We understand that insurance billing can be confusing—especially if your out-of-pocket cost with insurance ends up being more than your provider's cash-pay rate. Here's why that could happen, and what it means for you.

How are session paid?

Tava providers decide their own rates for clients paying directly. When a client is using insurance to pay for their session, Tava is required to send the bill to insurance at the standard rate (usually much higher than the provider's rate), but you will never pay the full charge.

What is the insurance rate?

Each insurance plan sets a maximum amount they’ll pay—this is called the "contracted" or "allowed" amount. For example, we bill the required rate ($341) to your insurance, but your insurer has an "allowed amount" of $131. That’s the amount used to determine how much you owe for the session.

Why would I owe more than my provider's cash pay rate?

If your plan has a deductible that you haven’t met yet, you might owe the full "allowed amount" (in this example, $131). If your provider's rate is less than $131 (for example, maybe the provider set their rate to be $125) you would pay more than the cash pay rate. If your deductible is met, you would only owe a copay or coinsurance, which would likely be lower.

For extra help:

• Check Your Deductible: If you thought your deductible was already met, you can call your insurance’s Member Services phone number to confirm, usually listed on the back of your insurance card.

Example:

We billed your insurance $341 for your session, which is the required billing amount. Your insurance plan only allows $131, and because your deductible hasn’t been met, that full amount was applied to you. If your deductible had been met, you likely would have only owed a smaller copay.