Insurance Reimbursement

The neuropsychologists of Neuropsychology Service, P.A. participate only with Anthem Blue Cross and Blue Shield, Aetna, Cigna, and Medicare.  We will help you to determine coverage for our services and, where possible (for other insurance companies), try to get out-of-network benefits to cover the evaluation.  The anticipated patient portion of the estimated total fees (e.g., any unmet deductible, your co-payment) will be expected prior to or at the time of the first appointment unless we have made other arrangements with you.  In cases where the estimated bill turns out to be higher than the actual bill, you will be reimbursed the difference; likewise, any outstanding portion of the final bill attributable to the patient will be charged to you. 

For all companies other than Anthem, Aetna, Cigna, and Medicare, we usually require direct payment from the patient, in the same manner as a self-pay situation.  In those instances, we will submit a claim to your insurance company for reimbursement, and any payment we receive would then be returned to you. 

You should be aware that your contract with your health insurance company requires that you authorize us to provide it with information relevant to the services that we provide to you.  If you are seeking reimbursement for services under your health insurance policy, you will be required to sign an Authorization form that allows us to provide such information.  We are required to provide a clinical diagnosis.  Sometimes we are required to provide additional clinical information such as all or part of the report of your evaluation and copies of other material in your clinical record.  This is unusual but does occur.  Sometimes these requests are made from the insurance company later in the process, and in those cases, further written authorization from you may be necessary.  You have the right to refuse to provide such authorization, but in such a case, the insurance company is permitted by law to deny your claim, leaving you responsible for payment of the services out-of-pocket. 

Billing and Payments

Patients who expect to rely on health insurance to cover the costs of the neuropsychological evaluation will be billed as outlined above.  Please be aware that having coverage for neuropsychological evaluations as part of your insurance policy does not necessarily mean that your insurance company will actually pay for the evaluation. 

In self-pay situations, we expect a down-payment of at least half the total charge prior to or at the time of the first appointment, with the remainder of the bill due at the outset of the feedback session. 

In situations where another agency or individual is expected to pay for the evaluation, it will be necessary to obtain the contact information of the person or agency responsible for the bill at the time the appointment is made.  In most cases, we will then obtain written confirmation of the payment agreement directly, so as to reduce the risk of the bill being denied when it is submitted.

In any situation where the patient receives a bill after the evaluation is complete, payments are due within 30 days of notification, or as otherwise outlined if a payment plan has been negotiated.  Forms of payment we accept include personal or corporate checks, money orders, and credit cards or debit cards with the Visa, MasterCard, or Discover logos.