By Barbara Griswold, LMFT (July 23, 2017)
As more employers look for new ways to share the burden of rising health costs with their employees, more clients have employer health savings accounts. Your clients may want to pay for sessions with their account, and you may even want to encourage it (I’ll say more about that). So here’s a quick introduction to these accounts:
Employers may offer a Health Savings Account (HSA) or Medical Savings Account (MSA), which allow employees to set aside pre-tax dollars from their income for future medical expenses. Contributions can be made by the client, his employer, or both; with Health Reimbursement Arrangements (HRA), only the employer contributes. It’s as if money is being put aside in a special piggy bank throughout the year, and then when it comes time to pay a healthcare provider, the client can use the banked funds to reimburse themselves for these expenses.
Flexible Spending Accounts (FSA) are another type of pre-tax employer savings account which allows for reimbursement of healthcare expenses but also childcare/dependent care expenses. FSA funds typically must be used within the calendar year or forfeited. If a client estimates he will be paying $2000 in the coming year for these expenses, he’d have his employer deduct this amount from his salary over the course of that year, and deposit it into his FSA. Anytime he submits an invoice from a medical or childcare provider, he would be reimbursed from his account.
How reimbursement works: Some clients will ask you for an invoice so they can submit it to their account for reimbursement. Some plans require diagnosis and CPT codes. Or clients may have access to their account via specialized checks or credit cards. You may need to register as a healthcare provider with your credit card processing company. In other cases, some MSAs/HSAs are managed by a health plan. In this case, if you are participating provider you would submit a claim in the usual manner, and the provider is paid in the usual manner (with EOBs, etc) but the money comes directly out of the member’s health savings account. Check with the client or his health plan in advance for instructions.
“I charged a client for a missed session. She wants an invoice to be reimbursed by her HSA. Should I give her one?” No. Missed appointment fees are not eligible for reimbursement with any of these accounts.
Marketing Tip: In your initial contact with potential clients, ask if they have one of these accounts, and remind them that your fees are covered by these accounts. It’s a great way to help clients make therapy more affordable. It’s also a great idea to put this reminder on your website and other marketing materials.
Condensed from “Navigating the Insurance Maze: The Therapist’s Complete Guide to Working With Insurance — And Whether You Should”. To order your copy, click here.