by Dr Kaleem Baig
The views below represent the information that patients ask me when making initial contact and the questions they usually ask my admin team to clarify. This is a factual description of my understanding of the approach by BUPA for neurodiversity assessments and is not representative of the views of BUPA, which only BUPA can confirm with you.
Standard Psychiatric Assessment/Initial Psychiatric Assessment
This is a formal 40-50 minute psychiatric assessment looking at your difficulties and what might explain them. The evaluation makes recommendations for the treatment plan. Where indicated, the assessment also notes if an in-depth evaluation/further specialist assessments or investigations are needed when the difficulties are more complex, including a specialist assessment for ADHD or Autism. A standard psychiatric assessment can not conclude a diagnosis of ADHD/Autism because of the time and the complexity such specialist assessment requires.
Specialist ADHD/Autism Assessment
These are specialist assessments which have several components. Each assessment requires:
Completion and review of comprehensive psychological measures before the assessment
Gaining information and feedback from a close family member
90 - 120 minutes with the patient
A comprehensive clinical report following NICE guidelines
Thank you for contacting me for an adult Autism or ADHD assessment via BUPA funding. I have put together this essential information page for BUPA patients seeking ADHD/Autism assessment. I have written this to cover the questions I get asked at the stage when patients are trying to book an appointment with me and would like to have an ADHD/Autism assessment. Unfortunately, given the issue's complexity, my admin team can't address these questions with individual patients. I have requested that they direct you to this page for your information.
There are different approaches and limitations in health coverage policies by PMI providers, which are individualised and variable in the context of policy terms and conditions. Many PMI policies exclude pre-existing conditions, and ADHD/Autism is seen as a condition present from childhood.
Your insurance coverage with BUPA may or may not include pre-existing conditions such as Autism and ADHD. For most policies, this is an exclusion. However, suppose you approach your PMI provider requesting authorisation for ADHD/Autism assessment. In that case, they do not yet have a diagnosis and therefore do not know whether symptoms are because of a pre-existing condition such as ADHD/Autism and are an exclusion or for a different mental health condition covered by your policy. They also are unable to authorise a specialist assessment for Autism/ADHD directly because of the above. If you do have cover for pre-existing conditions, they still can not authorise a specialist assessment in most cases as there is no preliminary assessment which recommends it and concludes that no other mental health condition seems to be causing these symptoms, and a specialist assessment is indicated. It could also be the case that the symptoms are not because of ADHD/Autism, which would make you eligible for treatment even if your policy excludes neurodevelopmental conditions.