This article will guide you through the process of being referred for medication via your AXA health insurer. This is for AXA clients who have been diagnosed with ADHD using another provider.
Approval for our medication pathway is subject to clinical review of your existing diagnosis. We can’t confirm access to any of our post diagnostic services without this review.
Select a step to find out more:
Step 1 – AXA approval and referral to us
The first step in being referred to ProblemShared for your care should be initiated with AXA.
Once AXA have assessed your claim and approved your request, they will send a referral to us. This is usually an online referral, and once we receive it, we will send a welcome email to you with the next steps to sign up. Please ensure that your details are up to date with AXA, particularly your email address.
If you don’t receive an email from us within a couple of days of AXA sending your referral, please get in touch so we can check that the referral has been received.
Step 2 – Signing up and Initial Needs Assessment
Sign up by clicking the link in your welcome email from ProblemShared. You will need to:
- Upload a proof of identification
- Upload a proof of address
- Upload your existing diagnosis report
After uploading the required documentation, you will be able to book an initial needs assessment with a ProblemShared clinician. This is to review your referral information and discuss our options with you.
The initial needs assessment usually lasts for around 30-45 minutes.
If the client is under 18:
- Young people aged 12 and over are expected to attend and participate fully with their parent/guardian also present.
- Children under 12 do not need to attend.
Step 3 – Review of existing diagnosis
Following your initial needs assessment, you will receive an email informing you that your existing diagnosis is being reviewed.
You will be asked to provide your diagnosis report, if this has not already been uploaded, to your dashboard. Your dashboard will update to reflect the same.
During this time, one of our clinicians will review the diagnosis report and any supporting information provided.
Step 4 – Outcome
We will send an email to you with the outcome of our review of your diagnosis report and supporting documentation.
There are three possible outcomes:
OUTCOME 1
Existing diagnosis not approved for any Post Diagnostic Services including medication
You may be deemed not suitable for Post Diagnostic Services for one of the following reasons:
- The report/assessment is not deemed to be robust or NICE compliant.
- The assessment was not carried out by a registered professional appropriate for that assessment.
- The report does not include a diagnosis for the specified condition.
In this situation, our clinician may recommend that you are referred onto one of our assessment pathways.
If a full assessment is not appropriate, or you do not wish to proceed with one, you will be discharged.
OUTCOME 2
Existing diagnosis not approved for Medication only
In this case, you may be approved for one of our post diagnostic services, such as Psychoeducation, but we cannot refer you to our medication pathway. This can be because of:
- Heart & circulation conditions
- Brain & nerve conditions
- Mental health conditions
- Drug or alcohol use
- Hormones & metabolism conditions
- Eye health conditions
- Eating & nutrition conditions
- Other medical conditions
You will receive an email from us detailing the reason why we cannot progress with a medication only pathway, along with any recommendations for other pathways suggested by the reviewing clinician.
If there are no appropriate pathways, you will be discharged.
OUTCOME 3
Existing diagnosis approved
If you are approved for your chosen pathway, we will send you an email confirming this and your dashboard will be updated with the relevant forms that you need to complete.
Once these forms are complete, you will be added to the wait list.
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