{"componentChunkName":"component---src-templates-page-tsx","path":"/virtual-care-insurance-billing/","result":{"pageContext":{"_type":"pageTabs","main":{"_type":"pageContent","modules":[{"_key":"051693a3cf01","_type":"hero","backgroundColor":"bcoat","bgImage":"ShapeTwo","imageColor":"tertiary-2","spacing":"pym","text":[{"_key":"17cd2852e6ee","_type":"block","children":[{"_key":"946077f79164","_type":"span","marks":["highlight"],"text":"FREQUENTLY ASKED QUESTIONS"}],"markDefs":[],"style":"h5"},{"_key":"826da6914261","_type":"block","children":[{"_key":"39eeee54f587","_type":"span","marks":[],"text":"Virtual Care insurance and billing FAQs "}],"markDefs":[],"style":"h1"},{"_key":"05dab110546b","_type":"block","children":[{"_key":"b3460780b3d6","_type":"span","marks":["em"],"text":"We know healthcare billing can be confusing, but you don’t have to figure it out alone. "}],"markDefs":[],"style":"normal"},{"_key":"39a1d4cfb9e4","_type":"block","children":[{"_key":"97b704810278","_type":"span","marks":["em"],"text":"Get clear, straightforward answers about insurance coverage, out-of-pocket costs, and payment options for virtual care services offered at Tia."}],"markDefs":[],"style":"normal"}]},{"_key":"536c35c53098","_type":"shape","backgroundColor":"secondary-1","shapeColor":"secondary-2","shapeType":"shape-2"},{"_key":"bf0cfdbaed26","_type":"standardText","backgroundColor":"bccream","text":[{"_key":"fa17b3bf2c94","_type":"block","children":[{"_key":"fd9a54e4d3bb","_type":"span","marks":["strong"],"text":"Virtual Care Insurance"}],"markDefs":[],"style":"h2"},{"_key":"0a8b6c59c8f4","_type":"block","children":[{"_key":"0fdf89955ec9","_type":"span","marks":[],"text":"Patients must have in-network coverage with an accepted insurance plan to receive care in "},{"_key":"6d5787992c24","_type":"span","marks":["strong"],"text":"Connecticut (CT), Massachusetts (MA), or New Jersey (NJ)."}],"markDefs":[],"style":"normal"},{"_key":"a9a6c4b385e5","_type":"block","children":[{"_key":"f1bb7d6f5f690","_type":"span","marks":[],"text":"At this time, "},{"_key":"f1bb7d6f5f691","_type":"span","marks":["strong"],"text":"Tia does not accept cash-pay or out-of-network patients"},{"_key":"f1bb7d6f5f692","_type":"span","marks":[],"text":" in "},{"_key":"f1bb7d6f5f693","_type":"span","marks":["strong"],"text":"Connecticut (CT), Massachusetts (MA), or New Jersey (NJ)"},{"_key":"f1bb7d6f5f694","_type":"span","marks":[],"text":". "}],"markDefs":[],"style":"normal"},{"_key":"9b67e94fedc9","_type":"block","children":[{"_key":"874b75beceeb","_type":"span","marks":["strong"],"text":"Virtual Care Services Billing"}],"markDefs":[],"style":"h2"},{"_key":"64e313428384","_type":"block","children":[{"_key":"3db328f85184","_type":"span","marks":[],"text":"Tia providers deliver your care through our trusted medical group partner, "},{"_key":"95c37a91556b","_type":"span","marks":["strong"],"text":"Cloud Health"},{"_key":"ec42d9762d29","_type":"span","marks":[],"text":"."}],"markDefs":[],"style":"normal"},{"_key":"9b748f51012d","_type":"block","children":[{"_key":"8e3e6f27bdd2","_type":"span","marks":[],"text":"When we bill your insurance:"}],"markDefs":[],"style":"normal"},{"_key":"4107a81ce598","_type":"block","children":[{"_key":"dff8f1717629","_type":"span","marks":[],"text":"Claims will be submitted under the group "},{"_key":"0359d52a4b2b","_type":"span","marks":["strong"],"text":"NPI 1528744935"},{"_key":"f6a441f053aa","_type":"span","marks":[],"text":" for "},{"_key":"e15861e5e411","_type":"span","marks":["strong"],"text":"Massachusetts and Connecticut"},{"_key":"952df31939b4","_type":"span","marks":[],"text":", and under "},{"_key":"50e8a97db418","_type":"span","marks":["strong"],"text":"NPI 1043995467"},{"_key":"6fdc734baa6b","_type":"span","marks":[],"text":" for "},{"_key":"2a545b716c2d","_type":"span","marks":["strong"],"text":"New Jersey"},{"_key":"bc2e54b8c3e7","_type":"span","marks":[],"text":"."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"72b9abfdf10b","_type":"block","children":[{"_key":"890ec98c9968","_type":"span","marks":[],"text":"Your claim will also include the "},{"_key":"f7ff822fcc4a","_type":"span","marks":["strong"],"text":"NPI of the individual provider"},{"_key":"c10ce1f31b27","_type":"span","marks":[],"text":" who delivered your care."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"0bebd80e712a","_type":"block","children":[{"_key":"ff146e76ef73","_type":"span","marks":[],"text":"We recommend contacting your insurance provider for details on your specific coverage. 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We’re here with the essential steps and insights you need to make the best decision for the year ahead."}],"markDefs":[],"style":"normal"},{"_key":"020f183409bb","_type":"block","children":[{"_key":"1de8a6186eb10","_type":"span","marks":[],"text":"Healthcare is confusing. Between the need-to-Google terminology and the ever-changing rules, it can be a headache to understand—but it’s also crucial to know how your plan works. Knowing your coverage makes it easier to choose the right plan "},{"_key":"1de8a6186eb11","_type":"span","marks":["em"],"text":"and"},{"_key":"1de8a6186eb12","_type":"span","marks":[],"text":" take full advantage of your current benefits. (You’re paying for them, after all.)"}],"markDefs":[],"style":"normal"},{"_key":"19932b31458f","_type":"block","children":[{"_key":"bd6d0ddc49b90","_type":"span","marks":[],"text":"To ensure you get the healthcare you need without surprises, we recommend carving out time during the Open Enrollment window to call your insurance provider, ask some important questions, and truly get to know your plan options."}],"markDefs":[],"style":"normal"},{"_key":"704cbde1f918","_type":"sectionHeader","headerLevel":"h2","title":"Step 1: Get Prepared to Research Your Options"},{"_key":"9fe04bd86b02","_type":"block","children":[{"_key":"d5a5bf2426f80","_type":"span","marks":[],"text":"Before getting on the phone with your insurance provider or logging into your benefits portal, take a few minutes to get ready."}],"markDefs":[],"style":"normal"},{"_key":"425536d66bfd","_type":"block","children":[{"_key":"d96072412853","_type":"span","marks":[],"text":""}],"markDefs":[],"style":"normal"},{"_key":"3d6dad85682a","_type":"block","children":[{"_key":"8735d7e7e651","_type":"span","marks":["strong"],"text":"Gather Your Plan Documents"}],"markDefs":[],"style":"normal"},{"_key":"f42ce66d14ee","_type":"block","children":[{"_key":"71ae0696c6dc0","_type":"span","marks":[],"text":"Have the following documents from your current or potential plans handy:"}],"markDefs":[],"style":"normal"},{"_key":"2883f5fbd2ee","_type":"block","children":[{"_key":"71a2ad85c8020","_type":"span","marks":[],"text":"Your current insurance card."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"707f7a34c6bf","_type":"block","children":[{"_key":"487221ec374f0","_type":"span","marks":[],"text":"A copy of the plan’s "},{"_key":"487221ec374f1","_type":"span","marks":["strong"],"text":"Summary of Benefits and Coverage (SBC)"},{"_key":"487221ec374f2","_type":"span","marks":[],"text":"."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"8bc5996ade97","_type":"block","children":[{"_key":"c291fb0f1b140","_type":"span","marks":[],"text":"Recent "},{"_key":"c291fb0f1b141","_type":"span","marks":["strong"],"text":"Explanation of Benefits (EOB)"},{"_key":"c291fb0f1b142","_type":"span","marks":[],"text":" statements, if applicable."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"c595998f1ddc","_type":"block","children":[{"_key":"97a12ca8ec6b0","_type":"span","marks":[],"text":"A list of past and upcoming medical appointments or treatments, including any ongoing prescriptions."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"f2d832669a8d","_type":"block","children":[{"_key":"782b3c8a7944","_type":"span","marks":["strong"],"text":""}],"markDefs":[],"style":"normal"},{"_key":"ff74e7276320","_type":"block","children":[{"_key":"d089cfcf2d910","_type":"span","marks":["strong"],"text":"Review Your Medical History and Think About the Year Ahead"}],"markDefs":[],"style":"normal"},{"_key":"661e2ee51c41","_type":"block","children":[{"_key":"b837818b814a0","_type":"span","marks":[],"text":"Make a list of any ongoing health conditions (e.g., fertility treatments, chronic illness management) and medical needs for the upcoming year (e.g., planned surgeries, mental health support, family planning). Determine how your coverage needs might change based on lifestyle shifts, like starting a family or taking a new medication."}],"markDefs":[],"style":"normal"},{"_key":"77170071513a","_type":"sectionHeader","headerLevel":"h2","title":"Step 2: Key Questions to Ask When Comparing Plans"},{"_key":"89a062dc79ae","_type":"block","children":[{"_key":"174fabad576e0","_type":"span","marks":[],"text":"Getting a thorough understanding of your coverage involves asking some nitty-gritty questions. Use this list as a guide when speaking with an insurance representative or reviewing the "},{"_key":"174fabad576e1","_type":"span","marks":["strong"],"text":"Summary of Benefits and Coverage (SBC)"},{"_key":"174fabad576e2","_type":"span","marks":[],"text":" for a potential plan."}],"markDefs":[],"style":"normal"},{"_key":"a6c7e5b1b7d4","_type":"sectionHeader","headerLevel":"h3","title":"Coverage & Network Questions"},{"_key":"54c25e68f126","_type":"block","children":[{"_key":"2b83a9d1500c0","_type":"span","marks":[],"text":"Getting these answers will help you learn how your benefits work and how to make the most of them."}],"markDefs":[],"style":"normal"},{"_key":"cca49e88d4da","_type":"tableModule","subTable":{"rows":[{"_key":"8974759c-bd5f-4cdb-91fa-69e83157b11c","_type":"tableRow","cells":["Category","Key Questions to Ask"]}]},"table":{"rows":[{"_key":"fb8a0faf-e838-451f-9ca7-6ba5a496d023","_type":"tableRow","cells":["<b>General Coverage</b>","What is my <b>deductible</b>? How much do I pay before my plan starts covering care? What are my <b>out-of-pocket maximums</b>? Does my maximum include copays? Is there a <b>co-insurance</b> rate after my deductible is met? Do I have to select a <b>primary care provider (PCP)</b>?"]},{"_key":"0e841ae7-66e0-4a97-bcc4-2a7f27252f15","_type":"tableRow","cells":["<b>Network & Providers</b>","Is my current doctor or specialist <b>in-network</b>? Do I need a <b>referral</b> to see specialists (e.g., dermatologists, mental health professionals)? What are the rules for <b>out-of-network</b> providers?"]},{"_key":"bc5bc4d4-fb20-4ab5-8680-5247f966b8c4","_type":"tableRow","cells":["<b>Prescription Coverage</b>","Are my <b>prescription medications</b> covered? Is there a <b>formulary</b> I should review? 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Their scenarios will reference three different types of Insurance plans: the Gold PPO 2000, the Gold PPO 1000, and the HDHP 5000."}],"markDefs":[],"style":"normal"},{"_key":"e7c194e890c8","_type":"tableModule","subTable":{"rows":[{"_key":"89aef08e-1ab0-486c-898d-710ff82e2a88","_type":"tableRow","cells":["Plan","Premium / Deductible","Best For"]}]},"table":{"rows":[{"_key":"a9047c96-988f-47b6-8b0c-cfecf59444e3","_type":"tableRow","cells":["<b>HDHP 5000</b>","$50/month (Lowest) <b>/</b> $5,000 (Highest)","Healthy individuals who only anticipate needing routine preventive services and want a low-cost plan."]},{"_key":"4c8e3cf8-639d-4097-9cf0-e364013807e0","_type":"tableRow","cells":["<b>Gold PPO 2000</b>","$100/month (Low) <b>/</b> $2,000 (Mid)","Those who need specific covered services (like acupuncture) but don't expect frequent visits."]},{"_key":"18160790-6ce3-46a9-a366-a858b0344c17","_type":"tableRow","cells":["<b>Gold PPO 1000</b>","$200/month (Highest) <b>/</b> $1,000 (Lowest)","Those expecting frequent doctor’s appointments who need predictable costs (copays)."]}]}},{"_key":"681ea84f74d8","_type":"cta","backgroundColor":"bcb","text":[{"_key":"735495fa5daa","_type":"block","children":[{"_key":"e974c6801c320","_type":"span","marks":["strong"],"text":"Open Enrollment Alert: Government Uncertainty and Your Premiums"}],"markDefs":[],"style":"h3"},{"_key":"f74fd11119a4","_type":"block","children":[{"_key":"7b2e38e780320","_type":"span","marks":[],"text":"As you approach your Open Enrollment decision, be aware that the current government funding debate may have a significant and immediate impact on your costs."}],"markDefs":[],"style":"normal"},{"_key":"932f70b20278","_type":"block","children":[{"_key":"cfaf2acf9b860","_type":"span","marks":[],"text":"A key point of dispute causing the current federal government shutdown is the potential expiration of the "},{"_key":"cfaf2acf9b861","_type":"span","marks":["strong"],"text":"Affordable Care Act (ACA) enhanced premium tax credits (subsidies)"},{"_key":"cfaf2acf9b862","_type":"span","marks":[],"text":" at the end of the year."}],"markDefs":[],"style":"normal"},{"_key":"78819ea20967","_type":"block","children":[{"_key":"1df3dccc523d0","_type":"span","marks":["strong"],"text":"What This Means for You:"}],"markDefs":[],"style":"normal"},{"_key":"34c894a9b4dd","_type":"block","children":[{"_key":"8d72b6ee200e0","_type":"span","marks":[],"text":"If these enhanced subsidies are "},{"_key":"8d72b6ee200e1","_type":"span","marks":["strong"],"text":"not extended"},{"_key":"8d72b6ee200e2","_type":"span","marks":[],"text":" by Congress, millions of Americans who purchase their coverage on the ACA Marketplace could face a dramatic increase in their monthly premium payments—in some cases, seeing costs more than double."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"},{"_key":"ac14b4874d79","_type":"block","children":[{"_key":"ee157d77c15e0","_type":"span","marks":["strong"],"text":"Actionable Step:"},{"_key":"ee157d77c15e1","_type":"span","marks":[],"text":" The rates you see quoted during Open Enrollment may reflect the loss of these subsidies. It is vital to ask your Marketplace or insurer how the ongoing debate will affect your final, out-of-pocket premium. Check for communications from your state or the federal marketplace regarding rate changes and the subsidy status."}],"level":1,"listItem":"bullet","markDefs":[],"style":"normal"}]},{"_key":"1540bcefad74","_type":"sectionHeader","headerLevel":"h2","title":"Case Study 1: Carly's Open Enrollment Choice - Prioritizing Low Premiums"},{"_key":"d22643ea975e","_type":"block","children":[{"_key":"60db67098b930","_type":"span","marks":["strong"],"text":"Healthcare needs:"},{"_key":"60db67098b931","_type":"span","marks":[],"text":" Carly is rarely sick and doesn’t expect to need frequent medical care, but wants to stay prepared in case of emergencies. 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