H Berryman Edwards, MD, FAPA

Insurance Reimbursement

For the most part the patient is responsible to secure reimbursement from their health insurance plan for services rendered by Dr. Edwards. Insurance coverage for mental illness varies from generous to none at all. Different companies may have different criteria or definitions for determining what is or is not reimbursable. Most companies cover only what they consider "medically necessary". The criteria for medical necessity vary from company to company. Services provided by Dr. Edwards may not be considered medically necessary by the company or case reviewer. This may mean that the patient's symptoms do not interfere with social or occupational functioning or that the treatment has returned the patient to adequate functioning. If the patient wishes to continue in treatment anyway, it may be without any reimbursement by the insurer. Please do not ask Dr. Edwards to misrepresent diagnosis or level of functioning in order to obtain insurance benefits.

Information about managed care from the American Psychiatric Association