About Assessments

All assessments must be pre-scheduled with Dr. Griffith by telephoning her at (315) 210-6475. All assessments must be done in person, at Dr. Griffith’s Ogdensburg, N.Y. office, which has a handicapped ramp exterior access, but stairs up to her second floor office. Wheelchair clients may be able to be seen in a first floor conference room, but extra time is needed to schedule this. Dr. Griffith will consider seeing clients from Canada, given that her office is directly at the U.S.-Canadian border in Ogdensburg, N.Y., but potential clients must be able to cross the border legally to see her in New York State. Dr. Griffith does not conduct any assessments on line, by telephone, or by video conferencing methods such as Skype. Adults must schedule their own assessment appointments themselves; another adult cannot schedule an assessment for them. They are responsible for paying insurance co-pays at the time of their assessment session, as required by law or, if they are private pay clients, they are responsible for paying for each hour of assessment at each scheduled assessment session. Appointments for assessments for minor children or adults with legal guardians must be made by their parents or legal guardians, who must also attend all scheduled assessment sessions. In the case of minor age (under 18 years of age) children of divorce, the parent whose insurance covers the child, or the parent who is paying privately for assessment sessions, must accompany the child. In the case of majority age children (those 18 years and older) who intend to use parental insurance to cover the cost of their assessment, the child must sign a release to allow Dr. Griffith and her practice management service to be able to contact their parent(s) and bill their parental insurance to cover the costs of their assessment. The majority age child, then, is responsible for bringing any co-pays required by insurances to each scheduled assessment session, as required by law. In the case of majority age children who intend to have their parent(s) pay privately for their assessment, the child must sign a release to allow Dr. Griffith to be able to contact their parent(s) and bill them for the child’s assessment costs. In these cases, the majority age child will then be responsible for paying for each hour of assessment scheduled, per session, by cash or parent signed check. In the case of guardianships, the guardian must bring legal guardianship papers to the initial assessment sessions for them to be held and, if insurance is to cover the cost of assessment, the guardian must sign a release to allow Dr. Griffith and her practice management service to bill for assessment services provided, and must pay all required co-pays at the time of sessions, as required by law.

Clients are advised that, for assessments to be covered by insurance, in the overwhelming majority of cases, a physician’s referral is required. Therefore, Dr. Griffith only accepts referrals for assessments from Primary Care Providers (MD, RPA, NP) or medical specialist providers (psychiatrists, neurologists). In the case of school district requested assessments, Dr. Griffith will require the student’s school district to send her a letter indicating their intent to pay for the assessment services they are requesting prior to her being able to schedule assessment time with a student. Testing for the purpose of CSE or school services, like IEP’s or 504 plans, will not likely be covered by insurance plans, based on the Milliman Care Guidelines 21^st Edition for 2017. This is because such testing will be deemed “educationally”, but not “medically” necessary, requiring private payment for the service. Testing, in most insurance plans, is not considered a “primary benefit”, and so an initial diagnostic assessment screening appointment is required, with additional approval needed for testing to be covered, based on the results of that initial assessment and accompanying referral information, to ensure it is “medically necessary’. With some insurances, pre-authorization for testing is never given, and payment is based on what Dr. Griffith finds diagnostically. This means that a client, with these insurances, may ultimately be responsible for the entire cost of testing performed, as their insurance plan does not cover certain diagnoses. To be “medically necessary”, testing will not be authorized by insurances merely at the request of the patient or because the referring physician prefers it. Testing must be shown to be “less costly than other medications or services that are as likely to produce the same or similar diagnostic and/or treatment results.” Private pay testing by Dr. Griffith is always available to patients whose insurances will not cover the cost of PCP requested testing, at a standard rate of $150/hour, including one hour for report scoring and one hour for report writing. The number of direct testing hours will be determined at the initial testing session, depending on the number of questions to be answered, the number of measures to be administered, and the diagnostic/treatment complexity of a case. Dr. Griffith is officially “opted out” of Medicare, but does offer senior rates for testing, ranging from $50 to $100/hour, but the senior, or their legal guardian, must agree not to bill Medicare or Medigap policies, and only pay Dr. Griffith privately, out of pocket.

Testing may be considered “medically necessary” (but insurance approval is not guaranteed) in the case of documented TBI, documented epilepsy, documented concussion, brain imaging studies showing tumors or absecesses, laboratory or clinical history documented fetal toxin exposures (i.e. drugs, alcohol, lead), documented stroke, and memory loss with documented concerns about dementia, demylenating diseases, and encepatholopathies. Testing for ADHD or autism spectrum disorder is generally not considered “medically necessary”, unless the above conditions are also present, or unless there is genetic testing documenting an autism spectrum disorder. Testing may be considered “medically necessary” (but insurance approval is not guaranteed) if an individual “has not responded as anticipated” to multiple medication attempts, but usually specialist consultation for further medication is preferred to testing by insurances. Testing may also be considered “medically necessary” in the treatment of chronic pain when there is a documented need to further assess mood or personality characteristics related to a patient’s coping with pain. As well, testing may be considered “medically necessary” if there are changes in cognitive or intellectual functioning after long term use of alcohol or street drugs, provided the patient has “at least 6 weeks’ abstinence from alcohol or drugs.” Testing may also be considered “medically necessary” as a component of pre-surgical evaluation to “rule out behavioral conditions that could contraindicate surgery” and/or to “evaluate a patient’s ability to understand surgical risks and participate in post-surgical recovery.” Based on Milliman Care Guidelines 21^st Edition 2017 criteria, testing is not deemed “medically necessary” for: “headaches (including migraines), a history of myocardial infarction, intermittent explosive disorder, computerized testing for concussion or cognition (used alone, without other measures), and baseline neuropsychological testing in asymptomatic persons at risk for a sports-related concussion.”

Neuropsychological and Clinical Psychological Assessments are offered for:

- Alzheimer’s Disease/ Dementias/ Memory Loss (adults and seniors)

- Traumatic Brain Injury (all ages, is specially trained to assess children)

- Post-Concussion Disorder (all ages, including readiness to return to school/sports)

- ADD/ ADHD (all ages, including adults)

- Learning Disabilities/ Recertification for College Educational Accommodations for previously assessed learning disabilities (all ages, including adults)

- Autism Spectrum and Neurodevelopmental Disorders (all ages, including preschoolers)

- Reactive Attachment Disorder (preschool/school age children and adolescents)

- Fetal Alcohol/Drug Exposure Effects on Behavior (preschool/school age children and adolescents)

- Behavioral Management of Other Brain Conditions—epilepsy, brain cancers, stroke, post-brain surgery recovery, etc. (all ages)

- Assessment of Mental Health Concerns, including Depression, Anxiety, Bipolar Disorder, Obsessive-Compulsive Disorder, Schizophrenia, PTSD, and efficacy and side effects of medications for these (all ages)

Assessment charges are $150.00 U.S. dollars per hour for private pay or school vouchered clients. For clients using insurance to pay for their services, charges will reflect the assessed insurance rate for tests administered, if insurance agrees to pay for the assessment. Fees for private pay and school voucher clients include a two hour charge for assessment scoring, write up, and report feedback at Dr. Griffith’s office and do not require any co-pays. Clients utilizing insurance to pay for assessments will be charged co-pays, as required, at the time of each assessment session, but all plans Dr. Griffith participates in include report scoring and writing in their fees, so that a separate fee for these services is not charged to insurance clients. Ultimately, clients themselves, or school districts themselves, if a referral is to be paid for by a school district, are responsible for assessment fees that are not covered by insurances or are denied by insurances. Dr. Griffith will meet with St. Lawrence County schools, for feedback on clients referred through the CSE process, on-site, for an additional hourly charge. The total time for an assessment varies by type, the number of questions to be answered, and the amount of prior assessment done on a client, and all services provided are subject to insurance pre-authorization and pre-approval, if insurance is to be used for the payment of assessment fees. However, to ensure adequate history gathering and the development of an effective assessment contract, the minimum time Dr. Griffith will charge for an assessment will be two hours. Charges are payable at the start of an assessment hour for the number of hours booked for that day. Dr. Griffith accepts some insurance plans, provided necessary pre-authorizations and pre-approvals are obtained, and co-pays are collected at the time of assessment, as required. She doesn’t accept Medicaid or Medicare. She will consider signing clients’ insurance claims forms to provide diagnostic information for clients’ reimbursement, if she does not accept their insurance plans. However, when she provides assessment services for such “out of network” clients, she must be paid directly by the clients themselves, at the time of their assessment. Insurance reimbursements must then be paid back directly to the clients themselves, by law. Preschoolers, school age children, adolescent minors, and adults under the guardianship of another, must be accompanied to all appointments by their parents or legal guardians, with appropriate releases signed, prior to the assessment being conducted, to communicate information to other professionals, should a school or institution be the referral source.

Following an initial appointment and the development of an assessment contract, at least two separate assessment dates are scheduled to conduct a client’s assessment, to ensure adequate sampling of testing behaviors and ensure an adequate number of tests are used. Assessments can be scheduled Mondays through Saturdays, and a limited number of evening hours are available for scheduling. A parent/guardian may be present in the assessment area for the duration of a child’s or adolescent’s assessment, and a guardian may be present in the assessment area for the duration of an adult’s assessment, if they have a legal guardian. However, waiting area space is limited, so no other parties can be waiting with or for a client as they are completing their sessions. This includes other siblings and family members of clients. Report feedback sessions may include other professionals and family members, but these sessions must be scheduled in advance, and minor children other than the client may not attend feedback sessions. Feedback sessions attendance will also be limited by COVID-19 social distancing requirements. See Dr. Griffith’s section on COVID-19 office policies and procedures on the home page of this website.

It should be noted that Dr. Griffith does not conduct forensic, court-involved, court “ordered”, or child protective services assessments. She also does not conduct child custody, visitation, or placement assessments, civil competency assessments, civil commitment assessments, and workmen’s compensation assessments. Her focus is on providing only clinical neuropsychological and psychological services, so Department of Social Services and other “court mandated” referrals cannot be accepted by her legally and ethically, given her profession’s standards of practice.