Medication management and insurances at Brainbloom Neurotherapy center
We encourage potential clients to schedule 15-minute consultations with a provider to briefly check-in on being a good clinical fit. Your first one-to-two appointments will focus on reviewing intake paperwork, consent forms and office policies, and creating a treatment plan which lists your goals for therapy. We recommend that clients begin therapy on a weekly schedule, but you can talk about doing a bimonthly or monthly schedule with your provider if there are scheduling or financial concerns. To best understand your financial responsibility for sessions (ex. copays, coinsurance, and deductibles), we ask that you contact your insurance company prior to your first session. To do this, please call the customer service number on the back of your insurance card and ask if mental health therapy is a covered service, and if so then ask what your financial responsibility is. Sometimes insurance will ask you about procedural codes to look this up (also known as CPT codes) which are: 99205 initial intake, 99215 for a 55-minute session, and 99214 for a 45-minute session and 99212 for a 20- minutes session. In addition, they might also ask for our group practice Tax ID (99-3394306). Some insurance companies have a member portal where this information can be obtained via chat with a member representative, as well.
If a client is unsure of their benefits, our platform, SimplePractice, typically updates this information after the initial claim is submitted. This process usually takes about a month.
TMS and insurances at Brainbloom Neurotherapy center
Here at Brain Bloom Neurotherapy Center, our Neurostar TMS is FDA-approved for people ages 15+ and covered by multiple insurances. To find out if TMS is right for you, take the Neurostar-approved quiz for TMS or give us a call at (703) 712-7539.
Working with these insurances to get you the right care
At Brain Bloom Neurotherapy Center, we firmly believe that emotional health is the cornerstone of your overall well-being. That’s why we are dedicated to prioritizing your health and making our treatment as accessible as possible by collaborating with a diverse range of insurance payers. We accept most major insurance plans including United Healthcare, Aetna, and Tricare. Our team is committed to providing comprehensive guidance and assistance throughout the process. We handle insurance so that you can fully focus on your care.
If your insurance plan is not listed above and you are interested in TMS, don’t hesitate to contact us. We can explore single-case agreements with your insurance provider. Please note that insurances only cover TMS for the treatment of depression. Other indications such as ADHD, PTSD, etc. are considered out-of-network. Our practice still offers treatment for a variety of indications that have undergone research but have yet to be approved by the FDA. These are considered off-label treatment protocols and would not be covered by insurance.
When considering depression treatment covered by insurances, assess your mental health journey so far and take into account these factors:
How can I know my copay amount?
We ask all patients to understand what their financial responsibility is for sessions PRIOR to their first appointment. You can learn this by calling the customer service number on the back of your insurance card and asking if mental health therapy is a covered service, and what your responsible portion is. The copay amount listed on your insurance card is not always correct, as it can be influenced by your deductible amount or if a coinsurance applies. Sometimes insurance will ask you about procedural codes to look up this information (also known as CPT codes), which are:99205 initial intake, 99215 for a 55-minute session, and 99214 for a 45-minute session and 99212 for a 20- minutes session.
1.Patient Eligibility:
A patient may qualify for care covered by insurance if they:
- Are unsatisfied with the results of antidepressants
- Responded to medication but not in remission
- Are struggling with medication side effects
- Have failed two or more medication trials
- Prefer to avoid antidepressants or augmentors
2.Insurance Requirements:
Common requirements from insurances include:
- Diagnosis of Major Depressive Disorder (done in-office)
- Participation in two or more medications of different classes (SSRIs, SNRIs, TCAs, etc)
- Psychotherapy
- For ages 15 to 17 TMS has been approved as a first line of treatment for the treatment of Major Depressive Disorder in adolescents. That means some insurances approval that without a prior antidepressant trial
Please don’t hesitate to reach out to us with any questions or concerns you may have.
Address
Brain Bloom Neurotherapy Center is a mental health clinic in McLean, Virginia and is not affiliated with the BrainBloom App or any other similarly named businesses.
Phone
(703)712-7539