Tiramisu Posted October 9, 2012 Share Posted October 9, 2012 nm Quote Link to comment Share on other sites More sharing options...
Crimson Wife Posted October 9, 2012 Share Posted October 9, 2012 My oldest has a referral from the audiologist to get clarification of CAPD vs. ADHD and my 2nd has a referral from the pediatric neurologist to get a 2nd opinion on the ADHD diagnosis. Both ADHD and CAPD are considered medical diagnoses so our insurance would cover at least some NP testing. However, we'd have to go see a network NP for a consultation and assessment plan. Then we'd need to submit that assessment plan to the insurance company so that some bean-counter can determine which tests will be authorized. After all the back-and-forth haggling over the medical necessity of the various tests, we'd go back to the NP for actual testing. I've got only so much patience and energy to deal with our insurance company and right now I'm using that to advocate for youngest DD. But I do plan on eventually pursuing NP testing. Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted October 9, 2012 Share Posted October 9, 2012 My son's 1st np assessment was covered at 60% using the mental health portion of insurance. She performed a full eval and assessed for ADD/ADHD. 3.5 years later, the 2nd np didn't accept insurance. Both docs fully supported homeschooling. Quote Link to comment Share on other sites More sharing options...
rafiki Posted October 9, 2012 Share Posted October 9, 2012 nt Quote Link to comment Share on other sites More sharing options...
SkateLeft Posted October 9, 2012 Share Posted October 9, 2012 What "medical" justification did you need to get your neuropsych eval covered? Our psych evals are covered as a diagnostic service under the mental health benefits (United Behavioral Health) part of our insurance. Quote Link to comment Share on other sites More sharing options...
LostSurprise Posted October 9, 2012 Share Posted October 9, 2012 We've had 2 done in the last 3 years (normal for ds's condition). We were referred by ds's neurologist. Insurance covered most of it. The neurologist usually requests a certain type of evaluations. For instance, we had the standard developmental tests to find out where he fits with his peers and the second test also compared the two tests. After that round of tests the NP may decide that other tests are in order. (Ours gave us referrals to PT and SLP evaluations.) If you feel the neuro and the NP are not in sync give your neuro a call and discuss your concerns. The NP may decide to test physical things because of what they know, but the neuro's concerns (as the referring doctor) should be covered in the evaluations. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted October 9, 2012 Author Share Posted October 9, 2012 nm Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted October 9, 2012 Author Share Posted October 9, 2012 nm Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted October 9, 2012 Author Share Posted October 9, 2012 (edited) My oldest has a referral from the audiologist to get clarification of CAPD vs. ADHD and my 2nd has a referral from the pediatric neurologist to get a 2nd opinion on the ADHD diagnosis. Both ADHD and CAPD are considered medical diagnoses so our insurance would cover at least some NP testing. However, we'd have to go see a network NP for a consultation and assessment plan. Then we'd need to submit that assessment plan to the insurance company so that some bean-counter can determine which tests will be authorized. After all the back-and-forth haggling over the medical necessity of the various tests, we'd go back to the NP for actual testing. I've got only so much patience and energy to deal with our insurance company and right now I'm using that to advocate for youngest DD. But I do plan on eventually pursuing NP testing. This is very helpful. Edited December 5, 2012 by Tiramisu Quote Link to comment Share on other sites More sharing options...
FairProspects Posted October 9, 2012 Share Posted October 9, 2012 This is very helpful. I remember being told that ADHD was a medical diagnosis. That's the excuse the educational psychologist gave three years ago when I asked her straight out if dd has adhd. She said it was a medical dx and she wasn't qualified to dx that. :glare: Doesn't this depend on the insurance laws in your state though? I asked about coding the neuropsych for ADHD and was told it didn't matter, the only acceptable code would be traumatic brain injury or stroke, nothing developmental would be covered despite being a medical code because there are zero insurance requirements for developmental diagnoses in our state. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted October 10, 2012 Author Share Posted October 10, 2012 nm Quote Link to comment Share on other sites More sharing options...
TraceyS/FL Posted October 10, 2012 Share Posted October 10, 2012 And if I had a little more than that I'd do something about my grey hair coming in and my ratty clothes! I'd be a glamorous hsing mom for the neuropsych evaluation! :tongue_smilie: :lol: I went to a meeting the other day and looked down and realized I had spilled lunch down me. Oops! I've got to get out more :tongue_smilie: Quote Link to comment Share on other sites More sharing options...
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