You may have several questions about your health insurance plan and coverage for NeuroStar TMS Therapy. Below is information to help answer any questions you may have about reimbursement of health insurance coverage.
I want to find out if my health plan covers TMS Therapy
How much does TMS Therapy cost?
How do I know if a provider accepts my insurance?
What treatment costs will I be asked to pay?
- Your deductible
- Your co-pay
- Your co-insurance
- Other costs, depending on your coverage
Partner with your doctor’s office to understand your benefit coverage and how much you may have to pay. Contact a NeuroStar provider.
Does NeurosStar Reimbursement Support (NRS) assist with the cost of TMS Therapy?
What reimbursement services does NRS provide?
How does the whole process work for getting treatment and approval from my insurance?
What does preauthorization mean and is it required?
My doctor said this procedure is a medically necessary, does that mean it is covered by my insurance?
What happens if my doctor recommends treatment that isn’t covered by my insurance?
My insurance denied my claim. What should I do?
An insurance company must describe the reason for the denial and inform you of their process for filing an appeal. It is important you understand the appeal process for your particular insurance plan; this information can be found in your summary of plan benefits, on the insurance website or by calling the insurance company’s customer service representative. Your doctor’s office should partner with you to file the appeal. But you need to be involved or you may want to file the appeal yourself. During the appeal process, keep records of all correspondence between you, the insurance company and your doctor.
Appealing a Medicare claim denial can vary from commercial insurance. An appeal can be filed after a Medicare claim has been denied. Any appeal must begin at the first level, called redetermination. A redetermination is a review of the claim by a person who is different from the person who made the initial claim determination. This appeal must be provided in writing within 120 days. Once all procedural steps are completed, an appeal may be elevated to the next decision level in the process. The second level of appeal for Medicare is called reconsideration. Reconsideration is conducted by an independent contractor. The contractor has their own physicians and other health professionals to review and assess the appeal. Appeals may be elevated to the next higher level until an appellant’s appeal rights are exhausted. Please refer to Medicare’s website for more appeals information: http://www.medicare.gov/claims-and-appeals/file-an-appeal/appeals.html
NeuroStar Reimbursement Support
Please Note: All reimbursement information provided by Neuronetics is for general guidance only. It does not represent a statement, promise, or guarantee by Neuronetics concerning levels of reimbursement, payment, or charge, if any. Coverage and payment for NeuroStar TMS Therapy is based on various factors, including but not limited to, medical necessity, the patient’s specific benefits plan, and individual insurance company’s policies and guidelines. It is the responsibility of the physician and the patient to be knowledgeable of the applicable guidelines.