Understanding your benefits shouldn't require a decoder ring.
Insurance coverage for psychological services can be confusing. Deductibles, copays, coinsurance, prior authorization, and testing benefits can all affect what you ultimately pay.
This guide is designed to help you understand the terminology, know what questions to ask, and have a clearer conversation with your insurance company before care begins.
The amount you may need to pay toward covered healthcare services before your insurance plan begins paying its share.
A fixed amount you pay for a covered service, such as a therapy appointment.
The percentage of the allowed cost you may be responsible for after your deductible has been met.
Approval your insurance company may require before certain services—particularly psychological testing—can be provided as covered benefits.
A service included under your insurance benefits. A service being “covered” does not necessarily mean your plan pays the full cost.
The maximum amount your insurance plan recognizes for a covered service. Your deductible, copay, or coinsurance may be based on this amount.
Being in network is only one part of understanding your benefits. Coverage can vary based on your specific plan, the service being provided, whether authorization is required, and whether you have met your deductible.
Two people with insurance through the same company may have very different benefits.
Your insurance company—not MasterMind Psychology—makes the final determination about coverage and patient responsibility.
Write down the representative’s name, the date of the call, and any reference number they provide.
Psychological and neuropsychological evaluations are billed differently from routine therapy. An evaluation may include a clinical interview, standardized testing, scoring, interpretation, report writing, and a feedback appointment.
Insurance plans may require prior authorization, limit certain services or testing units, or determine that some portions of an evaluation are not covered under a particular plan.
Our team will complete required authorization steps when applicable, but authorization is not a guarantee of payment.
Therapy benefits are often easier to understand than testing benefits, but deductibles, copays, coinsurance, provider networks, and telehealth benefits can still vary by plan.
We recommend confirming your behavioral health benefits before beginning treatment so you have a better understanding of your expected costs.
MasterMind Psychology is contracted with a number of insurance plans. Participation can vary by specific plan, network, service, and clinician, so we recommend confirming your individual benefits before beginning care. If you do not see your insurance listed, please call our office as some plans may use a different network or administrator.
Aetna
Asuris
Cigna
First Choice Health
HMA
Kaiser Permanente
Medicare
Optum / UnitedHealthcare
Premera Blue Cross
Regence BlueShield
TRICARE
UMR
Important: Being contracted with an insurance company does not guarantee that every service, clinician, or evaluation is covered under every plan. Benefits, authorization requirements, deductibles, copays, coinsurance, and patient responsibility vary by individual policy. Your insurance company makes the final determination regarding coverage and payment.
You don’t have to navigate the process completely on your own. Our office can help explain our billing and authorization process, identify information you may need from your insurance company, and answer questions about charges from MasterMind Psychology.
We cannot guarantee coverage or determine your final benefits, because those decisions are made by your insurance plan.
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Spokane • Eastern WA • North Idaho • Pacific NW