing and is commonly called surprise billing.

On Jan. 1, 2020, a new state law went into effect to protect you from surprise billing. These protections apply when:

• You receive covered emergency services, other than ambulance services, from an out-of-network provider in Colorado.

• You unintentionally receive covered services from an out-of-network provider at an in-network facility in Colorado.

This law only applies if you have a “CO-DOI” on your health insurance ID card and you are receiving care and services provided at a regulated facility in Colorado.

When you cannot be surprise billed:

Emergency Services: If you are receiving emergency services, you can only be billed for your plan’s in-network cost-sharing amounts, which are copayments, deductibles, and/or coinsurance. You cannot be billed for anything else.  This applies only to services related to and billed as an “emergency service.”

Non-Emergency Services at an In-Network Facility by an Out-of-Network Provider: Facility or agency staff must tell you if you are at an out-of-network location or if they are using out-of-network providers, when known. Staff must also tell you what types of services you will be using that might be provided by an out-of-network provider.

You have the right to request that in-network providers perform all covered medical services. However, you may have to receive medical services from an out-of-network provider if an in-network provider is unavailable. If your insurer covers the service, you can only be billed for your in-network cost-sharing amount, which are copayments, deductibles, and/or coinsurance.

Additional Protections:

• Your insurer will pay out-of-network providers and facilities directly.
• Your insurer must count any amount you pay for emergency services or certain out-of-network services toward your in-network deductible and out-of-pocket limit.

• The provider, facility, hospital, or agency must refund any amount you overpay within 60 days of being notified.
• No one, including a provider, hospital, or insurer, can ask you to limit or give up these rights.

If you receive services from an out-of-network provider or facility or agency in any other situation, you may still be surprise billed, or you may be responsible for the entire bill. If you intentionally receive nonemergency services from an out-of-network provider or facility, you may also be surprise billed.

If you think you have received a bill for amounts other than your copayments, deductible, and/or coinsurance, please contact the facility’s or agency’s billing department or the Colorado Division of Insurance at 303-894-7499 or 1-800-930-3745.

 

Payment/Insurance:

Clients are required to:

• Pay any copays/responsibility when services are provided
• Keep information updated (insurance, address, etc.)

We will make attempts to bill your insurance plan(s), but clients are responsible for ensuring information is up to date. Clients are responsible for informing Solvista Health if their insurance or personal information changes. Clients are responsible for any outstanding balances including any responsibility assigned by their insurance company, such as coinsurance or deductible. We send statements monthly, and billing makes our best effort to communicate with you by phone and mail regarding any issues.

When capacity allows, Solvista Health accepts most major insurance plans, including, but not limited to the list below. Please call billing if you don’t see your insurance plan on this list, as this list may change. Some specific plans may be out of network for Solvista Health, but we will still do our best to take care of you while making your care affordable. We will also make efforts to contract with employer sponsored plans called Employer Assistance Programs (EAP) which are not included in this list below. We will also consider contracting with new insurance providers/plans upon request.

Assistance Programs:

Solvista Health offers services at a reduced cost for those that cannot afford services (with or without insurance). We offer a sliding scale fee for those without insurance. We also will not charge you more than the in-network rate, if your plan is out of network. Solvista Health has financial assistance available that clients may apply for if they have difficulty affording services. Our assistance programs require proof of income (see the financial assistance link).