FREQUENTLY ASKED QUESTIONS about fees and insurance

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There are multiple reasons that Well Neuropsychology does not participate with any insurance carriers:

• First and foremost, I am out of network to ensure the highest quality of patient care possible to provide thorough, individualized care at every step of the evaluation process. This will not be a "cookie cutter" evaluation, since we do not have to follow insurance criteria. 
• Neuropsychological evaluations are usually lengthy and complex. Insurance carriers do not generally cover the full scope of these services or may limit the number of hours or types of services authorized. This way, we can address all of your concerns without insurance dictating your care.
• Insurance plans have strict criteria for covering neuropsychological and psychological testing, such as only approving assessments for certain diagnoses, and they do not cover psychoeducational testing at all since it is not medical-based. These issues can result in denied claims or partial coverage, and makes it difficult for providers to offer comprehensive care within these network constraints. 
• Simply put, insurance is often difficult to work with. It requires significant administrative work (e.g., pre-authorizations, documentation, billing, disputing claim denials, etc.). For a solo practice like Well Neuropsychology, this would detract from patient care.
• Provider reimbursement rates for psychologists are typically not reflective of the time, expertise, and resources required for comprehensive evaluations, making it financially unsustainable to participate in insurance networks.
• Because we are self-pay, this allows us to provide faster access to care. We generally can get folks in within a month or less - many in-network options have 6-months or even 1+ year wait lists. 

A: Since Dr. Cheatham tailors the evaluation to your needs, the cost is variable. Because of the wide range of evaluation options, fees also have a wide range and are estimated to cost between $1,500-$5,000. After an email or phone call with our practice administrator (Emily) or Dr. Cheatham, you will receive an exact quote for your evaluation. 

If during the testing process, additional needs or referral questions are discovered, Dr. Cheatham will speak with you about options to further assess these areas, including if there are any additional fees associated with providing additional testing. There will never be billing surprises. 

A: Maybe. This answer is entirely dependent upon the out-of-network (OON) benefits of your specific insurance plan. 

This is at the sole discretion of your insurance carrier and we cannot predict, guarantee, or take any responsibility for these decisions.

A: We will provide you with the billing (CPT) codes and diagnostic codes that will be used for your evaluation. Before scheduling, it is HIGHLY ENCOURAGED that you call your insurance company and ask if your specific plan allows you to be reimbursed for an out-of-network neuropsychological evaluation, and provide them with the billing/diagnostic codes we give you. 

A: After your evaluation is complete, you will receive a "SUPERBILL", which is an itemized statement for your insurance company. It will include all information necessary for your insurance to reimburse you (e.g., provider licensing information and practice information, each date of service with description of services rendered and fees, as well as the total fees paid by you for the services). At the end of the evaluation, you submit this to your insurance by calling the member services number on the back of your insurance card. They will then draft a check to you for the amount that they agreed to reimburse.

A: Debit cards, credit cards (Visa, MasterCard, American Express, JCB, Discover, and Diners Club), FSA, HSA, HRA, or cash

Yes!

A: Yes. In order for insurance to reimburse you, there must be a diagnosis listed. Since insurance is part of the medical model, you must have a diagnosed health condition if you utilize these OON benefits. This means that any diagnosis listed on the superbill will become part of your insurance's medical record. You are submitting your superbill to your insurance with this understanding. 

Please note, other than you sharing your superbill with your insurance, Well Neuropsychology's medical record system is not connected to your insurance or other provider's medical record systems in any way. Your protected health information with Well Neuropsychology is CONFIDENTIAL and will not be shared without your explicit consent or unless dictated by circumstances outlined during the informed consent process. 

A: Payment is generally split into 2-3 parts: 1) $200 at pre-testing intake session (if applicable), 2) about half of the balance is due on test day, 3) the remainder of balance is due on the day of feedback or when you receive your report. It will correspond with the CPT billing codes in the way that most insurance carriers prefer to see it billed, which will assist with you with maximizing your reimbursement.