Assessments and Insurance
There are some very important things to keep in mind regarding dealing with insurance companies when trying to get them to pay for assessments at Anderson Psychological Associates, PLLC. It is actually difficult to obtain reimbursement from insurance companies for psychological/neuropsychological assessments.
One important idea is “Medical Necessity.” This means that the service is necessary according to medical judgment. For example, a learning disability evaluation may be viewed by the insurance company as not medically necessary, because they will consider this as an “educational issue.” Many insurance policies explicitly exclude learning disability evaluations because they are viewed as something that should be handled by the school systems.
One important idea is “Medical Necessity.” This means that the service is necessary according to medical judgment. For example, a learning disability evaluation may be viewed by the insurance company as not medically necessary, because they will consider this as an “educational issue.” Many insurance policies explicitly exclude learning disability evaluations because they are viewed as something that should be handled by the school systems.
