Currently, Pediatric Neuropsychological Services does not take insurance and is classified as an “out-of-network” provider. Patients must pay for services at the time of their visit. If patients have out-of-network benefits, they may be eligible for reimbursement. We can provide a “Super Bill” upon request to help families submit their claims, but obtaining approval for reimbursement is the patient’s responsibility.
Why Opt for an Out-of-Network Provider for Neuropsychological Services?
Choosing an out-of-network provider for neuropsychological evaluations can unlock a range of advantages that go beyond standard, insurance-constrained care. Here’s how it can make a meaningful difference:
Access to Preferred Specialists
Out-of-network providers give you the freedom to choose a qualified specialist without being restricted by your insurance’s network. This allows you to connect with providers who are not only competent but also possess advanced training in their niche, such as a pediatric neuropsychology. By doing so, you can ensure that the care you receive is tailored to your unique needs and delivered by an expert with the specific expertise required for your situation.
Comprehensive Evaluations
Unlike in-network evaluations, which are often limited by strict insurance protocols—such as time constraints, coverage caps, medical necessity requirements, and narrow criteria for specific diagnoses—out-of-network providers can offer more comprehensive care. This allows our practice to deliver in-depth assessments tailored to individual needs, ensuring a clearer picture of each child or adolescent. Additionally, by avoiding rigid cost-sharing measures like deductibles and co-pays, our providers can focus on the quality of the evaluation rather than adhering to insurance-imposed restrictions.
Personalized and Flexible Care
Out-of-network providers, free from rigid insurance driven time constraints, have the ability to spend more time on evaluations.
Privacy and Confidentiality
Out-of-network providers significantly enhance confidentiality by bypassing insurance reporting requirements. They are not obligated to share sensitive information such as diagnoses, treatment plans, or detailed reports, which protects your personal data from being stored in insurance databases or accessed by third parties. This freedom also allows for care without assigning a formal diagnosis, ensuring privacy while addressing your needs.
A Fresh Perspective
If you’ve previously undergone an in-network evaluation that left you with lingering questions or an unclear diagnosis, an out-of-network provider can provide a fresh, unbiased perspective. Some insurance plans often impose annual or lifetime caps on the number of assessments they will cover, regardless of medical necessity, which can limit your ability to pursue follow-up evaluations. Out-of-network providers bypass these restrictions, offering the flexibility to conduct thorough reassessments and address ambiguities.
Insurance Reimbursement Options
While it’s true that out-of-network care may involve higher upfront costs, many insurance plans offer reimbursement when you submit detailed invoices and reports. Always check your out-of-network benefits to plan accordingly.
Clinical Fees
A neuropsychological evaluation involves an interview, tests, scoring, interpretation, record review, report writing, and a feedback session, all conducted by Dr. Kirmse. All fees are due at the time of service. Contact us for more information and to ask about flat fees for our testing services.
