Covering the Cost of TMS Therapy: Sacramento TMS Staff Work With You to Obtain Insurance Coverage
One of the most common questions we are asked is, “How much does TMS therapy cost?” Patients are often concerned about whether their insurance will cover the cost of TMS treatments. At Sacramento TMS, we are committed to helping you navigate the insurance claims process and maximizing the possibility of obtaining coverage for your treatment.
A unique aspect of our practice is that we work very closely with insurance companies to obtain coverage on behalf of our patients. Typically, three-fourths of our patients are covered at a rate averaging about 80% of treatment costs. Recent patients have received coverage through companies such as:
- Blue Cross Blue Shield (Federal Program)
- Blue Cross Blue Shield of Nebraska
- Blue Shield California
- Kaiser
- Anthem Blue Cross
- Magellan/Western Health Advantage.
At Sacramento TMS, we are extremely persistent with insurance companies. Our philosophy is that we do not take “no” for an answer. If an insurance claim is initially denied, we are willing to write letters, make phone calls, and take all necessary steps up to and including an external insurance appeals process. This perseverance has paid off; in several cases, we have won insurance approvals on external appeal that were otherwise denied. The office staff at Sacramento TMS continues to make progress utilizing the appeals process with several carriers and we remain optimistic about future insurance coverage decisions.
A patient’s first step is to schedule a consultation at our Sacramento TMS office. A psychiatrist will review your medical history and current symptoms to determine if TMS is right for you. Once TMS is prescribed by the psychiatrist, we will work with you to begin insurance authorization inquiries and research other financing options.
The insurance review and approval process can take as little as 2-3 weeks, but sometimes extends as far as 6-8 months. At Sacramento TMS, we have found that when patients can begin their treatments before the initial insurance inquiries, the likelihood of insurance approval is increased. We are available to work with you to explore supplemental payment and financing options.
Learn more about payment and financing options >
Read Dr. Bermudes’ BLOG regarding recent insurance approvals >