All hail the neuropsychological evaluation and report! So potentially useful, it even has a nickname: âthe neuropsych.â
If youâre reading this, your child may or may not have been recommended for one at this point. Or, you may be up for a re-evaluation and on the look for a provider to make it happen.
Now what?
First of all, this post is NOT about explaining what this testing is, who does it, and why this testing is valuable. Nor is this post to provide recommendations for providers.
The intent of this laymanâs overview is to highlight some considerations youâll find between the different avenues for evaluation â essentially, WHERE you choose to have a student tested has a reverberating effect on various things. Final caveat: There are exceptions to everything and things can and do change over time. This is NOT an end-all-be-all guide.
Neuropsychs via a Big Institution (MGH, Childrenâs, etc.)
Lead times can be incredibly long. Not weeks or months long - years sometimes.
Health insurance is more likely to be taken because they have such big systems.
There may be a facility charge as well as a provider charge.
They may be able to bill via the avenue that offers better insurance coverage for your plan (facility vs institution). Double check.
You may have to be a patient of the institution in another department (PCP, specialist, etc.) and need a referral via that provider to get in the queue.
Large institutions are more likely to have policies preventing providers from attending meetings or collecting data (observations) outside of the facility. It is my understanding it is a scheduling challenge thing, at least that is what one institution once told me directly.
Neuropsychs via a Smaller Institutions
By âsmaller institutions,â this can refer to a smaller urban-type hospital or mental health provider, or a small handful of Ph.D professionals that have created an entity together. There is a range out there.
Health insurance may or may not be taken directly based on how the business entity chooses to operate.
There may be a facility charge as well as a provider charge; they may be able to bill via the avenue that offers better insurance coverage (provider vs facility) for your plan. Again, ask them directly.
Lead times may be just as long as bigger places or a lot less so. Availability can swing based greatly on staffing and bandwidth â which ebb and flows more dramatically simply because there arenât as many providers. When one leaves or is added, it can make a noticeable difference.
You are less likely to need to be an existing patient to secure testing.
Can be a roll of the dice as to whether a provider can attend meetings and/or do observations. Always ask them and know ahead of time.
Core Evaluations via District
Iâm using the term âcore evaluationâ vs âneuropsychâ because districts can offer many of the same testing measures but it is my understanding that whatâs it called may depends on the qualifications of the evaluator and other factors.
This is where things are tricky: district offering and staffing can vary dramatically case by case, district to district. Consider consulting an advocate or lawyer, as well as your district, based your individual situation.
Core evaluations (at least in MA) follow a very specific timeline for consent, the testing itself, and when team meeting happens to go over testing.
The timeline process is school day based, not days of the week based. To give you a sense, it hovers in the realm of 2 months or more, give or take school breaks, holidays, etc. Factors do influence turnaround, including how quickly the paperwork part happens.
These services can be covered by public funding when the process is followed.
Neuropsychs via School Referral
This refers to when a parent requests an evaluation via their district that is to be completed by someone outside of school employees. (There may be more accurate legal terminology for this.) This scenario happens for various reasons that can be very individual case by case, district to district.
This one can also be tricky as far as process navigation. Consider consulting an advocate or lawyer in order to navigate the requesting process properly. It is very specific.
Timelines are longer than the core evaluation timeline because it includes the process of making the request, getting it approved, finding the provider, and then said providerâs schedule.
Districts tend to prefer professionals that accept district/public funding rates, which may narrow down choices in providers. Again, an advocate or lawyer may help navigate this.
These services can be covered by public funding when the process is followed.
Private Provider Neuropsychs
Providers have their own individual practices. They may or may not also practice in parallel with a larger institution.
Private providers have more control over scheduling bandwidth and report turnaround and therefore you have more control regarding the testing timeline.
Many private providers will attend team meetings, virtually or in person, to answer team questions directly.
Private providers will often do school observations as part of their testing.
A private neuropsych evaluation ballpark may cost $3 - 6K+ based on the measures needed, where you live, the providerâs experience and other factors individual to their pricing structure.
Experienced providers with testifying experience tend to cost more.
Private providers often do not take insurance directly but will provide the paperwork you need to seek partial or total reimbursement if your plan allows.
Despite this being a lot of bullet points, here are some moreâŠ.
As you work to book that appointment consider the following:
Does spending money on service professionals (advocate, lawyer, etc.) in an effort to have another professionalâs services covered (Neuropsychologist via school referral) sound counter intuitive financially? It is. Not going to argue that. You will have to calculate whether the time and math makes sense.
Call around to more than one provider. Like any specialist, matching their approach to you and your childâs needs may take a little work.
Ask a providerâs thoughts on all-day testing vs. 1/2 day testing.
Explore your specific insurance plan coverage, not just your carrier. A place may take xyz insurance, but your specific plan may have something within it that prevents certain things from being covered.
If you think you might need someone to go to a team meeting, ask if they are empowered to do so.
If you think, no matter how remotely, you might need someone with testifying experience (admittedly, not a great situation but happens), ask if they have experience.
Ask as many questions as you need.
In conclusion, while a neuropsych is not necessarily a easy process to navigate and schedule (or to pay for), they can be priceless in countless other ways. And, over the years, you will likely need more than one. Buckle up. Youâve got this!
Do you have a list of providers that accept the MA State Rate if the district is paying for the IEE?