Insurance & Billing
What insurance is Dr. Anne in-network with?
Kaiser Permanente (Options, Access PPO, Summit PPO)
Regence (Blue Cross/Blue Shield)
What if my primary or secondary insurance is one Dr. Anne is not credentialed with?
Claims are not submitted to insurance companies other than those listed above. You will be billed directly for services. If you wish to submit requests for reimbursement to your insurance company, you will be provided with all the necessary procedure and diagnostic codes to do so.
What will insurance cover if we are seeking evaluation for Specific Learning Disorder and/or Attention-Deficit/Hyperactivity Disorder?
The initial interview is generally covered by insurance.
Educational and academic testing is not a covered benefit as there is no billing code for these tests. Thus, some or all of the tests and the reporting writing time will be billed directly to the family. Depending on the scope of the referral question, some tests and reporting time may be covered.
If none of the assessment is approved by the insurance, then the feedback appointment will also be the family’s responsibility.
What if my insurance requires pre-approval for psychological or neuropsychological testing?
Generally, requests for testing are submitted to the insurance after the initial appointment and take most insurance companies 5-10 business days to process and respond. Thus, testing appointments will be scheduled for several weeks following the initial appointment. However, with your consent, testing can proceed prior to insurance approval.
In some cases, insurance companies require the client or parents to call for pre-approval before the initial appointment.
If I want to speak to my insurance company about my coverage before scheduling, what questions should I ask?
Ask if preapproval is needed for psychological testing. The procedure codes are 96136 for first half hour of psychological testing and 96137 for each additional half hour. The most common diagnostic code used for these assessments is Unspecified Learning Disorder (F81.9).
Ask if any diagnoses, such as Attention-Deficit/Hyperactivity Disorder or Specific Learning Disorder, are excluded from either psychological or neuropsychological testing.
Benefit checks are not considered a guarantee of payment by your insurance company, and ultimately information about your insurance plans’ coverage is your responsibility. Please talk with Dr. Anne directly if you have questions or concerns about insurance coverage, fees, and/or payment.
What is the cost of a comprehensive assessment?
The comprehensive assessment consists of the initial interview, four to six hours of testing, five to six hours of report writing, and the feedback session. Current fees range from $2000 to $2500 if all expenses were to be out-of-pocket.
Cost is dependent upon the length and scope of the assessment, what charges can be submitted to the insurance, and the allowable rate of the insurance. Since academic testing is not a covered benefit, please be aware that academic testing and report writing for the academic piece takes three to six hours and is billed at $175/hour. Thus, most families will have a minimum out-of-pocket expense of $525-$875.
A fee agreement is provided to all families prior to proceeding with evaluation to ensure that you are aware of and agree to all assessment costs. Payment plans can be discussed at any time.