Dear Valued Patient,
At Clarity Psychological Testing, we are committed to ensuring you and your family receive the highest quality care with minimal delays. To better serve our patients and streamline the scheduling process, we are thrilled to introduce a new Priority Booking Option that allows you to secure expedited scheduling by covering upfront fees.
How Does It Work?
1. Upfront Deposit:
Amount: $500
Purpose: This deposit reflects a small portion of the total cost and allows us to maintain our ability to deliver high-quality, comprehensive care while navigating the challenges associated with insurance processes. Although mental health parity laws exist, insurers frequently require prior authorizations and implement policy changes that can delay reimbursements. Additionally, while we are in-network with most insurance providers, your plan may include a high deductible or co-insurance. Collecting this deposit ensures that your case progresses smoothly through our patient journey, even if your insurance requires significant out-of-pocket contributions.
• Refund Process: Upon receipt of full payment from your insurance company, as per their contractual obligations, the deposit will be refunded to you.
2. Non-Refundable Testing Materials Fee:
Amount: $150
Purpose: Due to recent cost increases from our suppliers, such as Pearson, and the fact that insurance does not cover these expenses, we are implementing this non-refundable fee to partially offset the actual costs incurred in providing testing materials.
Why This Change?
Due to increased challenges with insurance reimbursements (outlined in more detail below) and rising costs of testing materials, we’ve implemented this system to prioritize patient care and reduce wait times. By streamlining the financial process upfront, we can allocate resources efficiently and continue to provide top-tier services without compromising quality.
Good Faith Estimate:
This Good Faith Estimate is provided to help patients understand the potential costs of psychological testing services. For most patients, we are in-network with their insurance, which typically covers most, if not all, of these services after their annual deductible has been met. The following breakdown is particularly relevant for self-pay patients or those without insurance coverage:
Appointment 1: Psychological Intake with Clinician - $250 (telehealth)
Appointment 2: Testing Session (3–5 hours) - $1500 (in-person, or telehealth for patients residing 30+ miles from one of our testing centers)
Appointment 3 (Optional): Learning Disability Testing - $2500 (Dyslexia, Dysgraphia, Dyscalculia; not covered by insurance)
Testing Materials and Scoring Software Fees: $700
Preliminary Report Development: $300
Appointment 3 or 4 (if LD testing performed): Feedback Session - $250 (telehealth)
Finalizing Report and Delivery: $200
Total Estimated Costs:
Standard Testing Total: $3200
LD + Standard Testing Total: $5700
Flexible Payment Options:
We understand upfront costs can be a challenge. To help, we offer financing through CareCredit, which provides flexible payment plans, often with 0% interest, subject to approval. Our team is happy to assist you in setting this up.
Recently, we've encountered several obstacles, both with workforce shortages and insurance company challenges, that may affect your experience both in scheduling and in getting your finalized report, and we want to keep you informed.
Insurance Company Practices Affecting Your Care
Prior Authorizations: Before certain treatments or medications can be provided, insurance companies often require approval, known as prior authorization. This process can lead to delays in receiving necessary care. While this obstacle was removed for medical providers, behavioral health providers have still been subject to these unnecessary hurdles despite the mental health parity act of 2008.
Claim Denials and Payment Clawbacks: Even after services are rendered, insurers may deny claims or retract payments, a practice called "clawback." This can create financial strain for healthcare providers and potentially disrupt ongoing patient care.
High Deductibles: A health insurance deductible is the amount you must pay out-of-pocket for covered healthcare services before your insurance plan begins to share the costs. For example, with a $2,000 deductible, you're responsible for the first $2,000 of covered services; after meeting this threshold, your insurer starts to pay its portion of the expenses. Even though we are in network with most major insurers, psychological testing may not be reimbursed until you've met your deductible. This means that if your deductible is high and hasn't been satisfied yet, you'll still bear the full cost of these services out-of-pocket. Consequently, most facilities request upfront deposits to cover anticipated costs, ensuring they receive payment for services rendered, especially when there's uncertainty about insurance reimbursement due to unmet deductibles.
Data Breaches: Cybersecurity incidents can conveniently disrupt healthcare operations in favor of the insurance company. For example, a ransomware attack on UnitedHealth Group's Change Healthcare unit in February 2024 caused significant delays in claims processing, affecting many patients and providers, but not the insurers.
Rebranding Confusion: Insurance companies sometimes “move the goalposts” for behavioral health providers, creating carve-outs or changing their names or the names of their subsidiaries, which can lead to confusion. For instance, Anthem rebranded its services under new names like Carelon and WellSense. Tufts to Health Plans and Point 32.
Ghost networks: insurer directories listing providers who are unavailable or not accepting new patients. This issue creates an illusion of accessible care, leading to long wait times and unreturned calls for patients seeking mental health services. In this challenging environment, clinician-owned practices like Clarity Psychological, which accepts a wide range of insurance plans, are increasingly rare. We strive to offer affordable, high-quality psychological testing and care. However, the prevalence of ghost networks allows insurers to refuse to renegotiate rates, citing “market saturation,” yet patients continue to experience significant challenges with access to in-network care.
Patients attempting to find in-network behavioral health services frequently encounter extensive waitlists or receive no response from listed providers. This discrepancy between listed and actual provider availability underscores the importance of verifying the accuracy of insurer directories and advocating for transparency to ensure timely access to mental health care.
Stagnant Reimbursement Rates: A 2021 Government Accountability Office (GAO) report highlighted that clinician-owned mental health organizations identified inadequate reimbursement rates as a primary barrier to accessing mental health care, even for insured individuals. This inadequacy discourages providers from accepting insurance, limiting patient access to necessary services.
Impact of Inflation: The rising costs of goods and services have eroded the purchasing power of behavioral health providers. For instance, the U.S. Consumer Price Index showed a 6.2% price increase in 2021. Without corresponding increases in reimbursement rates, providers effectively experience a reduction in real income, exacerbating financial and time constraints even further.
Complex Negotiation Processes: Negotiating reimbursement rates with insurers is often a protracted and complex process. Providers may need to present extensive data, such as patient outcomes and operational efficiencies, to justify rate increases. This process can involve 70-80 touchpoints to escalate, requiring significant administrative effort and diverting resources from patient care.
Market Dynamics and Competition: The consolidation of insurance markets and the new “payvider” model has increased bargaining power for insurers, enabling them to engage in anti-competitive practices and set lower reimbursement rates. They can effectively be the provider and payer, give themselves the highest rates, while denying other providers equitable rates. This environment is designed to intentionally make it challenging for smaller or independent behavioral health providers to compete and remain sustainable.
Our Commitment to You
We understand that these issues can be frustrating and may impact your access to timely care. Please know that we are actively working to navigate these challenges to minimize their effect on you. Our team is dedicated to:
Advocating on Your Behalf: We are committed to working with insurance companies to secure necessary approvals and ensure you receive the care you need without unnecessary delays.
Enhancing Communication: We strive to keep you informed about any changes that may affect your care, including insurance company policies and procedures.
Protecting Your Information: We prioritize the security of your personal and health information and are vigilant in safeguarding it against potential breaches.
Next Steps:
Once your payment is approved and collected- your information will be added to our scheduler's contact list to schedule your next appointment. Should you want to connect earlier, please email support@claritypsychologicaltesting.com or text us at 617-982-2129 for the quickest response.
Thank you for your understanding and cooperation.
Sincerely,
Clarity Psychological Testing
*Please be advised that most insurers consider test material fees a non-covered expense, including yours. As a result, we must apply a flat fee of $150 to help cover the rising costs of materials essential to your testing and assessment. While the actual costs of materials for a full test battery are significantly higher, we charge only a small percentage to ensure affordability while maintaining service quality. Upon receipt of the required form, the above-mentioned fees will be assessed. If the payment method on file is valid and the charge is successfully collected, you will be added to our scheduler's contact list to arrange your next appointment.
However, if the payment method on file is invalid or cannot be processed, you will receive one additional reminder to update your payment information and process the charge. If the payment is still not resolved after this reminder, you will not be contacted to schedule your intake appointment until funds are successfully collected. This policy ensures that we can provide continuity of care and avoid unnecessary delays due to payment issues throughout your patient journey.
Thank you for your understanding and support in helping us provide quality care while responsibly managing rising costs.
** Standard insurance-covered psychological testing typically includes evaluations for ADHD, autism spectrum disorder, mood disorders, and personality functioning, tailored to address the specific concerns raised by the referring provider or patient. However, learning disability (LD) testing, which is optional and conducted as a second day of testing, is not covered by insurance. This specialized assessment focuses on identifying conditions such as dyslexia, dysgraphia, and dyscalculia. While similar evaluations are often performed in schools by school psychologists, these professionals are generally master’s-level therapists with a special credential, not licensed psychologists. Consequently, they are unable to provide medical diagnoses, which can only be made by fully licensed psychologists with doctoral-level training.