Get Benefits Investigation Form - Neurostar

Filling out the Benefits Investigation Form - Neurostar online is a vital step in determining insurance coverage for TMS therapy. This guide provides clear and supportive instructions to assist users in completing the form accurately and efficiently.

Follow the steps to successfully complete the Benefits Investigation Form - Neurostar.

1. Press the ‘Get Form’ button to access the Benefits Investigation Form. Open the document in your preferred editor.
2. Input the patient's name and the date at the beginning of the form to ensure the document is properly identified.
3. Provide the insurance contact information, including the insurance company name, the customer service representative's name, their phone number, and a call reference number if available.
4. Answer questions regarding general behavioral health benefits or plan type, including any exclusions that may apply and whether the plan is self-funded or self-insured.
5. Indicate if the physician is part of the insurance network and if the plan has a behavioral health carve-out. Provide the name of the carve-out plan if applicable.
6. Fill in the benefits plan details, including in-network and out-of-network coverage, effective date of coverage, co-pay, co-insurance, and deductible amounts.
7. List the CPT codes relevant to TMS therapy and provide a brief treatment description.
8. Specify the diagnosis code(s) as provided by the physician and indicate the type and place of service.
9. If applicable, determine if preauthorization is required and collect the necessary submission information.
10. Record claims requirements, including the submission deadline and claims recipient details.
11. Review the appeals information section to understand the process in case of denial. Ensure to document any required contacts for further assistance.
12. Once all fields are completed, save your changes, download, print, or share the Benefits Investigation Form as needed.

Complete the Benefits Investigation Form - Neurostar online today to take the next step toward securing coverage for TMS therapy.