Understanding Insurance Coverage for Psychological Evaluations

At Beaufort Psychological Services, we believe in being as transparent as possible about the evaluation process and the costs associated with testing. Insurance can be confusing, especially when it comes to psychological and psychoeducational evaluations, and we want you to understand exactly what to expect before scheduling your appointment.

Which insurance do you accept for evaluations?

At this time, Beaufort Psychological Services only accepts Blue Cross Blue Shield (BCBS) for psychological and psychoeducational evaluations.

If you have insurance other than BCBS, evaluations are considered self-pay services. We are happy to provide a superbill after services are completed, which you may submit to your insurance company to request possible out-of-network reimbursement. Please note that reimbursement is determined entirely by your insurance plan and is never guaranteed.

Why can’t you tell me exactly what my evaluation will cost?

Unfortunately, our office cannot accurately determine your final out-of-pocket responsibility before the claim has been processed. Although we verify your insurance benefits and obtain pre-authorization when required, these steps do not tell us what you will ultimately owe.

Here’s why:

• Every insurance policy is different.
• Deductibles, coinsurance, copays, and annual maximums vary from one plan to another.
• Your deductible may change based on other medical claims processed before or after your evaluation.
• Insurance companies do not calculate your financial responsibility until they receive and process the completed claim.

Pre-authorization means the service has been approved to be performed- not that it will be paid at 100% or that your cost has been determined. For this reason, we cannot accurately quote your final balance before your insurance company finishes processing the claim.

How can I estimate my costs?

The best way to estimate your benefits is to contact your insurance company directly before your evaluation. The office will provide an NPI number and CPT codes. 

Helpful questions to ask include:

• Does my plan cover psychological or psychoeducational evaluations?
• Do I have a deductible? If so, how much has been met?
• Will I owe coinsurance or a copay?
• Is pre-authorization required?
• Based on the CPT codes provided, what would my estimated patient responsibility be?

What happens after my evaluation?

Once your final testing appointment has been completed, we submit your claim to BCBS.

Your insurance company then processes the claim and determines:

• The allowed amount
• Any deductible that applies
• Any coinsurance or copay
• The portion paid by insurance
• Any remaining patient responsibility

If a balance remains after insurance has processed your claim, you will be responsible for that balance.

Do you offer payment plans?

We understand that evaluations are a significant investment, and we are happy to offer flexible payment plans. Payment plans must be established before evaluation services begin and are not contingent upon insurance reimbursement.

Our Commitment to Transparency

Our goal is to help every family make an informed decision before scheduling an evaluation. We will:

• Obtain pre-authorization.
• Provide the billing codes and provider information needed to contact your insurance company.
• Answer general questions about the billing process.
• Offer payment plans when needed.

Because every insurance policy is different, the only party that can determine your final financial responsibility is your insurance company after they have processed your claim. We appreciate your understanding and are always happy to help you navigate the process as clearly as possible.

Please note: Insurance benefit verifications and pre-authorizations are provided as a courtesy and are not a guarantee of payment or a guarantee of your out-of-pocket cost. Your final financial responsibility is determined solely by your insurance company after the claim has been processed.