How to check out-of-network insurance benefits

Instructions:

1. Call the Member Services phone number on the back of your insurance card.
2. Ask if you have out-of-network benefits.
3. If no, end the call. If yes*, ask the following questions:
   A) Do I have coverage for the CPT codes listed below?
   B) How many units are permitted for each CPT code?
   C) What are the reimbursement rates for each CPT code?
   D) Do I need pre-authorization, and if so, how it is obtained?
   E) How much is my deductible, have I met the deductible, and when does it renew?
   F) How do I submit the claim?

Possible CPT Codes

96116, 96121   Neurobehavioral status examination
96132, 96133   Neuropsychological evaluation services
96136, 96137   Neuropsychological testing, by neuropsychologist
96138, 96139   Neuropsychological testing, by psychometrist

*It is important to understand that the amount ultimately reimbursed by the out-of-network insurance carrier is out of Chesapeake Neuropsychology, LLC’s control. It is the sole responsibility of the patient or patient’s guardian to determine, understand, and confirm their benefits with their insurance carrier.