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Psychological Services |
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I provide psychological evaluations prior to a medical procedure, such as a spinal cord stimulator implant or gastric bypass surgery.
If your doctor has referred you for a psychological evaluation prior to a medical or surgical procedure, the purpose of this evaluation is to help your doctor determine if you are a good candidate for the procedure, and to identify any psychological or emotional issues that might affect the outcome. This helps your doctor to develop a treatment plan that addresses your individual needs. The evaluation will entail a detailed interview and the administration of one or two psychological tests.
It has been my experience that insurance companies do not have adequate procedures in place for these types of evaluations. Because the evaluation concerns a medical problem and not a mental health problem, payment is often denied under mental health benefits. Obtaining authorization through the medical benefits of an insurance company is often laborious and time-consuming, and claims are frequently denied even when an evaluation was pre-authorized. For this reason, it is my policy that these evaluations must be pre-paid.
It is your responsibility to obtain authorization from your insurance company prior to the evaluation, if it is necessary. We strongly recommend that you obtain authorization or precertification through your medical benefits, and not through the mental health benefits. We will bill for the evaluation under the following procedure (CPT) codes: 96150 (four to six 15-minute units of health and behavior assessment) and 96101 (1.5 hours of psychological testing). Often these specific procedure codes need to authorized, and the authorization must be valid on the actual date of service.
The cost of the evaluation is $460, with additional charges for extended interviews or further testing. THIS MUST BE PAID IN ADVANCE. My office will submit one claim to your insurance company for this service. If the claim is paid, I will refund any overpayment on your account within 90 days. If the claim is denied, it will be your responsibility to pursue reimbursement from your insurance. |
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Presurgical Evaluations |
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503-292-9183 |
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Normund Akots, PhD |
