Frequently asked questions (FAQs)
Do you accept insurance?
Yes, but only for neuropsychological evaluations for patients with documented medical necessity. We accept BCBS (Network P only) and Aetna, but simply having these plans does NOT guarantee coverage. We will work with you to verify coverage with the appropriate CPT and diagnostic codes before the day of the appointment.
We currently do NOT accept insurance for therapy sessions or medication management. We are happy to prepare a “Statement for Insurance Reimbursement” (aka Superbill) for you to submit to your insurance plan for partial reimbursement to help off-set the costs. We cannot provide superbills for psychoeducational testing or academic add-ons.
What is medical necessity?
In order to bill insurance, there needs to be a previous medical (not behavioral) diagnosis that shows the medical necessity for the testing.
Examples of medically necessary indications for neuropsychological testing include, but are not limited to:
Assessment of neurocognitive abilities following traumatic brain injury, stroke, or neurosurgery or relating to a medical diagnosis, such as epilepsy, premature birth, or fetal exposure to drugs or alcohol.
Assessment of neurocognitive functions to assist in the development of rehabilitation and/or management strategies for persons with diagnosed neurological disorders.
Monitoring of the progression of cognitive impairment secondary to neurological disorders.
Testing for educational reasons is not covered. This testing is usually provided by school systems under applicable state and federal rules. Most benefit plans exclude coverage of educational testing. In addition, NPT or PT performed for educational reasons is not considered treatment of disease.
Do you offer financing?
We can provide you with a “superbill” which will list the diagnostic codes and service codes (also known as, CPT codes). These superbills can then be submitted to your health insurer for partial reimbursement. There are several companies that offer help navigating this process. Reimbursify offers to handle all of your out-of-network reimbursement paperwork for you for a small fee.
We also accept CareCredit. Care Credit is a credit card that can be used by individuals to pay accredited health care providers. It is a short term financing option offered to patients. It is designed to help individuals manage healthcare expenses that are not covered by their insurance companies. Go to the Care Credit website to apply today.
Who does the testing during evaluations?
We use a technician based model similar to how dental practices operate (i.e., a dental hygienist cleans your teeth but your dentist analyzes the data, provides the diagnosis, and discusses all the treatment options with you). All of our examiners go through a rigorous training period after meeting criteria put forth by the state of Tennessee to obtain licensure as a Certified Psychological Assistant. All licensed providers remain on site and communicate with the examiner continuously throughout the day to allow the best service possible in an efficient manner.
My child’s teacher told me that I need to have a “psychoeducational evaluation” completed for my child. What does that mean?
Oftentimes, teachers or other providers in the community such as pediatricians are the first line of defense in identifying when an individual may need an assessment to help answer questions about their thinking skills, academic achievement, and psychological functioning. We like to say that your job as a parent is to reach out and contact us, and our job is to help you figure out the best type of evaluation to answer your specific question(s). Sometimes a psychoeducational evaluation is appropriate, but other times it may be more helpful to focus on other cognitive thinking skills not typically assessed during a psychoeducational evaluation. In this case, a more comprehensive neuropsychological evaluation is a better fit, especially if there is a history of an underlying medical or neurologic condition.
What should I tell my child about what to expect on the day of testing?
We often get requests from parents about what to tell their child who might be nervous about coming in for testing. It is best to start with letting them know that we are “thinking and feeling” doctors, so nothing will hurt: no shots or scans! We will be giving them tests in a one-on-one setting in a quiet room, which is the type of setting where most children perform at their best. The tests that we give will assess their thinking, learning, memory, and processing skills and/or academic skills. This is done through a variety of different activities. Some will require verbal responses and some will require written or simple motor responses (arranging 3-D blocks, clicking buttons to select a response on a computer). Many children find this testing to be enjoyable because they think it is cool to learn about how their brain works through understanding their strengths and weaknesses. Results obtained through testing are then used to help them thrive in terms of using their thinking skills at school, getting along with others, feeling good about themselves, and helping with behavior in different settings.
Want more information to help prepare for the assessment? Check out this resource by Dr. Liz Angoff who is another testing psychologist!
Why is it important for providers to use a trained interpreter when a child or parent/guardian is bilingual?
Due to the unique qualities required for accurate interpretation, we do not allow friends or family to interpret during our sessions. Knowing the difference between someone who is bilingual and someone who is a trained interpreter can be helpful to understand why we have these requirements in place. The following link explains how and why there is a distinction between the two and why having a professional interpreter is imperative to accurate results.
5 Tangible Differences Between Bilingualism and Qualified Interpreters in Healthcare