Learning About Learning

Learning About Learning

A Free Presentation Series for Parents with Students of All Ages

Individual Matters hosts a series of presentations for parents of students of all ages.  Join Dr. Katen and other local experts to learn about all things that have to do with learning. 

Learning About Learning is scheduled
for every 1st Tuesday of the month.

The presentations take place on the FIRST TUESDAY of every month for the rest of the 2019-2020 school year. Topics will include:

Location: 2530 E. Foresight Circle, Grand Junction, CO 81505

Day/Time: 1st Tuesday of each month, 5:30-7:00pm

If you can make it, please RSVP by email or phone so we can be sure to have enough seats and snacks.

Hope to see you there!

-Dr. Katen

 

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Top 5 Things to Know Before Scheduling a Learning Assessment

Your school recommends a learning assessment… What does this mean?

So your school has recommended you get a “learning assessment” for your child…  What does this mean?

Perhaps your child’s teacher or counselor has concerns about learning, behavioral, or attention problems.  Or maybe testing is required as part of the admissions process for a certain school or program.

As a parent, you may be feeling unsure what to do next.  After all, a quick internet search will tell you there are lots types of “learning assessments” available – and variety of people who provide them.  But not all learning assessments are the same.

Here are 5 things you should know before scheduling your child for a learning assessment:

1. A learning assessment should be completed by a licensed psychologist.

A licensed psychologist is someone with a doctoral degree (Ph.D. or Psy.D.), legal authorization to practice, and specialized experience/training in psychological testing.  Typically, schools (both K-12 and college) will only accept assessments completed by individuals with these qualifications.  In most cases, only a psychologist holds the requisite credentials for diagnosing clinical disorders, such as ADHD, specific learning disorders, autism, developmental delays, and intellectual disabilities.

2. Learning assessments should include a comprehensive evaluation of IQ and academic achievement.  

“IQ” (intelligence quotient) testing refers to the evaluation of intellectual and cognitive abilities (i.e., verbal and non-verbal reasoning, working memory, and processing speed).  Academic achievement testing measures acquired procedural knowledge, skills, and facts related to school (i.e., reading, writing, and math). A psychologist should use “gold standard” measures to evaluate these areas.  We recommend the following:

  • IQ: Wechsler intelligence scales (WPPSI-IV for preschool/kindergarten, WISC-V for children and teens, or WAIS-IV for late-teen and adults).
  • Academic achievement: Wechsler Individual Achievement Test, Third Edition (WIAT-III).

3. Screeners are insufficient for assessing learning problems.

Screeners are behavioral checklists and/or abbreviated versions of “gold standard” measures, and there are several reasons why they are inadequate for evaluating complex learning problems.  First, they are not generally accepted by schools as evidence of diagnoses or need for classroom accommodations.  Second, while they may be cost effective and a good first step towards identifying possible learning challenges, when used in isolation they do not allow conclusive or differential diagnosing (i.e., teasing out other possible causes).  Third, they do not support identification of strengths.  Fourth, screeners can deliver false positives/negatives for children with significant weakness, advanced abilities, or both (i.e., twice-exceptional learners).  Fifth, unlike “gold standard” measures used by psychologists, screeners can and often are used by professionals with a wide variety of credentials and experience.

4. Insurance does not cover learning assessments.

Learning assessments are classified as “educational” rather than “medical” services.  As such, health insurance policies will not pay for them.  However, policies may cover testing that is provided by a psychologist or physician and results in a diagnosis for specific clinical disorder (e.g., ADHD or anxiety).  The best way to find out what your policy will cover is to call the insurance company and ask.  A psychologist can provide you with detailed invoices (that include clinical billing codes) that you can submit for possible reimbursement.

5. Learning assessments should evaluate strengths – and not just “problems.”

A quality learning assessment should provide insights and guidance that help scaffold a child’s overall happiness and success – not only in school, but across life.  The process should include a survey of strengths, preferences, learning styles, interests, and temperament – all of which impact learning, self-concept, personal relationships, and career choices.

What is the first step you should take?

Some psychologists offer initial consultations for new assessment clients.  During this meeting, they will gather history, ask about your goals for testing, review previous testing or other relevant records, describe their philosophy about assessment, outline the process, explain costs, and discuss other options.  Essentially, clients should leave this session with a clear “road map” of what to do next, and what to expect along the way.  The psychologist should then be able to connect with your child’s school to ensure that the testing they provide is what the school needs.

Above all else, never stop asking questions until you feel confident you’ve chosen the right path for you and your child.

– Dr. Katen

“Live the life you were meant to live!”

©2016 Individual Matters.  All rights reserved. Permission is granted to share this article with others, as well as to print or post it on other websites, so long as credit is given to the author.

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Insurance vs. Private-Pay?

How to Pay for Learning Assessments
How to Pay for Learning Assessments
Insurance vs. Self-Pay

How to Pay for Learning Assessments?

To use insurance or to private-pay?  That is the question, right?  Perhaps you’ve already decided to go forward with a psychoeducational (or learning) assessment for your child or yourself.  Or maybe you’re still busy comparing services, costs, and trying to determine whether and how to pay for the assessment.  No doubt you’ve spent a lot of time researching options.  You understandably want to find the best possible assessment service – but also at the most reasonable cost!

Somewhere during your research, you’ve probably wondered whether to pay for the psychoeducational assessment with insurance or private-pay (i.e., paying with cash, check, or credit card).  What are the advantages of each payment option?  And which is right for you and your family?

Both options – insurance and private-pay – have their advantages:

Insurance

  • Can reduce the cost burden.  Depending on your insurance plan, as well as the type of assessments and diagnosis, insurance companies may pay for some or all of the costs of testing for “medical” conditions (usually these refer to mental health or neuropsychological issues that are deemed “medically necessary”).
  • Discounts are typically available for going through “in-network” providers.
  • Other discounts may be available when you use “out-of-network” providers.

Private-Pay

  • Insurance does not pay for “learning” or “educational” assessments.  Insurance policies do not typically cover “learning” or “educational” assessments such as testing for learning disabilities.  In general, insurance does not pay for psychoeducational assessments of academic achievement, cognitive (IQ) testing, or personality and temperament inventories.   However, as discussed above, your health insurance might cover assessments of certain “medical” conditions.  For example, depending on your insurance policy, you might be reimbursed for assessment of mental health issues or, in some cases, ADHD.  Your policy might also pay for certain types of neuropsychological testing that your physician believes to be a “medical necessity.”
  • In order for insurance to pay, you must be diagnosed.  This is important to consider before you decide to utilize insurance.  Since health insurance is part of the medical model, you (or your child) must be diagnosed with a mental health condition if you utilize insurance.  This stipulation is important to understand up front, since any subsequent diagnosis will become part of your permanent medical record – possibly affecting your future insurance coverage, school options, employment, etc.
  • Your privacy is protected.  When you pay privately, you share an agreement with your psychologist – and no one else.  With the exception of special cases (e.g., issuance of a court order, or in situations where someone’s life or safety is threatened), your records will never be released without your written authorization.  Cash sessions are entirely confidential.  Conversely, insurance companies can and do audit psychologists – meaning your (or your child’s) records must be made available to the insurance company and, quite possibly, various other “third party entities” (such as government agencies).  Even if your psychologist is not audited, he/she is still required to submit certain information about you to your insurance company (see below).
  • Only you and your psychologist determine scope of care.  When you pay privately, your psychologist will work with you to formulate goals and intervention based upon your unique circumstances.  These plans can be modified, continued, or concluded based on the decisions you make together – in confidence.  On the other hand, insurance companies require psychologists to submit client treatment plans – which their claims departments will then decide to approve or deny.  When you choose to utilize insurance, the type of assessment, results and diagnoses, and recommended treatment must be submitted to your insurance company.  Their claims department will then determine whether the outcomes and recommendations of your sessions fit the insurance company’s decision-making matrix.
  • You have more options.  When you pay privately for an assessment, your psychologist can utilize any assessment tools that he/she believes will be most helpful and appropriate for yielding a clear and comprehensive profile.  He/she is not constrained by what your insurance company will or will not pay for.
  • No hidden costs.  Private-pay typically involves “flat fee” rates.  For example, if an assessment is advertised as $800, then that’s the final cost.  All agreed upon services will be provided for that price.  There are no “extra” or “hidden” costs.  You will not receive any “surprise” follow-up bills.
  • Often less expensive than insurance.  In the long run, the cost of a psychoeducational assessment may end up being less when you private-pay. One reason is “deductibles.”  Insurance companies typically require you to pay a certain amount before they will cover additional costs. If this amount (i.e., your deductible) is greater than the cost of the evaluation, your insurance policy will not pay.   Keep in mind that, just because you have received an initial quote for reimbursement, this does guarantee you will actually be reimbursed (as mentioned above, claims may still be denied).  Furthermore, since insurance companies direct scope of care, they may agree to cover only a limited-scope assessment.  And in all cases, the insurance company will require a diagnosis.  But what if no diagnosis is warranted?  And what if further testing is appropriate?  When all is said and done, you may be left with more questions than answers, and the total cost of the assessment process will increase substantially.
  • You pick your provider.  Perhaps most importantly, when you pay privately you are able to choose your provider based on “best fit” for you (and your child).

What should you do?

There is no single, best, “right” way to pay for a psychoeducational assessment.  Both insurance and private-pay have their advantages.  Here are a few final suggestions to consider:

  1. If you have insurance coverage, check your particular plan by calling the customer service number on your card.  Ask the representative about the benefits of using in-network and out-of-network providers, as well as to explain exactly what is (and is not) covered by your plan.
  2. If you have a Health Savings Plan, you may be able to use these funds to pay for psychoeducational assessment.  Check with your HSA provider.
  3. If you can afford to do so, use cash or check to pay for psychoeducational assessment.  This ensures the highest levels of privacy and comprehensive service options.
  4. If you need to use insurance, get a quote from your company, pay privately first, and then seek reimbursement.  Your psychologist can issue you a detailed invoice with insurance billing codes.  However, keep in mind that, if you do utilize insurance, your psychologist will still be required to issue a diagnosis (and then submit it to the insurance company).  But with this option, you can at least have greater freedom in your choice of psychologists.
  5. If you still have questions or are uncertain about the options, call and ask your psychologist.  They love helping individuals and families – and they will be more than happy to provide information or answer any questions you have!

– Dr. Katen

©2016 Individual Matters, LLC. All rights reserved. Feel free to republish so long as credit is given.

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