In-Network Plans 

We are in-network with nearly every commercial insurance company.  If you don’t see your insurance listed, don’t worry!  New insurance plans pop up all of the time and we are continually adding insurances.  

Out-of-Network Plans 

We currently accept Tricare and United Healthcare patients as out of network. 

We will call your insurance company prior to your child’s first visit to determine insurance benefits.  

We ask that you also call your insurance company to verify coverage and understand your benefits. 

Please note that the information provided during the verification process is not a guarantee of coverage or payment. Coverage and payment are not determined until the claim is received and processed by your insurance carrier.  Copays, deductibles, and non-covered services are due at time of service.  

• Deductible: The amount of money a family must pay before insurance will pay anything of pocket max: 
• Out of Pocket Max: The amount of money a family must pay before insurance pays for everything.
• Co-insurance: The percentage that a family must be paid after deductible has been met.  This amount may vary depending on services provided.
• Co-pay: The set amount to be paid for each visit.  Co-pays will be collected at the date of service.
• Visit limit: The amount of therapy visits an insurance plan allows.  Some insurances allow children with certain diagnosis to have unlimited therapy visits.
• Authorization: Following an evaluation or certain number of visits, some insurance companies require us to send chart notes to justify medical necessity and continued therapy.  If you know your plan requires prior authorization, please communicate that to our office staff.

No Surprises Act – Good Faith Estimate  

Effective January 1, 2022, you have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.  Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. 

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.  This includes related costs like medical tests, prescription drugs, equipment, and medical visit charges.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item.  You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule at item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure you save a copy or picture of your Good Faith Estimate. 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or submit an email to office@agapetherapywa.com

Questions or Concerns?  

We would be happy to talk with you about your insurance and answer any questions you may have.

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