FAQs

My insurance has out-of-network benefits. Do you accept that?

If you have out-of-network benefits, you are treated like a "self-pay" patient. You would be responsible for the entire cost of the evaluation upfront. At the time of service, you will be given all of the information needed to fill out your own claim. You would be responsible for submitting this claim to your insurance company on your own.

What will my copay be?

Co-pays do vary depending on your policy. Before we schedule initial appointments, we verify coverage with your insurance company. The insurance company will tell us what your copay is and we will relay that information to you. However, we strongly recommend you confirm your copay information with your insurance company as well.

I have a Medicare plan through United Healthcare. Do you accept it?

We are able to accept straight Medicare plans only. That means if your policy is managed by another company, like United Healthcare, we do not accept it in our office.

I am interested in an evaluation relating to a learning disability. Is that covered by insurance?

Most insurance companies don't cover learning-related evaluations because they do not deem them as medically necessary. We strongly recommend contacting your insurance company directly (their "member services" phone number is on the back of your ID card). It is important that you be very specific when asking whether or not a neuropsychological evaluation is a covered service. You must tell them that the issue is related to a learning disability so they give you the correct information.

Any letters or statements required for a disability, such as a request for Social Security Disability, is always considered private pay and is not covered under insurance.

I have the Empire Plan. Do you accept that for evaluations?

The Empire Plan, often referred to as "NYSHIP", utilizes two different companies to handle their claims. Any service that is considered "medical" is handled by United Healthcare. Any service that is considered "behavioral" is handled by Carelon (formerly Beacon Health Options).

A neuropsychological evaluation is considered a medical service, so it is processed by United Healthcare, which we do not accept at our practice.

I am being represented by an attorney and wish to use the information from my evaluation in a legal capacity. What do I do?

While we do provide evaluations for patients with legal representation, these must be set up by the attorney themselves. The best way to proceed is to have your lawyer contact us by phone or email ([email protected]). We will send the necessary information about our legal fees and policies. It is inappropriate to utilize medical insurance for any evaluation where the information will be used in a legal manner.