Psychological Testing not used anymore

[elite1]

I am doing a post-doc and was told by my supervisor that although we still use psychological testing in a med school milieu, in the real world insurance will rarely pay for psych testing, especially for children. She said that sometimes psychologists will do IQ testing but bill it under "therapy". However, she said that doing this constitutes insurance fraud.

I am just kind of disappointed that insurance doesn't reimburse us for using one of the best tools we have!

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[Therapist4Chnge]

I am doing a post-doc.....

Huh?

I thought you were starting your internship?

I regard to the assessment stuff....I haven't heard of that. I know it depends on what you are testing for....wanting to get your child tested so that they can get placed into a gifted program may not be reimbursable, I'd think doing assessments for Alzheimer's and the like is still covered.

 

[erg923]

I am not sure what you mean by "medical school milieu", but I would just qualify that that the testing has to be clinically justified in order to get reimbursement.

When a neurologist or PCP has referred a pt. for a neuropsych eval, this is typically billed under the medical arm of the individuals insurance (as you are assessing or attempting to rule-out brain and CNS dysfunctions). Insurance companies will not refuse to cover this, although they may try to put a cap on the amount of hours that can be billed for the eval. I have witnessed alot of this in neuropsych. If they are insistent that they will not pay for anything over 8 billable hours, my supervisors have typically just written a shorter report, instead of sacrificing any of the testing itself. This way we provide the necessary standard of care and don't risk missing any diagnostic issues. The report is then written as more of a brief summary that gets right to the point, as opposed to the more elaborate reports we usually write.

 

[PsyDr]

so your "CLINICAL SUPERVISOR" does not know what the reimbursement rates for cpt codes for testing and therapy for major insurance panels in your region are?

and you went from starting internship in march to being on post-doc in September?


fascinating.

 

[PsyDr]

wait: you also took post doctoral MS courses! before you went to internship!


either t4c and you attended the same place for MS pharm program OR the general regulations of the profession don't apply to you!



lol. good fake out.

 

[Therapist4Chnge]

There were 8 of us in our cohort, and I spent 2 years with them....pretty sure he wasn't in there.

 

[PsyDr]

this is almost as good as the time someone claimed they dropped a feather into a burr hole during a wada procedure!

 

[myelin]

this is almost as good as the time someone claimed they dropped a feather into a burr hole during a wada procedure!

Now that's a good one.

:troll:

 

[elite1]

I don't think she was saying that there wasn't a cpt code, she was saying in the real world that insurance does not pay for psych testing except in very, very rare cases. for example, she said that insurance would sometimes pay if there was a tbi or some sort of invasive treatment going to be done to the patient (gastric bypass) and they needed to know the psych status before operating.

if you need an IQ for a patient, you just have to do the testing for free or ask the parents or guardians to pay cash for the service, or have students where you work do it

 

[erg923]

Whats the definition of "real world" you are using here? PP, community mental heath centers, rehab hospitals?

I have worked in a university counseling center, a community mental health center, a VA, and an academic med center. Granted, I don't do the billing stuff, but, if the patient has insurance that includes mental health coverage, these services can be done if is clinically justified. You may have to squabble with them or write a letter or something on occasion though. Billing for Medicaid/Medicare is pain in the ass and can be confusing, but they rarely refuse to pay if you use the right CPT codes. Neuropsych assessment is different issue because its covered under the medical arm of peoples insurance.

 

[paramour]

Define "real world." Having worked for an insurance company for several years, I can tell you that your info is erroneous. And, for the record, a psych eval for gastric bypass usually isn't covered.

 

[Therapist4Chnge]

Define "real world." Having worked for an insurance company for several years, I can tell you that your info is erroneous. And, for the record, a psych eval for gastric bypass usually isn't covered.

Most see the gastric bypass as elective, so it wouldn't be covered....correct?

 

[PsyDGrrrl]

Define "real world." Having worked for an insurance company for several years, I can tell you that your info is erroneous. And, for the record, a psych eval for gastric bypass usually isn't covered.

It is at Kaiser. It depends on the insurance, I guess.

 

[PsyDr]

1) elite1 is at best exaggerating about his/her accomplishments. or lying about his/her entire background. given his/er complete lack of consistency of his/her story, i am compelled to deride his/her entire story. As evidenced by the following data:

a. time between starting internship and post doc only lasting 7 months (not possible by any standards). somehow this magical 7 mo internship then translates into a much sought after

b. Starting MS psychopharm classes before starting internship. Only one MS program in the country allows this. T4C is enrolled in this program and denies any familiarity with this person. Also elite1 mentions several things about the midwest, which have no such programs in the area. sounds fishy.

c. the use of vocabulary that is inconsistent with the degree of claimed achievement.


2) IMHO, is/her claim is complete B.S. Any survey of any professional listserv will indicate many practices that only do testing. most rely on third party payors. please see AACN and NAN salary data for further info.

3) paramour: 20% of my practice is specifically doing gastric preopt psych evals. all paid for by 3rd party payors. So i have no idea what you are talking about. psych evals are specifically called for as the standard of care for gastric bypass.

 

[paramour]

It is at Kaiser. It depends on the insurance, I guess.

I would agree with that.

3) paramour: 20% of my practice is specifically doing gastric preopt psych evals. all paid for by 3rd party payors. So i have no idea what you are talking about. psych evals are specifically called for as the standard of care for gastric bypass.

As PsyDGrrrl stated, likely depends on the insurance. As T4C suggested, gastric bypass (at this particular insurance company) is typically deemed an elective surgery. Any procedures related to an elective procedure are not covered, regardless of whether they're considered standard of care. If the procedure is approved, then yes, a psych eval is mandatory and eligible for benefits.

 

[PsyDr]

paramour: i can't really argue with that tautology.


In short, if the patient is going to get some bariatric surgery then a psych eval is going to be done if only to reduce the risk for the surgeon.

 

[paramour]

paramour: i can't really argue with that tautology.


In short, if the patient is going to get some bariatric surgery then a psych eval is going to be done if only to reduce the risk for the surgeon.

I'm not arguing about whether an assessment is considered sop. I believe the issue was as to whether or not it would be covered by insurance, which we have already established as "it depends" (as usual) upon whether or not the insurance company even considers the primary procedure (the surgery) eligible for benefits.

 

[BellaPsyD]

3) paramour: 20% of my practice is specifically doing gastric preopt psych evals. all paid for by 3rd party payors. So i have no idea what you are talking about. psych evals are specifically called for as the standard of care for gastric bypass.

OT: but I am VERY interested in doing this. currently searching for internships...none seem to offer surgery clearance opportunities!

 

[Cosmo75]

OT: but I am VERY interested in doing this. currently searching for internships...none seem to offer surgery clearance opportunities!

What about Rush in Chicago? The DCT is involved in this area from what I understand. Highly competitive site, but worth a shot

 

[BellaPsyD]

^would LOVE to, but I don't think they take PsyD's yet!