By Anthony DiPino, Synergy Strive Lead TMS Treater
TMS is covered by nearly all insurance plans under the right conditions, but sometimes it can be confusing to determine the extent to which you, personally, will receive full coverage. Here, I’ll explain the process of receiving insurance coverage and what goes on behind the scenes for those who may be interested in beginning TMS.
The first step is to look into your insurance plan. Does the TMS practice you’re looking into accept your healthcare plan? Here at Synergy Strive, we accept the following plans for TMS:
Some individuals may need a referral from a current provider to receive coverage, though most don’t. If you’re not sure, you can always call the practice and ask about coverage, especially about whether you need a referral.
In order for providers to confirm your coverage, you’ll need to give the practice a call so the staff can get your health insurance information (tip: have your insurance card handy, so you can tell them your policy number etc.).
Once we have your information, we’ll conduct a “benefits investigation” where we contact your insurance company, check on your deductible status, determine your copayment amount (if any), and so forth.
Your insurance company may request a “prior authorization”, essentially a process that we’d undertake to prove that you are a strong and eligible candidate for TMS (e.g., diagnosed MDD, treatment-resistant presentation). If they give us the green light, we can get started with treatment!
After we’ve done the work on our end, we’ll reach back out to you– we’ll confirm your coverage, let you know about any out-of-pocket costs for you, and make sure our billing is all squared away. From here, we can proceed into treatment so you can start seeing the benefits of TMS!
How Can I Start?
If you’d like to learn more about TMS or begin the onboarding process, please feel more than welcome to call us at (410) 946-6119, or fill out the “We Want To Help” form on this page. We’d love to see you here! For more online information about insurance coverage for TMS, you can visit our dedicated insurance webpage.
