Insurance-Coverage
       Hope TMS and Neuropsychiatric Center 
646 558 5299
Elvin Ruiz M.D.
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57 West 57th Street       Suite 808       New York, New York       10019
57 West 57th Street      Suite 808      New York, New York      10019
After a patient has learned of the benefits of TMS, 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 Hope TMS of NY, 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 and are extremely persistent with insurance companies to obtain coverage on behalf of our patients. Presently, TMS Therapy is currently covered by most insurance companies on a case by case basis. Because they feel this treatment is relatively "new" according to the health insurance industry, most plans do not have a clear coverage guideline and, in some cases, it is considered to be an "elective" procedure, despite the inadequacy of other covered treatments. In some cases, a prior authorization approval for coverage may be obtained after the treatment has been prescribed and requested by the attending physician. Most insurance plans are reimbursing patients if they choose to have this treatment before their plan has developed a coverage policy. Because TMS Therapy is becoming more available around the United States, the media has begun to notice and more patients are receiving treatment, insurance plans are actively evaluating their policies on TMS Therapy and we all expect benefits to become more widely available by 2015. 

In the meantime, we do not flatly accept “no” and/or "coverage denied" for an answer when we have assessed TMS as the best treatment option for a patient. If an insurance claim is initially denied, we are dedicated to writing letters, including composing the necessary clinical information demonstrating the medical necessity of this treatment for our patient, while our partner, NeuroStar, compiles and submits appeals, published journal articles, and additional information from the FDA, the American Medical Association, and other governing bodies, which support the use of TMS Therapy as a standard of care in psychiatric medicine best practices. This ensures that each patient receives a fair and thorough review of their individual case, If the insurance companies still deny our patient the care they need, we do not stop there. We then make phone calls to case managers and eventually to the medical directors and state our case. We take all the necessary steps up to and including an external insurance appeals process. This perseverance has paid off; in several cases, as we have won insurance approvals on external appeals that were otherwise denied. The insurance review and approval process can take as little as 2-3 weeks, but sometimes extends as far as 6-8 months. At Hope TMS of NY, we have found that when patients can begin their treatments before the initial insurance inquiries, the likelihood of insurance approval is increased. The office staff at Hope TMS of NY continues to make progress utilizing the appeals process with several carriers and we remain optimistic about future insurance coverage decisions. 

If out-of-pocket payment is necessary in order for you to receive treatment now, we at Hope TMS of NY are glad to be able to provide several different financing options. Some of our patients choose to finance their treatments by utilizing their healthcare savings account. Other patients choose to use medical financing plans. There are several different companies offering competitive rates, with which we have partnered with, to offer low monthly payments. We will be happy to assist you in determining which kind of financing options work for your budget.

Once TMS is prescribed by the psychiatrist, we will diligently work with you to begin insurance authorization inquiries and research other financing options. Call us today at 646 558 5299 or click the contact tab at the bottom of the page.

Breaking News Regarding Insurances Accepted
For a great number of patients TMS is the only treatment that could significantly improve or bring their depression into remission. Hope TMS is committed to make TMS available to ALL patients in need of this treatment. Our dedicated staff will work with you to tailor a plan that will make TMS affordable.

Hope TMS of NY is Proud to announce that GHI, EMBLEM, HIP, UNITED, BLUE CROSS & MEDICARE are NOW covering TMS services provided at Hope TMS of NY, Don't have those Insurances? Don't Have any Insurance? Call us today and let us show you how affordable TMS can be. We will work diligently to make this treatment affordable to those who require it.
Insurance For TMS