Common Insurance Questions

What if I have more than one type of insurance?

Any commercial and/or medicare plans must be billed as the primary insurance. For example, if you have Blue Cross Blue Shield and Vaya medicaid, then we would bill Blue Cross first and then Vaya. If we are not in network with one of your plans, then we may not be able to work with you or remaining balances will have to be paid for out of pocket.

How do I know if I have a copay or coinsurance?

Due to our appointment volume, we are generally only able to check on insurance benefits for scheduled clients. We do our best to obtain coverage information in the weeks leading up to an appointment and will let you know what financial responsibility you may have, if any. Please note: information we are given is subject to change and not a guarantee on the insurance company's end. If you wish to double check the information we are given, we can provide you with the information you will need to call your insurance company to verify your benefits and requirements. Clients are responsible for paying any copay or coinsurance amount.

Additionally, insurance companies may require prior authorization requests to be submitted by the provider you are scheduled with before the appointment depending on your plan. Prior authorization is not a guarantee of coverage. Sometimes prior authorizations are denied and we cannot move forward with testing.

What if I don't have insurance or GEC is not in network with my insurance?

If you do not have insurance, testing must be paid for in-full at the time of testing. Please contact our office for more information.

If we are not in network with your insurance and you wish to work with us then we may be able to bill out-of-network. Please contact our office for more information. Clients are responsible for paying any amount not covered by out-of-network benefits. For example, your plan may cover 30% of the cost of testing. In this case, you will be responsible for the remaining 70%. We will do our best to get you an estimated cost.

What types of testing does insurance cover?

Insurance companies cover "medically necessary" psychological testing, which generally includes developmental disorders, emotional/mood disorders, and behavioral disorders. Educational concerns, such as testing solely for ADHD, dyslexia, and other problems related to learning are not considered medically necessary reasons for testing. However, we are able to screen for some of these problems as a part of testing for problems that are considered medically necessary.

Please contact us if you have any questions not addressed here. We understand health insurance can be difficult to navigate and are happy to help you.