Navigating Out-of-Network Insurance Benefits

At Ann Arbor Psychological Testing, we understand that navigating out-of-network insurance benefits can be complex. This guide is designed to help you through the process, ensuring you can access the psychological assessment services you need.

Understanding Out-of-Network Benefits

Out-of-network benefits allow you to receive services from providers not contracted with your insurance company. While this may result in higher out-of-pocket costs, many insurance plans offer partial reimbursement for such services.

Steps to Access Out-of-Network Benefits

  1. Contact Your Insurance Provider: Call the customer service number on your insurance card and inquire about your out-of-network mental health benefits for psychological testing. Consult the table of CPT Codes below.
  2. Verify Necessary Authorizations: Determine if prior authorization is required for psychological testing and request any necessary forms.
  3. Understand Reimbursement Rates: Ask about the “usual and customary rates” (UCR) for psychological testing services. Insurance companies reimburse a percentage of these rates, which may differ from our fees.
  4. Obtain a Superbill: We will provide you with a detailed invoice, known as a superbill, which includes all necessary codes and information for reimbursement.
  5. Submit Claims: After your testing is complete, submit the superbill and any required documents to your insurance promptly.

Commonly Used CPT Codes

Your insurance company may ask about Current Procedural Terminology (CPT) codes associated with your assessment. At Ann Arbor Psychological Testing, commonly used codes include 90791, 96130, 96131, 96136, and 96137, which cover diagnostic interviews, psychological testing evaluation services, and test administration and scoring. The specific codes used depend on the nature and scope of the assessment, with variations based on complexity and time required. Some codes may be billed for multiple units. Once we assess your specific needs, we can provide a more detailed estimate of the applicable CPT codes and units. We recommend checking with your insurance provider to determine what out-of-network benefits may apply.

By following these steps and understanding the process, you can effectively utilize your out-of-network benefits to access the quality psychological assessment services we offer. If you have any questions or need further assistance, please don’t hesitate to contact us.