Reply to How to calculate potential cost of neuro-psych or ed-psych evaluation and whether it's worth changing insurance

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Reply to "How to calculate potential cost of neuro-psych or ed-psych evaluation and whether it's worth changing insurance"

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[quote=Transplant_1]OP here.  Thank you all very much.  I wind up calling a practice to start exploring, and they helped me think things through. I wish I'd know I could've just called.  They told me the codes, and "how" to ask what questions to my insurance company.

1) What percentage do they cover out-of-network for the following procedure codes?  (The practice also told me on average the number of "units" they would use for each code.)

90791    
96130 / 96131 
96136  / 96137 
96138  / 96139

2) What is their "usual and customary" rate for the above procedure codes?

3) Do they have any limits on the number of units that can be charged?

4) How much of the out-of-network deductible has been met?

This was all very helpful to me.

I suggest if you are facing the same issue, get a good recommendation on a practice.  And call and ask how much and what kind of questions you should ask your insurance to help you plan and figure out how much it will cost you.

My best to all, and good luck.  It's not easy.
[/quote]

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