About Our Partnership
What exactly is this partnership? This is a direct-pay referral network where you receive clients from employees of companies we've partnered with. We pay up to 120% of Medicare reimbursement rate and we pay you within 30 days.
How is this different than traditional insurance panels? Unlike traditional insurance panels, there are no claim denials and no lengthy reimbursement processes.
What is the fee to join? There is no fee to join.
Getting Started
What do I need to do to join? Simply sign our straightforward partnership agreement. That's it! No credentialing packets, no lengthy applications.
Do I need to be credentialed with Unity Preferred? No separate credentialing is required. Your partnership agreement with TPN.health covers your participation in the network.
Is there a minimum time commitment? No. You can start with as few or as many hours as you'd like with no minimum commitment required.
What if I'm already on insurance panels? This partnership works alongside your existing practice. You can maintain your current insurance panel participation while also receiving these direct-pay referrals.
Rates & Payments
What rate will I be paid? We pay the lesser of up to 120% of Medicare reimbursement rate OR 25% off your stated rate.
How will I get paid? Nothing needs to change from your ordinary payment process.
What is the Unity fee schedule? Unity does not have a customized fee schedule. Unity will reimburse you based on information in your provider agreement.
I see that the agreement is following the laws established in the state of Oklahoma but I am in a different state, why is that the case? Unity is an Oklahoma based company.
Is Unity the primary network for all of its clients and members? Unity acts as a primary network for most of its clients but is also a secondary network for large insurance plans that have their own direct contracts with providers. Regardless of them acting as a primary or secondary network, your reimbursement will be consistent.
What will I need to do differently with my billing process? Nothing will change in your billing process, you will still submit claims to the payer listed on your client's health insurance card. If any issues ever come up with billing, collections, appeals, disputes or any other problems you will be able to contact Unity for assistance.
Client Referrals
How are referrals made? Referrals are made through TPN.health, connecting you directly with qualified clients.
Can I choose which referrals to accept? Yes, you maintain full control over which clients you accept into your practice.
What happens after I accept a referral? You’ll schedule your new client according to your availability – no changes to your system required.
What about documentation? Standard clinical documentation applies. No special insurance forms or prior authorization paperwork.
I don't want to be placed "In Network" with some of the large national payers on the list, will this put me in network? No, this will not put you in network with any of these plans. This will only add you to the Unity Directory.
How will I identify Unity Members? Members will be identified on their ID card and or through the EOB.
You only pay 25% of my session fee? (For example, my reg session rate is $150/session. So, you'd pay me $37.50 per session?)
No, we will reimburse you 75% of your total billed amount. There is a 25% discount is so that we can steer members to your center and create an incentive for the member. This will be the allowed amount you would collect.
I recently started my own practice and am not planning on being in-network with any insurance provider because of all the hassle I've experienced with insurance over the past decade.
This will not put you "in network" with any insurance company. This will allow you to stay out of network while still having access to our members who might belong to these plans. You will be able to bill your normal rate and collect the allowed amount we have agreed to.
I need to have some clarity on who will be paying cancellation fees. My policy is that if a client cancels within 24 hours of a session I will charge that client the full rate of the session (I believe that many therapists have a similar policy). Can you provide clarity on how this will work with the contracted clients through Unity?
That would still fall on the member's responsibility. You can bill and collect that from the member, nothing would change in your cancellation process.
Is this for providing online counseling and would it be through an established platform that appointments would be made and then services provided through? I currently use Betterhelp.
The members would be able to access you in many ways and through our multiple directories. You can still continue using those apps, nothing to be alarmed about from a booking or appointment management perspective.
Would the clients need to be given a diagnosis in order to receive the services as paid through their employer?
No, that is not needed. Treat the members as you normally would.
Would the sessions be held on the TPN.health platform?
No, TPN.health is not a telehealth service provider. You’ll be able to see patients in person or via telehealth in the same way you do now.
Are the clinicians expected to have our own EHR for documentation or is there an EHR associated with TPN.health?
You need your own EHR for documentation.
What is your no-show policy?
That is up to each individual provider. Whatever is in place with your practice will be the policy.
Are you an Employee Assistance Program (EAP)?
We are not.
My rate for individual 45-min sessions is $220 and for couples/families/groups is $250. I am not in network with Medicare or any other insurance companies. Does this mean I get paid $165 and $187.50, respectively?
That is correct, you will bill your normal fee, you will be able to collect the allowed amount that is agreed upon. This will not put you "in network" with the insurance company so you will be able to bill at the rate you choose, not a rate or fee schedule they set for you.
Do I send my fee request to you after each session for you to pay me electronically within 30 days?
You will bill the member's ID card or member directly. Nothing will change in your billing cycle or how you submit claims. All claims will be paid within thirty days.
I would like to understand how billing works; can I use my Alma or Headway accounts with referrals I receive from TPN.health?
Nothing will change in your billing cycle or how you submit claims. All claims will be paid within thirty days. You will never bill Unity or TPN.health directly. Any technology, RCM, Billing company you use will still be in place.
I had a quick question about the referral network. I have a group practice so would I be able to have my group practice on and give the referrals to my practitioners?
We welcome your group practice! We would ask that every Provider and TAX ID associated with the group sign and join our panel. You can include their information in the agreement or you can have them sign individually.
Hi as relates to contract and referrals, I am confused. It talks as if I'm already billing through TPN when all I have is a public listing. I read everything but am not understanding how I would bill for a client and you'd pay me. Please advise
You will bill the client/member directly and use the information on their ID Card. You would never bill TPN or Unity directly. We will reprice the claim when it is sent by the plan/payer and you will be paid at the rate you agreed upon within thirty days or less.
Can I provide services through Telehealth?
Yes.
I oversee several clinicians between our 3 clinics. Is there a way to register our clinics as a group and I could field incoming referrals to match with clinicians? We offer a wide range of services and styles for all ages.
Yes we would love to have all of them participating. We can load them all into one agreement or they sign up individually.
For payment, do you offer direct deposit?
The client’s plan will reimburse you directly, payments will come as they normally do from the plan.
Is this just for telehealth?
No, you can meet with referrals in your office or via telehealth, whatever your preference.
Who do I contact with questions? You'll receive the same excellent support you've always received from TPN.health. Didn’t see your question answered here? Contact us at [email protected].