neuropsychologist evaluation quest.

[sjexpress]

Hi-
many of you have been so helpful and supportive with your advice. I now have my husband on board about getting a neuropsychologist. evaluation for difficult child and possibly medications. My quest. is can a neuropsychologist. prescribe medications or does he just get you a diagnosis and then refer you to a psychiatrist who is an MD who can dispense medications? Thanks again for all your time. I am trying to really get the ball rolling now and want to know what I have to do to best help difficult child and our family. Also, a few neuropsyhs I contacted say they do not accept any insurance? Is this the norm? I see psychiatrists and psychologists in my insurance book but not neuropscyhs. I hope I can even afford to do this!

 

[SRL]

A neuropsychologist is involved in the assessment and diagnostic phase of the process. They also will make referrals to other specialists (such as a psychiatrist or occupational therapist). If they're in practice with other specialists they may consult with them as part of the process.

They do not prescribe medications and are not involved in ongoing counseling or therapy, however they might suggest bringing the child back in X number of years for followup assessments.

Hope this helps.

Check the Children's Hospital websites in your area to see if any neuropsychologists are on staff. If you can't find anyone that way, then google the nearby large cities along with the term "pediatric neuropsychologist". If your insurance doesn't list anyone, they still may cover someone out of network if there's not a representative within network. Usually that would take a letter from your pediatrician to make happen.

 

[confuzzled]

no, a neuropsychologist(ologist) can't dispense medications, you have to take the reports to a doctor...but be forewarned...not all psychiatrists are open to test results.

you are totally doing the right thing by lining up all appts now. when you settle on a neuropsychologist, also find out how long it will take them to generate a report....i was shocked at
how long it took.

i couldnt find one either that accepted my ins, but for us, in the interest of time, we were looking privately and not through a hospital system. i was however able to get preapproval
for some of the testing and i'm still waiting on reimbursement. i believe we got 2 hours out of 8 approved, and supposedly it was that the other hours were considered educational testing--it was a crock...i had the actual EDU testing done at the school, the neuropsychologist did diagnostic testing.

but call your ins. company. if you have seperate mental health benefits start there. don't just go by the ins handbook.

glad husband is on board--hope you get appts fast.

 

[confuzzled]

OH. ::slaps forehead::

the neuropsychologist himself was covered.

the ins. code for him was the same as a therapist--90806. (90801 for an initial evaluation). call your ins and if they dont know what you are talking about ask for a casemanager and give those code # and see if they will cover those services. be aware that, depending on your ins, if he sees a private therapist who is also a "90806" it may be a conflict-in our case it was considered a duplication of services, even though they werent even similar services!, and it was a huge PITA...we had to do some funky footwork to get things covered.


its the testing that a koi-shoot, for us anyway.

 

[BusynMember]

Neuropsychs at University Hospitals tend to be covered by all insurance, including Medicaid. My son got covered by Medicaid and he had ten hours of fantastic evaluation by a neuropsychologist who had worked at Mayo Clinic for ten years then set up practice in Wisconsin. I didnt' even go to a Psychiatrist after that because most psychiatrists don't have a clue what to do about autistic spectrum disorder and that requires interventions far more than medications. But if I had used medications, I would have only gone to a psychiatrist who agreed with the diagnosis because, after it was explained to me, I knew that we finally had our answer. The interventions made all the difference in the world in my son's life. He doesn't relate well to psychiatrists...spectrum kids are not communicators.

 

[SRL]

I just googled and found a different code for neuropsychologist consult and a different one for neuropsychological testing. The codes were the same at several sites I saw.

 

[confuzzled]

96115Neurobehavioral Status Examination

interesting. i fought with the neuropsychologist, i fought with my ins co, i fought with anyone who would listen to me over the conflict. (it was the most bizarre thing i ever encountered--there was no way, in my mind, that a neuropsychologist was the same as a social worker, but everyone involved *INSISTED* the coding was the sam)...lol, i have these codes burned into my memory for eternity.

the testing code was what we used as well, but like i said, there was a whooping big portion of testing that was deemed educational by the ins. co.

there is not a single doubt in my mind that if i had competent billers with different coding it would have all been covered.

(oh, and our major uni childrens hospital had a lengthy wait and was pay as you go, *no* ins. apparently they somehow seperated out the mental health services from the medical services. i would have had to submit on my own at out of network rates...
it was $1000 to walk in the door--seemingly you needed to leave a kidney at the front desk to pay for any actual testing)

 

[confuzzled]

oh, and for sj...you really want to call your ins. company and check on both your mental health bene's and your out of network bene's (where you submit directly to the company yourself and ins. sends you a reimbursement check for a portion of the usual and customary fees--i find, in the tristate area, more often than not many private providers dont deal with insurance companies at all anymore, so its important to know what you need to do...some require preauth's, some are unlimited benefits but run like a managed care co where they require treatment plans and dispense X amount of visits at a time, and so on.

often the "handbooks" are lacking in information. you, (ok *I*) need(ed) a live person to talk you (me) through it

 

[SRL]

I have a friend who sought a neuropsychologist evaluation for her son and there weren't any in network. Her pediatrician wrote a letter recommending the assessments and she found a neuropsychologist in the area who was out of network. It was the neuropsychologist who submitted the appropriate codes to the insurance company and got them cleared.