Psychological Evaluations billed to your Health Insurance must meet "Medically Necessary" criteria established by your health insurance. A Psychological Evaluation is generally considered "Medically Necessary" when the request comes from another service provider who intends to use the written report for treatment, diagnostic clarification, medication management, service planning, and/or eligibility determination(s).
Examples of Psychological Evaluation which are NOT "Medically Necessary" and NOT covered by Insurance include:
i) Court Ordered
ii) Evaluations for to assess eligibility for the completion of USCIS form N-648: Medical Certification for Disability Exception
iii) To apply for or appeal a Social Security Disability Determination.
iv) To determine the presence of a learning disability.
v) When the Mental Health benefits for the patient have been used for the calendar year.
Scheduling/Length
Psychological Evaluations conducted by Dr. Sigler are scheduled for 1 appointment which is scheduled for 4 hours.
Psychological Evaluations conducted by Dr. Smith are scheduled as 2 appointments,, the first being the diagnostic interview, the second is the psychological testing session.
The Psychological Evaluations being conducted by Dr. Sigler and Dr. Smith CANNOT be conducted remotely. Due to the nature of the kind of testing conducted, all Psychological Evaluation appointments are scheduled as face-to-face at our clinic in Roseville, MN.
Some Health Insurances will require a Prior Authorization (PA) for a Psychological Evaluation. This means the evaluation must be schedule as 2 appointments at least 12 business days apart. The first appointment is to conduct the Diagnostic Interview and the second to administer the authorized psychological testing.
Out billing agency, JB Billing Services, LLC, will conduct a benefit check with the insurance company. JB Billing will gather information regarding your coverage for the services, whether you have a co-pay, deductible, co-insurance, or other costs which will be billed directly to you.