Client Experience Overview

Overview

Alma Integrity Standards promote our mission by: 1) Creating clear expectations for providers in terms of how to use the Alma platform and tools, and 2) Establishing an environment of safety and respect, while supporting providers in maintaining autonomy of their practices. To learn more about our integrity standards as a whole, please see What are Alma Integrity Standards?

This article covers Alma’s policies around Client Experience:

1. Communicating Fees

Providers must properly communicate their fee policies with clients in advance of sessions. This includes but is not limited to the following:

  • Fees associated with consultation calls
  • Fees associated with cancellations
  • Credit card details on file to collect unpaid invoice amounts
  • Advanced fees for private pay sessions
  • Passed on credit card transaction fees 

2. Submitting Eligibility Checks 

Providers must not submit eligibility checks less than one business day or after appointments (we will be notified of these violations via client write-ins). Members should update the Alma client portal with the most up-to-date insurance information, and allow Alma up to 1 business day to complete eligibility checks before the intended date of service.

In the event that eligibility checks are not submitted 1 business day in advance of the scheduled appointment and the client is not eligible for in-network coverage, Alma will not be able to pay the provider for the completed appointment.

If a client wishes to use insurance:

  • You should not hold a session until you’ve collected the client’s insurance information and Alma has completed an eligibility check. This applies to both EAP and non-EAP benefits.
  • We recommend that at the outset of treatment, you work with the client directly to determine what benefits they will be using, and then complete an eligibility check through Alma. This decreases the risk of unexpected increases or decreases in fees based on the payment responsibility determined by the insurance carrier when a claim is processed.

3. Insurance Program Policy

If a client connects with a provider through Alma and has an eligible insurance plan with which the provider is credentialed, the provider must submit claims for sessions with that client as in-network through Alma’s Insurance Program. That being said, we support clients’ autonomy in choosing whether to use their insurance benefits to cover mental health care. Providers must collect written consent to charge out-of-pocket for clients who do not wish to use their insurance.

 

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