Insurance
Our patients either fund the cost of their care themselves or the fees are paid by an insurance company. As a newly established operator we are not yet accepted by insurance companies but we hope to have this established soon. In the meantime you may be able access treatment at the Cardinal Clinic with the support of your insurer but this may involve you paying and reclaiming from your insurance company. If you have private medical insurance please speak to them first and they can advise you on the best course of action.
Before Commencing Treatment
Before patients commit to mental health treatment under a health insurance policy, we strongly recommend that they speak to their insurance company and understand whether there is an excess on their policy and how much mental health care funding is provided.
Policy Excess: This is the amount the patient must pay towards the total cost of their treatment. Cardinal Clinic will be advised of this by the insurance company and we will invoice the patient directly for this amount. The patient should pay this sum to Cardinal Clinic.
Mental Health Care Funding: Many health insurance policies limit the amount of funding for mental health care. This will normally be in the form of a total amount per year which will be paid by the insurance company. It is important to understand this as the patient will be liable for any shortfall in the cost of their care, which is not met by the insurance company. It is recommended that patients discuss this with their clinician to ensure that their care can be managed within these budgets.
When patients arrange their initial assessment appointment, there is certain information we will require in order to proceed. This is as follows:
- Insurance Provider
- Policy Holder Name
- Policy Number
- Authorisation Code
Patients should contact their insurance provider to obtain the authorisation code so we can ensure that organising funding does not interfere with the patient’s recovery.
In-Patient and Day Care Insurance Arrangements
If in-patient care or day care is required, the patient’s consultant psychiatrist will write to the insurance company to obtain authorisation. They will also liaise with the insurance company if additional care is required beyond what is initially authorised. They will complete the forms and make the necessary arrangements for this.
Insurance Company Requirements
Most insurance companies require a referral from the patient’s GP before they will authorise treatment. Please click on the link below for information about organising this:
Most insurance companies would also expect a patient to have an initial assessment with a consultant psychiatrist. Patients with health insurance policies may not be able to be referred directly to a psychologist. If a patient’s GP recommends referring directly to a therapist, it is worth confirming with the insurance provider that they will provide an authorisation code for this.
Corporate Health Insurance Policies
Patients who have health insurance provided by their employer will able to be referred by the employer’s occupational health doctor rather than the patient’s GP. The employer should be able to provide further information about accessing treatment.