Frequently Asked Questions
Billing & Payment
What types of payment do you accept?
We accept Medicaid, Medicare, self-pay (out-of-pocket/uninsured), and many private (commercial) insurance options.
For individuals without insurance, we offer financial assistance to those who qualify, in alignment with our core value that mental health care should be accessible and affordable for all. We work with every client to help them receive the care they need.
Visit our Cost & Insurance page to learn more.
What insurance do you take?
In addition to accepting Medicaid/Medicare, we are considered “in network” by most private (commercial) insurance providers, in alignment with our core mission to make health care accessible and affordable for all.
To ensure you can pursue wellness and treatment, our dedicated team will advocate on your behalf with your insurance provider by communicating with them directly and providing you guidance and support every step of the way.
Visit our Cost & Insurance page for a detailed list of insurers and payment methods we accept.
Can I get care if I’m uninsured?
Yes, we serve individuals and families without insurance. Clients can pay out-of-pocket, and we offer a Financial Assistance Program to help cover the cost of care as needed. We can also work with you to set up a payment plan.
Can I pay out-of-pocket for services?
Yes, there are two options if you need to pay. You can apply to our Financial Assistance Program (FAP) to help cover services, or you can pay out-of-pocket.
If you must pay out-of-pocket, we are committed to pricing transparency by providing clear and upfront costs for our services. Payment(s) is due before treatment.
Visit our Cost & Insurance page to estimate your costs ahead of time and view our most recent self-pay fee structure.
Is there financial assistance?
Yes, our Financial Assistance Program (FAP) is available to clients with no health insurance or limited insurance coverage, and who are eligible based on income. Income eligibility typically depends on if you fall below, at, or near the Federal Poverty Guideline (which changes annually). Even individuals whose income is above the Guideline may be eligible for some financial assistance depending on a range of factors (such as number of dependents and household size).
Do not hesitate to contact our Financial Assistance team by phone (303-486-7478) or email (FAP@mhpcolorado.org) to find out if you are eligible for financial assistance.
Can I get financial assistance if I have commercial (private) insurance?
Financial assistance is available to anyone who is eligible, even if you have a commercial (private) insurance plan. In such cases, financial assistance may be available to help cover the balance of unpaid services - including copays, coinsurance, deductibles, and/or services that your insurance does not cover.
How and when can I apply for financial assistance?
You can request a screening for financial assistance at any time while receiving care. Clients can be screened during the initial call, during assessment, or throughout their treatment.
To be considered for financial assistance, you will need to complete our application form and provide supporting documents to prove income eligibility. Supporting documents may include:
- Your most recent Federal Tax Return
- A photo ID (driver’s license, passport, state ID, student ID, etc.)
- Proof of 1-month of income (W2, 1099, paycheck stubs, etc.)
- Proof of dependents (if individual income exceeds Federal Poverty Level)
If you do not have any income to declare, then a Self-Declaration must be signed stating that your income is $0. Our team can help determine if you need to sign this form and instruct you on how to do so.
For help applying for assistance, contact our Financial Assistance Program team by phone (303-486-7478) or email (FAP@mhpcolorado.org) - or speak with a Front Desk Staff Member or Site Coordinator at your preferred location. Visit our Cost & Insurance page to learn more.
Who can I talk to about my bill?
All clients should receive a monthly statement sent to the mailing address they have on file. Our Billing & Customer Service team is available to assist you Monday – Friday, from 7:30am-4:30pm. We can help you make a payment, set up a payment plan, apply for financial assistance, and answer any billing questions you may have. Contact us by phone (303-413-6243) or email (AR@mhpcolorado.org).
Do you offer payment plans?
Yes. A payment plan is an agreement between you and Clinica Family Health & Wellness to repay an outstanding balance according to a particular schedule. The overall goal is to reduce the balance owed with each payment without interruption of services. Please contact our Billing team by phone (303- 413-6243) or email (AR@mhpcolorado.org) to setup up a payment plan or apply for financial assistance.
Will Medicaid/Medicare cover my treatment?
Most of our care and services are fully covered by Medicaid/Medicare, but there are a few select services that federally-funded insurance plans will not cover. In such cases, clients are given an ABN Notice (Advance Beneficiary Notice of Non-coverage) of what will not be covered before they begin treatment.
How can I update my insurance information?
Contact our Billing team by phone (303-413-6243) or email (AR@mhpcolorado.org) with your updated insurance information. We will ask for the name of your new insurance provider, your ID/policy number, and the date coverage became effective.
How can I dispute my bill?
All clients should receive a monthly statement sent to the mailing address they have on file. If you have a question or wish to dispute your bill, please contact our Billing team by phone (303-413-6243) or email (AR@mhpcolorado.org).
How often is the self-pay fee schedule updated?
The estimated out-of-pocket costs to pay for our services are updated annually. Visit our Cost & Insurance page for the most recent fee schedule.
Is the self-pay fee structure pricing accurate if I'm insured?
No, the prices posted on our fee structure are specifically for clients who self-pay because they do not have insurance, are not covered, or wish to pay out-of-pocket. Insurance companies negotiate their own prices for services, which may be different from self-pay prices. While an insurance company might pay a portion of insured clients’ bills, those out-of-pocket costs depend on your individual insurance plan (such as your deductible, coinsurance, co-payment, and/or a non-covered service).
For a more accurate estimate of how much our services will cost, please contact our Billing team by phone (303-413-6243) or email (AR@mhpcolorado.org) so they can assess the cost based on your individual coverage.
What is a deductible, co-pay, and coinsurance?
Deductible is the amount you owe for healthcare services before your health insurance begins to pay. This amount varies from plan-to-plan.
Co-pay is the fixed dollar amount you pay for a covered healthcare service.
Coinsurance is the shared cost of a covered healthcare service, calculated as a percent of the allowed amount for service. You pay coinsurance plus any deductibles you owe. Each health plan varies.
What if I have commercial insurance and Medicaid?
If Medicaid is active, it will cover the deductible, co-pay, and coinsurance amounts for covered services.
What is the No Surprises Act?
According to the Centers for Medicaid & Medicare Services (CMS):
The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers. It also establishes an independent dispute resolution process for payment disputes between plans and providers, and provides new dispute resolution opportunities for uninsured and self-pay individuals when they receive a medical bill that is substantially greater than the good faith estimate they get from the provider.
For clients who self-pay (out-of-pocket), this Act means we must provide clear pricing information to clients upfront so they know the cost of care or services at Clinica Family Health & Wellness. For clients with private (commercial) insurance, each plan varies depending on your deductible, coinsurance, level of coverage, and more. Please contact our Patient Financial Services team by phone (303-413-6243) or email (AR@mhpcolorado.org) to get a more accurate cost estimate based on your individual coverage.
Why do you charge fees at all as a nonprofit?
As a not-for-profit organization, we measure success by how many people we can help – not by how much revenue we can generate. However, because providing quality behavioral health care to our community has a cost (paying our employees, operating expenses, etc.), charging fees for our services is necessary and vital to ensuring all clients continue to receive the expert care and treatment they need.
Do you offer a sliding (reduced) fee scale?
Yes, a fee reduction is available for services provided to clients who do not have health insurance and who qualify for financial assistance based on their income and household size. For clients with insurance, a reduced fee is only available for services their insurance does not cover, and only when the required documents on income and household size have been submitted for verification.
You can request a fee reduction during your initial call or at any time during treatment. To be considered for a reduced fee, you must provide the specified documents about income for yourself and your supported family members. You must also complete a Fee Agreement and a Financial Assistance Program (FAP) application. Our team can assist you with this process.
What happens if I do not pay?
Taking responsibility by paying for services you have received and maintaining open communication with our Billing team about your account is an important aspect of recovery and continuity of care. For this reason, we have all clients sign a Fee Agreement at the time they begin receiving services. As a private nonprofit organization, we depend on payment for services to allow us to continue serving our community.
If you have trouble making payments, we can work with you to fill out a new Fee Agreement, request financial assistance, and investigate other available benefits for you or a loved one.
If non-payment continues and the client is unresponsive, additional steps that may occur include:
- Services may be paused or discontinued.
- No future appointments will be scheduled until a payment has been made and/or a payment plan is agreed upon and kept to.
- We will fully pursue collecting all fees possible, which may also include a collection agency.
How can I apply for Medicaid?
Enrolling in the federal health insurance program called Medicaid is quick, easy, and makes most of our services free or low cost. To find out if you are eligible and signup for Medicaid, visit Medicaid.gov.