A 63-year-old male asked:
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for depression how to choose a/best tms center/provider & how best to maximize chances of insurance (cigna ppo) paying for it?

2 doctor answers
Dr. Imad Khreim
38 years experience Psychiatry
Your Doctor: Your doctor whom you are working with and who is referring you to get the tms , usually is the one who gets the pre authorization and who makes the case for your insurance to pay for it (if that is in your plan to start with) . Also he will have a better idea about which local centers rank higher and he will recommend one for you.
Answered on Jan 21, 2020
Dr. Louis Cady
31 years experience Psychiatry
Fairly simple: One of the first things is location. Since this is typically 30 treatments in six weeks - m-f, you want some place you can either drive to or have a short stay hotel there for six m-f periods. You can go to www.Neuronetics.Com to search all tms centers in usa who have the neurostar system installed. Payment issues - i will have to answer this in a seperate comment. :).
Answered on Dec 2, 2014
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Dr. Louis Cady
Dr. Louis Cady commented
31 years experience Psychiatry
Provided original answer
Ooops. One other thing. If you are lucky enough to live in an area where there are multiple TMS centers to pick from, I would visit their web sites, call their centers, ask for references from patients they have treated, and go in and actually see their facility and talk with the physician (briefly!)and treating staff before making a decision. I would never turn down such a request by someone who was honestly interested in TMS. Mind you, this contact with the physician and the treatment staff should not be to help you wrestle through the decision of whether or not you want it or should have it - there is plenty of information on line and on youtube about it. The purpose would be to identify, in your mind, "are these nice people?" "Would I feel comfortable working with these people?" Hope these answers help.
Apr 28, 2013
Dr. Louis Cady
Dr. Louis Cady commented
31 years experience Psychiatry
Provided original answer
OK. Now for insurance. 1) Must have a documented, diagnosed major depressive disorder first. (other dx's may work, but this is the "FDA approved" diagnosis. 2) Insurance company MUST be asked to pay for it before treatment started - even if they say no. 3) Some insurance companies will not pay under any circumstances. They will lie and claim TMS is "experimental" - it is not. In every case that we have done at our center, we have had to go through three levels of appeals. 4) Happily, in some states, TMS is a "covered benefit" under some insurance plans. Anthem approved it here in Indiana. However, it is unclear how that will work if your TMS center doc is not an Anthem "provider." Coverage is also good in Michigan if you are covered under an insurance plan there. 5) Finally and ultimately, it comes down to how much it's worth to you. The cost of a a languishing, resistance, life-sucking, soul-killing depression over years or decades is impossible to calculate - but it's a lot more than biting the bullet one time and paying for a treatment that is this good. I have literally seen miracles occur at our center with TMS treatment, and it has worked when literally nothing else has - in two cases, including ECT.
Apr 28, 2013

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