Did
You
Know?
Your insurance company views a telehealth appointment (video + audio) the same as an in-person office visit.
A telehealth appointment (video + audio) is billed the same as an in-person visit and counts toward meeting your deductible.
Some insurance companies require a copay for telehealth appointments (video + audio) and some do not.
What do I need to know about the preauthorization process?
Even if your insurance company has given a preauthorization, that is not a promise they will pay 100% of the costs of your procedure. You are still responsible for your share of the cost, including any copayments or coinsurance set by your health plan’s design. Call our financial advocates to help you estimate your out of pocket costs and set up a payment plan.
1. Know your insurance benefits. This is a good time to contact your insurance company to understand your coverage.
2. Neuroscience Group cannot submit the preauthorization request until your provider’s office visit notes are complete and they have entered the order for your procedure.
3. Preauthorizations are only valid for a specific amount of time and may require periodic renewal.
4. Some medications require a preauthorization.
5. Many insurance companies send preauthorizations to third party companies to manage the process. This means if you call your insurance company, they may tell you that they have not received any information regarding your test, procedure or surgery. Examples: Evicore, AIM and RAD MD
6. Preauthorizations are also location specific. This means if you decide to change facilities, it will take longer to obtain the preauthorization.
Which insurance providers does Neuroscience Group accept?
What is a good faith estimate?
If you don’t have health insurance or you plan to pay for health care bills yourself, generally, health
care providers and facilities must give you an estimate of expected charges when you schedule an
appointment for a health care item or service, or if you ask for an estimate. This is called a “good faith
estimate.”
A good faith estimate isn’t a bill
The good faith estimate shows the list of expected charges for items or services from your provider or
facility. Because the good faith estimate is based on information known at the time your provider or
facility creates the estimate, it won’t include any unknown or unexpected costs that may be added during
your treatment. Generally, the good faith estimate must include expected charges for:
• The primary item or service
• Any other items or services you’re reasonably expected to get as part of the primary item or service
for that period of care.
The estimate might not include every item or service you get from another provider or facility, even if
some items or services may seem connected to the same service. For example, if you’re getting surgery,
the good faith estimate could include the cost of the surgery, anesthesia, any lab services, or tests.
In some cases, items or services related to the surgery that are scheduled separately, like certain presurgery appointments or physical therapy in the weeks after the surgery, might not be included in the
good faith estimate. You’ll get a separate good faith estimate when you schedule those items or services
with the provider or facility, or if you ask for it.
Your right to a good faith estimate
Providers and facilities must give you the good faith estimate:
• After you schedule a health care item or service. If you schedule an item or service at least 3
business days before the date you’ll get the item or service, the provider must give you a good faith
estimate no later than 1 business day after scheduling. If you schedule the item or service OR ask
for cost information about it at least 10 business days before the date you get the item or service,
the provider or facility must give you a good faith estimate no later than 3 business days after you
schedule or ask for the estimate.
• That includes a list of each item or service (with the provider or facility), and specific details, like
the health care service code.
• In a way that’s accessible to you, like in large print, Braille, audio files, or other forms of
communication.
Providers and facilities must also explain the good faith estimate to you over the phone or in person
if you ask, then follow up with a written (paper or electronic) estimate, per your preferred form of
communication.
Keep the estimate in a safe place so you can compare it to any bills you get later. After you get a bill
for the items or services, if the billed amount is $400 or more above the good faith estimate, you may be
eligible to dispute the bill.
For more information, review an example of what a good faith estimate may include and examples of good faith estimates that do and don’t qualify for the dispute process.