1.

What makes ACHIEVE Unique?

ACHIEVE is unique in that our practitioners are experts in both psychology AND education. While many area psychologists and therapists specialize in identifying and/or treating specific psychological conditions, we also fully comprehend and are able to address psychological difficulties from an educational lens. All of our practitioners have experience working in local public schools districts, so we also have a unique "insider" point-of-view.

Another way that ACHIEVE is unique is that we aim to be a "one-stop-shop." We begin with an intake meeting to determine the client's concerns, then if determined appropriate, complete a full psychological and educational evaluation. While most area psychologists provide evaluations and send you on your way with a report, we aim to not only identify the problem, but also to provide the interventions necessary to address the problem in-house after the evaluation has been completed. No more running around to 10 different specialists to address your student's needs!

2.

What conditions do ACHIEVE practitioners have experience working with?

You name the condition, and we have probably worked with students who have it! Our practitioners have worked with thousands of students in the area and throughout the U.S. The most common conditions we see and work with are ADHD, Anxiety, Autism, Depression, and Learning Disabilities, but we have experience with many other conditions as well. Some other conditions we can identify and treat include, but are not limited to: Behavioral Issues, Oppositional Defiant Disorder, Conduct Disorder, Developmental Disorders, Intellectual Disabilities, Mood Disorders, Bipolar Disorder, Social Anxiety, Panic Disorder/Panic Attacks, and Obsessive-Compulsive Disorder.

3.

Are there any conditions ACHIEVE does NOT treat?

At this time, we do not provide crisis intervention services, do not provide treatment for acute trauma, and do not identify or treat eating disorders. We are able to  work with students who have a diagnosis or history of PTSD, but are not certified trauma counselors. Please check out the options at the end of this page if you are seeking treatment for these conditions.
 

4.

Do you take health insurance?

ACHIEVE is considered an out-of-network provider for health insurance purposes. We are not currently listed on any insurance panels. Whether or not our services are covered will vary depending on your personal insurance plan. Insurance companies do not pay for psychological evaluations for educational difficulties. The only way psychological/educational evaluations are covered by insurance is if they are considered "medically necessary." For example, following a traumatic brain injury, or sometimes (rarely) when a case can be made that it is necessary to identify a medical condition such as ADHD or Autism. Payment for our services will be due at the time of your appointment, but we can help you work with your insurance company to seek reimbursement.

You are entitled to request a free psychological/educational evaluation from the school district in which you live. If they decline to complete the evaluation or you are not happy with the results or outcome of the evaluation they completed, please give us a call and we can walk you through next steps to obtain a private evaluation from us at no cost to you.

5.

How can I seek reimbursement from my health insurance provider?

  1. Check your out-of-network benefits
    Typically found in the Summary of Benefits. Look for:
    - Out-of-network deductible – the amount you have to pay before you are eligible for reimbursement.

    - Coinsurance – the percentage of the service fee that you are ultimately responsible for paying.

     

  2. Call your insurance company to verify benefits
    Ask the following questions:
    How much of my deductible has been met this year?
    What is my out-of-network deductible for outpatient mental health, psychological evaluations, and neuropsychological evaluations?
    What is my out-of-network coinsurance for outpatient mental health, psychological evaluations, and neuropsychological evalatuions?
    How do I submit claims for reimbursement?

     

  3. Request your Superbill
    The office will provide you with a “Superbill” that you send directly to your insurance company at the end of each month. The “Superbill” details how many sessions you’ve had, and the total fee.

     

  4. Receive Reimbursement if Applicable
    Payment will be required at the time of service, but depending on your specific plan, your insurance company will mail you a check to reimburse a portion of that cost.

6.

What are the advantages of paying for a private evaluation vs. going through insurance or my school district?

  1. Insurance does not pay for "learning" or "educational" assessments.
    Generally speaking, insurance policies do not pay for cognitive (IQ) testing, academic achievement testing, assessment of social-emotional or behavioral status or skills, or personality/temperament inventories. 

     

  2. You must have a diagnosis for insurance to pay.
    Since health insurance is a medical service, your child must be diagnosed with a mental health condition if you utilize insurance. Therefore, any diagnosis made as a result of an evaluation paid for by insurance becomes a part of your child's permanent medical record. This can possibly affect future insurance coverage, school options, employment, etc.

     

  3. Your privacy is protected.
    When paying privately, you and your psychologist's office are the only ones who will have access to your child's records (with extremely rare exceptions like court orders). Sessions and assessment results are 100% confidential. If billed through insurance, the insurance companies are able to access your child's records and possibly various other "third party entities" (like government agencies).

     

  4. Only you and your psychologist determine scope of treatment.
    When you pay privately, your psychologist will work with you to truly individualize treatment based on your personal goals, priorities, and unique circumstances. These intervention plans can be modified, continued, or ended based on decisions you make together confidentially. Insurance companies require psychologists to submit treatment plans, which they can then approve or deny. *Let us tell you - whether the treatment plan is approved or denied has more to do with saving the insurance company money than it does addressing your child's needs.*

     

  5. You have more options.
    When you privately pay for an evaluation, your psychologist can utilize any assessment tools they believe are necessary to provide a clear and comprehensive profile of your child. Similarly to treatment, this will allow the psychologist to customize the evaluation to your child's individual needs, rather than working around what the insurance company will or will not pay for.

     

  6. No hidden costs
    Private pay usually involves "flat fee" rates. The cost of the evaluation as advertised is what it's going to be. All of it. There are no hidden costs. You will not receive any "surprise" follow-up bills.

     

  7. You pick your provider.
    Most importantly, when you pay privately you can pick your provider based on who is the best fit for your child, and not have the only option be the psychologist who jumped through hoops to be listed on the insurance company's in-network list. They also often have a very long (months to years) wait list. There is so much intervention opportunity missed in that amount of time, it's heartbreaking.

6.

Do you complete Independent Educational Evaluations?

YES!

An Independent Educational Evaluation (IEE) is a comprehensive psychological and academic evaluation completed by a qualified person who is not employed by the school district. You may wish to pursue this option if: you disagree with the district's most recent special education evaluation of your child; the school district conducted an initial evaluation or re-evaluation but did not fully identify all areas that need to be evaluated and you disagree with the evaluation; or the school district has denied your child special education eligibility or a necessary service or support based on the recommendations of a poorly-done school district assessment. You can request an IEE for any assessment the school district has already conducted if you disagree with that assessment. It can include psychological/academic assessment, assistive technology assessment, speech/language assessment, or transition assessment.

How to Request an IEE
1. Send a written request for an IEE at Public Expense
Write an email or letter to your district's Special Education Director or Case Manager stating you disagree with the district's evaluation and are requesting an IEE at public expense. After it receives your letter, the school district may ask you to explain why you disagree with its assessment. You do not have to give any reasons for your disagreement to the school district. Also, the school district cannot use your refusal as an excuse for delaying its response to your request.

2. Wait for a response
The school district must respond "without unnecessary delay" - generally 15 school days is acceptable. School districts typically agree to the IEE to avoid taking parents to due process. They may suggest certain providers, but you may choose any providers you wish. If you do not receive a response, you may write them again indicating you understand their lack of response to mean they agree to the IEE and pursue it on your own accord.