Do you take insurance?
Lumos is considered an “out-of-network” provider for all insurance companies at this time. Dr. Clarke is known for her high quality and thorough assessments. In a private assessment Dr. Clarke is free to make tailor the scope of the assessment to your specific needs. This allows her to answer your specific questions and provide detailed recommendations on what you can do next to support your child in the best way possible.
Dr. Clarke will provide a super bill after your assessment is complete with any applicable diagnostic codes. You can submit this to your insurance provider to seek any “out of network” coverage. It is your responsibility to check with your insurance company before the assessment to understand your coverage. As a private pay provider, Dr. Clarke does not directly interface with insurance companies.
You can also use Flexible Spending Accounts (FSAs) or Health Spending Accounts (HSAs) to cover the cost of the assessment. FSA and HSA funds allow you to use pre-taxed money to cover health costs, including mental health services.
What should I ask my insurance company?
1. Does my plan cover behavioral health services? (e.g., mental health therapy, ABA,
psychological testing, etc. depending on the services you are seeking)
2. What are my individual and family deductible amounts?
3. How much of the deductible amounts remain for the year?
4. Is the deductible applicable to behavioral health appointments?
5. Are there any limitations, exclusions, etc. to behavioral health services?
6. How do I submit my claims? (Online, Fax, Mail)
7. Is there a maximum number of visits per year?
8. What percent of reimbursement is covered under my plan?
9. What is the out-of-network reimbursement rate for the specific CPT codes?
10. Is pre-authorization required for Psychological Testing (if you are seeking testing
services)? If yes, WHAT is required for pre-authorization and where can this
information/form be found?
What are your rates?
The typical comprehensive assessment is $4,500. Very young children may require less testing.
School, daycare or home observations are an add-on service.