Below are answers to some of the most frequently asked questions:
Who should consider undergoing a Neuropsychological Assessment?
Individuals who have experienced a change in mental functioning following a fall, car accident, sport injury, seizure, episodes of extreme high fever, or disease processes such as encephalopathy, meningitis, chronic or acute metabolic, endocrine, or degenerative disorders, liver failure, COPD and other vascular and respiratory conditions; should consider the possibility that their brain functioning may have been compromised by a mild closed head injury (mTBI) or a diffuse brain injury that is not easily detected in brain imaging studies such as CAT Scan or MRI, but caused enough brain damage so as to alter their cognitive functioning. Children and adults who have a history of child abuse, early malnutrition and/or neglect, low birth weight, toxic exposure, developmental delays, unexplained and severe reactions to environmental factors that are usually innocuous to others, learning issues that have failed to improve with conventional remediation programs, severe behavioral problems, including ADHD-like symptoms that have been unresponsive to psychiatric interventions such as psychotherapy, ABA, and medication; could also benefit from a thorough Neuropsychological Assessment so as to clarify the origins or root-causes for their difficulties, and identify the necessary interventions to achieve meaningful changes in functioning.
What should I do prior to the assessment?
The examinee or his/her representative (parent, spouse, adult offspring, or guardian) should provide me with all school and medical records available for my review. Questionnaires should be carefully completed and returned to me prior to the initial appointment. The information you make available before your visit, will help me develop some hypotheses of what the underlying issues may be and tailor the testing session with the inclusion of psychometric measures that will evaluate the targeted areas pertinent to your case with greater depth and specificity. Children should be reassured that the visit will not involve any painful procedures such as shots, and be informed that different activities will be presented such as drawing pictures, building things, doing puzzles, answering questions, and listening to stories. Make sure that you have a good night sleep and eat a good meal prior to the appointment.
What do I need to bring to the appointment?
The examinee should bring:
* Eye glasses and/or hearing aid
* MRI’s or other brain scans.
* Insurance cards
* List of medications
* Updated school and/or medical reports
* A snack or lunch, if the examinee plans to remain in the office during the lunch break.
What is involved in the assessment?
As mentioned above, the assessment begins with the collection of all pertinent school and medical records and the completion of the questionnaires. During our first face-to-face appointment I will meet with the examinee, and when appropriate his/her representative, and conduct a thorough and comprehensive clinical interview so as to gain an in-depth understanding of the relevant historical data and the problems at hand. After the interview is completed, I will begin administering the different psychometric measures which involves a variety of tasks that ranges from completing puzzles, building blocks, drawing complex designs, answering ambiguous questions, etc. The testing per se will be completed in 2 to 8 hours depending on the complexity of the presenting problems and the kind of assessment that was agreed upon. Usually, for a comprehensive Neuropsychological Assessment, the data collection will be accomplished in two sessions lasting 3 to 4 hours. However, if the examinee has a condition, medical or behavioral, that precludes him/her from performing the examination for an extended period of time, a greater number of sessions of shorter duration may be scheduled.
What will happen after the testing is completed?
After the testing is completed I will prepare a written report with the results, discussion of my impressions, and specific recommendations for treatment and interventions to be pursued, including rehabilitation, educational and vocational services, as well as referral to other specialists when warranted such as neurologists, psychiatrists, mental health professionals, educational specialists, or vocational counselors, occupational therapists, physical therapists, speech and language pathologists. The examinee and/or representative will be scheduled for a face-to-face meeting when I will explain the contents of the report in detail and be available to answer any questions. For students in grades 12 and below, at parental request, I will participate in the first scheduled IEP meeting following the completion of the assessment, so as to advocate for the services and accommodations that I believe should be provided by the school. For examinees that are residing in out-of-home placements such as nursing homes, residential treatment programs, etc. I will gladly meet with administrators and staff at the facility, to help determine appropriate care and address any behavioral concerns. I will be available for consultation to other professionals and health care providers who would like to discuss the findings and recommendations, once the proper consent forms authorizing me to exchange information is signed.
Will my health insurance cover the cost of a Neuropsychological Assessment?
A Neuropsychological Assessment will be covered under your Medical or Mental Health benefits depending on your particular carrier and specific coverage. In order to obtain information as to whether or not a Neuropsychological Assessment is a covered benefit under your specific policy or whether pre-authorization or referral for medical necessity may be required, we request that you fill out the Referral Form that is available for downloading in this site, and make the completed form available to us by faxed, email or regular mail to our main office in Walnut Creek. We will contact you, once we have heard back from your insurance. Since, a Neuropsychological Assessment is very costly, before you commit to this process, we feel that it is important for you to know what your financial responsibility will be for the service. The level of benefit varies significantly depending on your particular policy; consequently, your insurance carrier may cover for most or only a minimal portion of the cost. Before you commit to proceeding with any of the services we provide, with your permission, our personnel will contact your insurance company and take the steps necessary to obtain preauthorization and information regarding the amount that you may be held responsible for. As a consumer you should be aware that different costs are associated with different levels of assessment. A comprehensive Neuropsychological Assessment usually requires 6 to 10 hours of face-to-face testing and it differs greatly in-depth and scope from an assessment lasting only a couple of hours using screening measures.
It is also important for you to know that while a Neuropsychological Assessment is often a covered benefit, a Learning Disability Evaluation or Psychoeducational Evaluation is NEVER covered by insurance since this service is viewed as the responsibility of the public school system under the IDEA regulations and guidelines. However, a Pediatric Neuropsychological Assessment will be covered if the child is believed to be experiencing academic issues due to a medical condition or a neurocognitive disorder that affects brain development or the appropriate functioning of the Central Nervous System. Dr. Rakic is a Medicare Provider and by enlarge we accept most PPO’s.