Health insurance companies do not cover everything, even some services you and your health care provider feel you need.
The psychological evaluation/testing you have requested and that is scheduled to begin on the date you specify below is not covered according to information we received from your health plan.
Under your health plan, you are financially responsible for co-payments, co-insurance and deductibles for covered services, as well as those services that exceed benefit limits or that are not covered.
A non-covered service usually means that the service does not meet the insurance company's medical necessity requirements. Some reasons for this include, but are not limited to:
- The service is for an academic/educational purpose (e.g., learning disorder testing, early entry to kindergarten testing)
- The service is for a legal or administrative purpose (e.g., disability application, employer requirements)
- You do not meet the criteria for any mental health-related diagnosis, or the diagnosis is not covered under your plan
You have the option of proceeding with this service and paying us directly at the time of service. We are required to obtain your written acknowledgement before we can proceed.
If you request us to do so, we can file a health insurance claim for you despite knowing the service may not be covered in the hope that they will decide to cover it. If your insurance company does reimburse us, we will refund you the amount the insurance company paid to us. You will receive your refund once we receive payment from the insurance company, which can take weeks to months.