Neuropsychology is a specialty that combines the fields of neuroscience and psychology and deals with the brain and its relationship to behavior. The brain is the most complex organ of the human body and controls intellectual functioning, speech and language, the perception of touch, hearing, and vision, memory, attention, personality and the coordination of all movement. Because neurological disorders, such as traumatic brain injury or concussion, stroke, brain tumors, epilepsy, Alzheimer’s Disease, Parkinson’s Disease or multiple sclerosis, and developmental disorders, such as learning disabilities, dyslexia, Autism Spectrum Disorder, may affect any of these functions, a neuropsychological evaluation is an important part of diagnosis and treatment planning.

A neuropsychological evaluation is a diagnostic testing procedure to evaluate brain function. It provides unique information about the brain that is not provided by other diagnostic procedures like a neurological exam, EEG, MRI, or brain scan. 

The tests evaluate intelligence, attention, visual/ verbal and long-term/ short-term memory, language, auditory processing, sensorimotor functions, motivation, moods, emotions, personality, and executive functions. Some of the tests include oral questions, paper and pencil tasks, computers, and physical manipulation of materials. The neuropsychologist may use questionnaires to evaluate mood, emotional style, behavior, and personality.

For students, a psychoeducational evaluation (e.g., reading, arithmetic, and written expression) may be included to assist in planning for appropriate school interventions. The specific areas evaluated depend on the concerns, as well as the age and current level of functioning of the person being evaluated.

This evaluation can take between three and seven hours to complete. In especially complex issues, it can take even longer. After the test, the neuropsychologist will write a report which includes recommendations on how improvements can be made.

 

What does a neuropsychological evaluation tell you?

A neuropsychological assessment integrates the fields of psychology and neuroscience to provide a holistic understanding of why a patient may be struggling, how these challenges impact their academic, occupational, social, emotional, and/or behavioral functioning, and what research-based techniques are needed to support a child’s development and obtain the best possible outcomes at home, school, and in the community

A neuropsychological evaluation can tell you a variety of things. The goal of this evaluation is to assess the patient’s strengths and weaknesses when it comes to the brain and nervous system. It can help with diagnosis and help the neuropsychologist create a personalized plan of treatment.

This test will help determine a patient’s I.Q. and help diagnose learning and psychological problems. It can also help measure general intellect and reading comprehension. The evaluation will measure the patient’s language usage and understanding as well as processing speed, memory, and concentration. The test can also give insight into the patient’s mood and personality. The test takes into account any physical factors including physical complaints. This evaluation can also be used to measure the effect of neurosurgical procedures to track progress and see if a specified treatment is working. The evaluation can provide a baseline and a guide to measure future tests against.

Neuropsychology Evaluation Process

A neuropsychological evaluation usually involves an initial consultation with the neuropsychologist, the administration of a battery of tests, and a follow-up meeting with the neuropsychologist to discuss results and recommendations.  The initial consultation is for the purpose of discussing concerns, reviewing the patient’s history and other records, and developing an assessment plan.  A majority of testing will be done with a psychometrist, who is supervised and appointed by the neuropsychologist.  The purpose of a neuropsychological evaluation is to assess an individual’s cognitive/physical strengths and weaknesses.  Closely measuring abilities/symptoms can provide diagnostic information and assist in treatment planning. Some parts of the assessment process can be interesting and stimulating, while some may be more tedious and difficult.  At times, some degree of negative emotion such as frustration or anxiety may occur in reaction to tasks that touch on areas of weakness.  However, we try our utmost to make the evaluation positive and supportive.  In fact, a primary goal of the assessment is to help the individual better understand these areas of weakness and how to better deal with them on a day-to-day basis as well as rehabilitate them.  The exam can last for several hours, but there are ample opportunities for breaks.  As needed, testing may be discontinued and/or rescheduled to accommodate an individual’s needs.   

Appointment Process

Consultations and Follow-ups may be done via telemedicine or in our office, depending on the doctor and your preferences. Testing is always done in person at our office.

Step 1: Consultation with the Neuropsychologist 

• For pediatric patients, consultations are with parents/ guardians only

• The doctor will guide this meeting - asking questions regarding current symptoms and concerns, birthing history, personal and family medical history, social history, educational and occupational history, ect.

Step 2: Neuropsychological Testing 

• Evaluation times vary, most adult evaluations are about 3.5 - 4 hours, and pediatric evaluations are about 6-7 hours. 
  • More complicated or presurgical cases may take longer

• For these appointments, please bring
  • Any relevant prior evaluations or medical records
  • A list of all current medications
  • Any prescription or reading glasses, and/or hearing aids
  • Completed questionnaires (for pediatric patients)
  • Optional items:
    • snacks, drinks, jacket/sweater as sometimes the rooms are cold

•  If you/your child has a scheduled testing appointment with us, we encourage you to keep this appointment unless you, your child, or someone in your household:
  • are experiencing symptoms like fever (>99.5F), cough with shortness of breath, sore throat, runny nose, GI symptoms (e.g., nausea, vomiting, diarrhea), and/or body aches
  • have had close contact with someone in the last 5 days that is positive, confirmed, or suspected of having COVID-19

Step 3: Follow up with the Neuropsychologist

• For pediatric patients, initial follow-ups are with parents/ guardians only
  • We are happy to schedule another follow up for your child to go over the results with the doctor separately
• The doctor will go over the results and recommendations with you during this appointment
• After the follow-up, the report will be finalized and sent to you and/or your referring physician.

Afterwards!

• After the evaluation, the doctor will make recommendations on how to move forward with treatment. Recommendations can range from: accomodations, different therapies, or medication managment. We refer out for follow-up treatment.
• We are happy to create referrals if needed for recommended services, or complete disability or accomodation paperwork if warrented.

Reevaluations

• Sometimes, evaluations are recommended for patients depending on needs.
  • Example: Adults experiencing cognitive decline may be recommended to have an evaluation annually to monitor any changes
  • Example: Children, teens, and adults who are in school or needing continued accomodations for school or standardized testing, may need reevaluations every 3-5 years to have current evaluations for acoomodations.
  • And other cases as well!

Insurance Plans
Our developmental neuropsychologist, Dr. Melissa Bunner and Dr. Stephanie Paulos, do not directly bill insurance. Please see the self-pay section for details on out of network benefit submission.

If the neuropsychologist is an in-network provider for your insurance, you will be expected to pay any applicable co-pay or deductible on or before your day of service. It is important to note should your insurance company determine that evaluation is not a covered expense you will be responsible to self-pay for services provided. Please also note - if you are needing an evaluation for school accommodations, please let us know prior to your evaluation as insurance does not cover academic testing that is needed for these accommodations.

We use a third-party service, Silver Billing, to expertly verify plans and submit claims for our clinic. Though we do our best to give you a good quote of any out-of-pockt cost to you before the evaluation, a quote of coverage and benefits is not a guarantee of payment. It remains important to check with your insurance carrier prior to service delivery. 

If we are billing your insurance, please understand that your carrier will have access to your diagnostic information submitted with claims, as well as medical records if requested for quality review/audit. This release is typically covered in the terms of your coverage with the insurance company.

Medicare
Neuropsychological evaluation is a covered service under Medicare and does not require preauthorization. At the time of service, you may be required to pay your Meicare deductible or coinsurance. If you have a supplementary insurance policy in addition to Medicare, the supplemental policy will typically cover your co-insurance costs.

Self-Pay
If you do not have insurance; OR if the neuropsychologist does not participate in your insurance program, you will be responsible to pay for all fees with the following payment schedule:

• You will be expected to pay for the initial consultation ($350) at the time of service.
• On the exam day, you will be expected to pay estimated testing fees as well as the follow up visit ($2500-3500).

Most insurance companies have what are called “Out of Network” benefits that may cover a portion of the cost of the evaluation if we do not participate in your insurance. You should check with your insurance company to determine what out of network benefits you may be entitled to and to make sure that neuropsychological testing is a covered service. It is also important to ask your insurer whether pre-authorization from the insurance company is necessary before services are provided. We will provide you with information regarding services and fees to assist you with filing out-of-network claims with your insurance company.

 

Estimated Fees by the Hour
Initial consultation with neuropsychologist		$350
Testing with psychometrist (typically 4-8 hours)		$200
Examination by neuropsychologist, test interpretation and report preparation		$350
Follow-up visit with neuropsychologist to review resutls and recommenations		$350
Report and letter writing in addition to the standard report (one hour minimum)		$200

Cancellations 

Please notify us as soon as possible if you need to cancel or change an appointment.  Because the number of appointment times we can offer is limited, and there are many people in need of our services, we appreciate your assistance in giving us at least 48 hours notice of a cancellation. We will email you to remind you to complete our patient paperwork at the beginning of the month of your first appointment, and call you 2 business days prior to your appointment to confirm. If we do not hear back, nor recieve new patient paperwork by 8am the day before your appointment, we will cancel your appointment and wait to hear back if you wish to reschedule. 

Please take note: If you are 30 or more minutes late for your testing appointment, we will need to reschedule you for the next available date.

Austin Neuropsychology follows the CDC masking guidance for COVID prevention, which is
based on community transmission by county – and thus universal masking is no longer required by patients, and family members in our clinic.

Special circumstances may arise that require masking such as:

• If someone is exhibiting signs or symptoms of cold or flu
• Employee exposure to COVID
• Per patient request

Effective November 1, 2022

Telemedicine services involve the use of secure interactive videoconferencing equipment and devices that enable health care providers to deliver health care services to patients when located at different sites. 

1.  The same standard of care applies to a telemedicine visit as applies to an in-person visit. 

2.  Please understand, the patient will not be physically in the same room as the provider. You will be notified of and your consent will be obtained for anyone other than you healthcare provider present in the room. 

3.  Please understand that there are potential risks to using technology, including service interruptions, interception, and technical difficulties.

a.    If it is determined that the videoconferencing equipment and/or connection is not adequate, please understand that the provider or you may discontinue the telemedicine visit and make other arrangements to continue the visit.

4.  Please understand that the patient has the right to refuse to participate or decide to stop participating in a telemedicine visit, and that your refusal will be documented in my medical record. Please also understand that my refusal will not affect my right to future care or treatment.

a.    You may revoke your right in writing at any time by emailing our office at info@neuroaustin.com

5.  Please understand that the laws that protect privacy and the confidentiality of health care information apply to telemedicine services.

6.  Please understand that your health care information may be shared with other individuals for scheduling and billing purposes.

a.    Please understand that your insurance carrier will have access to your medical records for quality review/audit.

b.    Please understand that you will be responsible for any out-of-pocket costs such as copayments or coinsurances that apply to your telemedicine visit.

c.     Please understand that health plan payment policies for telemedicine visits may be different from policies for in-person visits.

7.    Please understand that this document will become a part of my medical record.  

 

Feel free to reach out to our office if you have any questions about telemedicine or this information.

Confidentiality and Release of Records 

The records we create in working with you are confidential and private except as provided by law. If you would like your records sent to someone else, we must have a signed written request indicating your permission and to whom you would like the record released.  You may write your own statement authorizing the release of records or you may use a form available at our office.  You may revoke your authorization at any time.  If we are filing insurance for you, insurance companies commonly require that you authorize the release of records to them as a condition for receiving reimbursement.

Information that a patient may be dangerous to him or herself or others, or that abuse of a child or adult has occurred must be reported, even without the patient’s consent. For more detailed information regarding confidentiality please refer to the Texas Rules for Protecting Health Information and the U.S. Department of Health and Human Services’ HIPAA Rules, both available at the check-in desk.

Emergency Contact Information
Should an emergency arise while you are at Austin Neuropsychology, the emergency contact you provided at registration will be notified.  If a medical emergency arises, EMS will be called.

Should an emergency arise at other times, please dial 911; or, for mental health emergencies you can contact the confidential Travis County 24-hour HOTLINE at 472-HELP (472-4357). 

Research Participation 

In our effort to learn more about how the brain functions and how to better help our patients, we sometimes carry out research.  For any type of research, we will need your authorization. We want to emphasize that participation in research at Austin Neuropsychology, PLLC is purely voluntary.  Your decision to participate or decline to participate in research will in no way affect your relationship with Austin Neuropsychology, PLLC or our commitment to your clinical care.

In this research, all identifying information is removed and confidentiality is protected. 

 

These types of research mainly include:

• Statistical analysis of clinical information from past patients
• Specific cases examples, which are a powerful teaching tool when training psychologists or physicians.
• Occasionally we also contact past patients to see if they are interested in participating in new research studies.  The specifics of any potential research project would be explained to you at that time, and you would have a choice to volunteer or decline participation at that time as well.

Complaints 

If you have concerns or complaints regarding your care at Austin Neuropsychology, PLLC, please raise these issues with your neuropsychologist.  Patient satisfaction is very important to us and we will strive to resolve any problems that may arise. .

You may also submit a written complaint to:

Texas State Board of Examiners of Psychologists

1801 Congress Ave., Ste. 7.300
Austin, Texas 78701
(512) 305-7700
Investigations/Complaints 24-hour, toll-free system- (800) 821-3205