Payment & Insurance Information
Your investment in specialized ADHD care that works
Self-Pay Practice: Focused on Your Care
South Shore ADHD is a self-pay practice, meaning we do not directly accept insurance. This allows us to:
- Provide longer appointments focused on your unique needs, not insurance quotas
- Offer innovative treatments like XR Health VR therapy that aren’t typically covered by insurance
- Eliminate insurance restrictions on treatment approaches and medication options
- Maintain complete confidentiality of your diagnosis and treatment
Our membership model ensures you receive comprehensive care with predictable monthly costs, avoiding surprise bills and insurance denials that often occur with traditional practices.
Did You Know?
Many of our patients successfully recover 40-70% of their treatment costs through out-of-network benefits.
Get Reimbursed: The Superbill Solution
While we don’t accept insurance directly, we make it easy to get reimbursed by your insurance company with our comprehensive Superbills.
What is a Superbill?
A Superbill is an itemized receipt that includes all the information your insurance company needs to process an out-of-network claim, including:
- Proper diagnostic codes (ICD-10)
- Treatment procedure codes (CPT)
- Provider credentials and NPI number
- Dates of service and fees
Our Simple 3-Step Reimbursement Process:
1
Request your Superbill through our client portal after each month of service
2
Submit to your insurance through their online portal or mobile app
3
Receive reimbursement typically within 2-4 weeks via direct deposit or check
Many insurance plans cover a significant portion of out-of-network mental health services, especially for specialized ADHD treatment. Reimbursement amounts vary based on your specific plan’s out-of-network benefits.
Maximizing Your Benefits
Before starting treatment, we recommend:
- Call your insurance company and ask specifically about “out-of-network behavioral health benefits”
- Verify your deductible for out-of-network services and what percentage they reimburse after it’s met
- Ask if they cover evaluation and management (E&M) services, psychotherapy, and neurocognitive testing when medically necessary
Helpful questions to ask your insurance provider:
- “What is my out-of-network deductible for behavioral health services?”
- “What percentage of UCR (usual, customary, reasonable) fees do you reimburse for out-of-network providers?”
- “Do I need pre-authorization for ADHD evaluation or treatment services?”
Our billing specialist is available to help guide you through this process and answer any questions you might have about maximizing your reimbursement.
Flexible Spending & HSA Compatible
South Shore ADHD is qualified to accept payment from FSA and HSA accounts. These pre-tax dollars can significantly reduce your overall treatment costs.
