Do You Accept Insurance?

Cygan Psychological Services accepts UnitedHealthcare, UMR, Cigna, Blue Cross/Blue Shield, Aetna, Medicaid, and Medicaid CMOs (e.g., CareSource, PeachState).

Payments, including deductibles and copays, are due at the time of service. For self-pay clients, a $200 deposit is required to schedule the evaluation and will be applied to your total balance, which must be paid in full before the assessment begins. I accept cash, checks, and credit cards. Please note that a 2.9% transaction fee is applied to all credit card transactions. Checks should be made payable to Cygan Psychological Services, LLC.

~More Information Regarding Insurance~ 

Please note that insurance companies do not cover psychological testing for developmental delays, “learning” or “educational” as they deem these services ‘educational’ rather than ‘medical’, even if the provider is in-network.

In addition, insurance does not pay for psychoeducational assessments of academic achievement, cognitive (i.e., IQ) testing, or personality inventories, which are often incorporated into our evaluations.

Insurance companies only pay for things that they consider ‘medically necessary,’ which means that an individual has to be diagnosed with a mental health disorder AND prove that it is impacting their health on a daily basis. Fortunately for their children, many parents seek evaluations and treatment before their child’s challenges either meet the full criteria for a mental health disorder or significantly impact their daily functioning.

 Insurance companies will often inform members that a ‘quote for benefits does not guarantee payment’, which means that you can be told over the phone that a service is covered, be given a pre-authorization number, and still be denied once they receive and review the diagnosis. Additionally, preapprovals for mental health services, including comprehensive evaluations, involve the insurance company's staff ‘permitting’ or ‘approving’ each and every individual test that I deem clinically necessary to administer, prior to the start of the evaluation.

Since I tailor my assessments to your child, as well as the referral question, if, while working with your child, I deem it necessary to alter the test battery to better suit your child’s needs, the insurance company can deny payment.

Finally, in order to receive payment or reimbursement from insurance companies, I am required to give a mental health diagnosis in the form of a billing code. It is unethical for me to provide one, strictly for billing purposes, if your child does not meet the criteria for one of their pre-determined mental health diagnosis. Also, this requires that your or your child’s diagnosis be shared with a third party.

If you have primary and secondary insurance and one is private and the other is state-issued, all private insurance plans are automatically considered primary, which means claims are always submitted to your primary insurance, even if that plan does not cover certain services. Any copays, co-insurance, and deductible amounts required by your primary insurance must be collected and processed before we can submit claims to your secondary insurance.

Secondary insurances will only review and process claims after the primary insurance has completed its review and issued an Explanation of Benefits (EOB). As a standard practice, our office does not bill secondary insurance directly; however, I am happy to provide you with detailed receipts and a superbill upon request. These documents contain all the necessary information for you to submit a reimbursement claim to your secondary insurance provider.

We encourage you to review your insurance policies regarding coordination of benefits and reimbursement procedures, as you are responsible for submitting any required documentation to your secondary insurance. If you have unique circumstances or specific policy requirements, please notify our office in advance so we can review and address them accordingly.

Most insurance companies provide “out-of-network” insurance benefits for non-participating providers. Should you wish to file for reimbursement, I can provide you with a written “super bill” with all of the information necessary to submit claims to your insurance company.

Please remember that it is your responsibility to check with your insurance company about Out-of-Network benefits. If your insurance company requests a list of the tests being administered, I can provide that for you.

When you call them, find out the answers to the following questions:

  • Do I have "out of network" benefits?

  • Are psychological/mental health services covered and what is the coverage amount?

  • How many sessions per calendar year does my plan cover?

  • Is there a deductible and how much is it?

  • What portion will be reimbursed?

  • Is a referral needed from a primary care physician?

 

Clients are highly encouraged to check with their insurance company prior to receiving services, as Dr. Cygan and Cygan Psychological Services, LLC cannot guarantee such reimbursement and are not responsible for unpaid insurance claims.