How To Receive Insurance Reimbursement From an Out Of Network Provider for ADHD Testing?
Learning about one’s health insurance can feel daunting and overwhelming—but it shouldn’t be! It is really empowering to learn the in’s and out’s of one’s insurance plan and receive reimbursement and coverage for your doctor appointments and visits. In this article, I will teach you the in’s and out’s of receiving reimbursements for your ADHD Assessment.
This article is for individuals who are seeing a Psychologist who is Out-Of-Network, who does not accept insurance directly but will provide you with a superbill. A superbill is a medical receipt that the client submits to their insurance for possible reimbursement.
How can I get my insurance to pay for some or all of the cost of my ADHD assessment?
Each insurance plan is different, but yours may reimburse you for some or all of the cost of your ADHD assessment. It is best to call your insurance company to obtain your plan benefits. Ideally the call will take between 15-20 minutes and provide the opportunity for you to familiarize yourself with your benefits and learn how to submit a Superbill.
On this call, make sure. to ask the representative, “What are my out-of-network healthcare benefits for behavioral health in an out-patient setting?”
Make sure to take notes to the answers and ask clarifying questions.
Find out if your health insurance plan will reimburse an Out of Network Provider. (your plan may cover 50% of the cost or even 80% of the cost, it is a case by case basis).
Verify how to submit a Superbill (have a point of contact at your insurance company).
Provide your insurance company with the testing codes that will be on the superbill and the overall cost of the assessment. This can help you undersatnd how much you will pay and how much the insurance company will pay.
After you find out the reimbursement rate, contact the testing psychologist to get started.
What Can I Expect After Submitting My Superbill?
When a claim has been received by insurance, most insurance companies will make a determination on reimbursement in two weeks to a month. However, each insurance company works differently and some may take longer than others to reimburse out of network claims.
If you have yet to receive payment and some time pas passed, give your insurance company a call and ask, “What is the status of the claim submitted?” On this call, the insurance representative will inform you of the status of the claim— denied, in process or completed.
Once the claim has been processed you may receive a check in the mail or through a direct deposit into your account for the percentage of the fee per service your plan covered.
I hope this article was helpful in providing you the information and tools to receive affordable and accessible mental health services.
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