What insurances does Synapse Solutions contract with?

What Insurances is Synapse Solutions contracted with?

We accept cash payments and have partnered with several insurances including: 

WE ARE NOT IN NETWORK WITH  Anthem BCBS, QUARTZ- UW Health network, MHS managed care, Network Health,  Chorus, Community  Manage care, Cenpatico, Group Health Cooperative, among others. It is very important to verify eligibility with your insurance provider to avoid unexpected costs. 

Why should I verify my eligibility with my insurance provider?

Why should you verify your eligibility with your insurance provider?

Verifying Your Eligibility:

Verifying insurance coverage, even if a provider says they're in-network, is like checking the weather before a picnic – it's important to ensure you're prepared for any unexpected showers! Here's why:

1. In-Network Doesn't Guarantee Coverage: Just because a provider is in-network doesn't mean every service they offer is covered by your specific plan. Some plans have specific limitations, like excluding certain types of therapy or requiring pre-authorization for certain procedures.

2. Billing Errors Happen: Even the most meticulous providers can make billing mistakes. Verifying coverage beforehand helps avoid surprise bills later, ensuring you're only charged for covered services.

3. Network Tiers Matter: Some in-network providers have different tiers within the network, each with varying costs. Verifying your coverage helps you understand what co-pays, deductibles, and coinsurance amounts you'll be responsible for.

4. Out-of-Network Charges Sting: If you unknowingly receive care from an out-of-network provider, you could be responsible for significantly higher costs. Verifying coverage upfront helps you avoid this financial shock.

5. Peace of Mind: Knowing your coverage details provides peace of mind, allowing you to focus on your health and well-being during your appointment, rather than worrying about potential billing issues.

Think of verifying coverage as an investment in your financial and emotional well-being. It's a quick and easy step that can save you time, money, and stress in the long run.

Here's a helpful analogy: Imagine you're planning a road trip. You wouldn't just hop in the car and drive without checking the gas gauge or mapping your route, right? Verifying insurance coverage is like checking your insurance "gas gauge" and ensuring you have the right "map" to navigate the healthcare system efficiently.

So, the next time you schedule an appointment, remember to take a few minutes to verify your coverage. It's a small step that can make a big difference in your healthcare experience.

How do I verify insurance coverage with my insurance provider?

How do I verify insurance coverage?

Demystifying Your Coverage: A Guide to Navigating Insurance with Confidence 

Navigating the world of insurance can feel like deciphering an ancient riddle - terms like "co-pay", "deductible", and "pre-authorization" swirling around like incantations. If you want to understand what's covered for therapy with a fantastic specialist like you’ll find at Synapse Solutions, you've come to the right place.

This guide is your friendly portal to demystifying your insurance coverage. Think of it as a trusty map, packed with straightforward tips and clear explanations, empowering you to confidently navigate those phone calls and understand the fine print. We'll walk you through the process step-by-step, from grabbing your insurance card to confidently asking the right questions about coverage, deductibles, and co-pays.

So, take a deep breath, shed the insurance anxiety, and get ready to embark on a journey of empowerment. By the end of this guide, you'll be equipped to speak insurance like a pro, ensuring you get the most out of your coverage and access the care you deserve.

Let's dive in!

Before making the call, gather necessary information such as your insurance card, provider’s full name, and the location Synapse Solutions, plus any relevant details about your therapy needs.

Find your insurance card, and on the back, you should see a customer service phone number. This is the number you'll use to contact your insurance provider. Dial the customer service number on the back of your insurance card. Be prepared for a series of automated prompts.

When prompted, provide your personal information, including your name, policy number, and any other details requested.

Clearly state that you are inquiring about coverage for outpatient therapy or neuropsychological testing services. Specify the provider that you are looking to see and be sure it is at the location Synapse Solutions (111 N Main Street, Suite 100 Janesville WI 53545).

Mention that you would like information about coverage for specific therapy services and ask if they can provide details about the Common Procedural Terminology (CPT) codes associated with outpatient therapy. Common CPT codes for therapy sessions include 90791 for individual therapy intake and 90837 for the following sessions. Neuropsychological testing codes include 90791, 96132, 96133, 96136, 96137, 96138, 96139, 96116, 96121

Confirm with the insurance representative that your provider is an in-network provider AND that Synapse Solutions is an in-network facility. This ensures you receive the maximum coverage

Ask about how much in network coverage will cost (this may be a percentage or a total amount). You can also ask how much out of network coverage will cost if you would like but we do not complete prior authorizations for out-of-network clients.

Ask about your current deductible status. If you haven't met your deductible, inquire about how much is remaining and how it applies to outpatient therapy services or psychological testing services.

Inquire about the co-payment (fixed amount) or co-insurance (percentage) you would be responsible for each therapy session or psychological testing appointment. Clarify if these costs apply after the deductible is met.

Check if there are any limitations on the number of therapy sessions covered within a certain time frame. Some policies may have session limits.

Take note of the representative's name, the date and time of the call, and any information provided. This can be useful for reference.

If there's anything you don't understand or if additional information is needed, don't hesitate to ask. This is your opportunity to clarify any uncertainties.

Remember, insurance policies vary, so it's essential to get specific details about your coverage. This information will help you make informed decisions about pursuing therapy at Synapse Solutions.