Billing & Insurance for ECT
As a patient at the MUSC Health Department of Psychiatry, Brain Stimulation Division, you will receive bills from the physicians and from the hospital. MUSC Physicians (MUSCP) submits bills for the professional fees charged by its physicians. The Medical University Hospital Associate (MUHA) bills for hospital facility charges for the use of equipment, space, and supplies. Both MUSC entities participate with Medicare, BlueCross BlueShield, and various other payers and managed care organizations. They do not, however, participate with all payers. Regulations also require us to bill for deductibles and co-payments, even for those insurances with which we participate. Co-payments will be required before or at the time of service.
MUHA may participate with a health plan, but MUSCP may not. In this instance, you would be responsible for paying for the portion of your physician’s bill that your insurance plan does not cover. Depending upon your insurance, you may not receive a bill at all, but instead receive an explanation of benefits, which will outline what your insurance was charged and what was paid on your behalf.
In some instances, your insurance requires a prior authorization before you begin treatment. Without the prior authorization, you will be required to pay for all bills. Some insurers do not require a prior authorization, but whether an authorization is required, it’s still not a guarantee of payment. All payments are based on medical necessity and cannot be determined until the claim is processed. The medical documentation will be reviewed in order for the insurance company to determine payment. Thus there is no guarantee how much is covered and if insurance does not cover the charges, then the patient is responsible for payment.
Some people choose to pay out of pocket for procedures, either because insurance is not covering treatment or because patients do not want to use insurance. Most patients paying out of pocket for ECT are eligible for 50 percent discount in total charges. Nevertheless, an ECT series is still generally expensive to pay out of pocket. You may request contact with Shayna Epstein at 843-792-1879, the Brain Stimulation Service hospital business manager, for questions about out of pocket costs for ECT.
Front Desk Downtown: 843-792-5716
Rates and discounts do change, be sure to confirm with the Brain Stimulation Service for any changes in charges that may not have been updated on this website as of 10/26/15.