Policies, Fees & Payment
Payment: All services are available through private pay; I do not contract with or submit bills to insurances companies. I provide an estimate for services needed when we speak. The fee for a comprehensive Neuropsychological Evaluation is typically in the $3,000 — $3,800 range. The amount of testing needed depends on the questions we want to answer. When testing has been completed recently elsewhere and therefore far less testing is needed, the fee might be in the $1,800 — $2,400 range, but this can vary depending on many factors. Intellectual Evaluations are typically in the $1,000 — $1,300 range.
Good Faith Estimate
Additionally, I provide a Good Faith Estimate as required by federal law. You can read about that requirement here:
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees. Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059.
Here in Massachusetts, an additional disclosure requirement takes effect on July 31, 2022:
Patients First Law
Healthcare Provider Disclosure Obligations Related to Scheduling Admissions, Procedures or Services, or Making Referrals to another Provider
Beginning July 31, 2022, Massachusetts law requires me to disclose the information below. When we first speak, I discuss estimated fees; I let you know that I do not accept insurance; that you can seek neuropsychologists who accept your insurance; and that insurance does not cover education-related services. Starting July 31, 2022, I will provide a written form with the information below when new clients decide to work with me:
I am not a provider for your insurance / health plan and I do not contract with or submit claims/accept payment from any insurance companies. This is outlined in the Payment Policy Form you will sign for these services. Working with a provider for your health insurance/plan would likely result in lower costs for you, if your health plan determines these services are medically necessary. We have discussed that services provided for educational planning purposes are not covered by health insurers / health plans. If I provide names of other clinicians for recommended services after the evaluation, I will not know if they accept your insurance, or if your health plan considers the services medically necessary. Therefore, you may be responsible for fees not covered by your insurance if you work with any of those clinicians. I will provide their name, credentials, and location of their practices so you can inquire about insurance coverage. I have a solo practice so they are not part of my practice/organization.
The law authorizes the Massachusetts Department of Public Health (MDPH) to penalize health care providers who fail to comply with these requirements, with a penalty of up to $2,500 in each instance. These penalties will take effect July 31, 2022. Any patient who has not received the required notice may submit a complaint, in writing, to the health care provider’s professional licensing board (see below), or in the case of a licensed facility, to the Bureau of Health Care Safety and Quality. The board will notify the health care provider of the complaint and give the provider 10 days to submit written documentation demonstrating compliance with the notice requirements.
This Board includes the Board of Registration of Psychologists:
The “Notice to Patients” issued by the Commonwealth of Mass. is available at the bottom of this web page.
Welcome to my Neuropsychology Practice. This document contains important information about my professional policies regarding privacy protection, use, and disclosure of your Protected Health Information (PHI). These policies are in accord with the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. Under HIPAA, I am required to provide you with this information and obtain your signature. By signing your Client Registration form/HIPAA and Informed Consent form, you acknowledge having received this information. Your signature additionally indicates informed consent for receiving services in my practice. I am happy to provide you with a copy of this document if you request it. Copies are readily available in my office.
Limits on Confidentiality
The law protects privacy and confidentiality of all communication between client and the client’s psychologist. In most circumstances, I can release information only with your written authorization. This section of the document explains the few exceptions to confidentiality and situations in which information may be released without your authorization or consent or with consent only. Parents hold confidentiality rights of children under the age of 18 who are not emancipated. In the following paragraph, “your child” is added when “you” are referenced and applies if your child is the focus of care here.
Under HIPAA, use or disclosure of PHI for the purposes of treatment, payment, or health care operations requires only your consent. Your signature on the Client Registration form/HIPAA and Informed Consent form provides consent for those situations. Treatment refers to services I provide which may include obtaining personal information from you/your child or about you/your child through interview, testing, documentation, or consultation with other clinicians intended to serve your/your child’s health care needs. Payment refers to obtaining reimbursement for services provided to you/your child. Insurers or other third-party payers typically require PHI in order to determine eligibility, coverage, or provide reimbursement for services. Healthcare operations refers to activities related to operating my practice such as billing services or typing services. Any personnel providing such services would be trained in privacy policies and be contractually bound to maintain confidentiality of PHI.
I am mandated by law to report to the appropriate agency suspected neglect or abuse of children under age 18, individuals with mental or physical disabilities, or adults age 60 and older. I may be required to provide additional information once I have made such a report.
If you (or your child) appears to be at clear and immediate risk of self-harm or harming an identified person, I must take reasonable precautions to ensure safety. These precautions may involve disclosure of PHI without your consent or authorization, which is permitted under the law in the circumstances.
If you file a Workers Compensation claim, your records relevant to that claim can be requested and provided to your employer, insurer, or the Department of Workers Compensation.
The Board of Registration of Psychologists has the power to subpoena relevant records when necessary, should I be the focus of an inquiry.
If you/your child are involved in court proceedings, unless there is a court order, your written authorization is required from you or your legal representative in order for me to release information. If your evaluation is court ordered, or there is a court order for your information, I am obligated to release your information.
When use and disclosure without your consent is authorized under other sections of Section 164.512 of the Privacy Rule and the state’s confidentiality law, certain narrowly defined disclosures are required/allowed: to law enforcement agencies, to a health oversight agency (such as HHS or a state Department of Health), to a coroner or medical examiner, for public health purposes or FDA-regulated products, or for specialized government functions such as fitness for military duties, eligibility for VA benefits, and national security and intelligence.
I will obtain an authorization from you before using or disclosing: PHI in a way that is not described in this notice; PHI for marketing purposes (this never occurs in my practice); PHI in what is considered a sale of PHI (this never occurs in my practice); psychotherapy notes.
email: Because unencrypted email is not a secure form of communication, your initials on the Client Registration form/HIPAA and Informed Consent form indicate that you authorize unencrypted emails for logistics, such as scheduling appointments, meetings, or phone calls or status updates on reports. I recommend keeping emails to a minimum. Emails that I generate or respond to that contain information beyond scheduling / logistics and contain specific identification of the client will be encrypted.
Client Rights and Psychologist Duties
You have the right to request restrictions on disclosure of your PHI. I am not required to agree to restrictions or your request, but will make every effort to do so, within the legal limits and exceptions to confidentiality. You have the right to request the location at which you receive communications involving PHI, as in an alternative address or phone number. You have the right to request in writing to examine and/or receive a copy of your records, unless I determine that access would be a danger to you. In that situation, you have the right to a summary of the record and you can request that your record be sent to another mental health provider or to your attorney. You have the right to request an amendment to your record. I may deny your request, but I can document your concerns in the record.
Your rights include requesting an accounting of disclosures of PHI for which you have provided neither consent nor authorization. You have the right to restrict certain disclosures of PHI to a health plan when you have paid for your care out-of-pocket. You have the right to be notified if there is a breach of any unsecured PHI. Unsecured PHI refers to PHI that has not been encrypted to government standards or if my risk assessment determines that the chance that your PHI has been compromised exceeds a low probability of compromise.
I am required by law to maintain privacy of PHI and provide you with this notice of my legal duties and privacy policies.
I reserve the right to amend or change the privacy policies described here. I am required to abide by the policy stated here unless I notify you of any changes.
Questions and Complaints
If you have questions about these policies, disagree with the decisions I make regarding access to your records, or have other concerns about privacy rights, you may contact me by phone or in writing. My contact information is available on my website and on the hard copy of this notice. You may also send a written complaint to the Secretary of the US Department of Health and Human Services.
Informed consent, which is required under Massachusetts state law, means that the purpose, procedures, and nature of the information that this evaluation or consultation can yield have been explained to you; that you understand this information; and that you agree to participate willingly in this evaluation or consultation.
Updated April 28, 2022