Ariati Rakic, Ph.D. Clinical Neuropsychologist

Individuals who have experienced a change in mental functioning following a fall, car accident, sport injury, seizure, episodes of extreme high fever, or disease processes such as encephalopathy, meningitis, chronic or acute metabolic, endocrine, or degenerative disorders, liver failure, COPD and other vascular and respiratory conditions;  should consider the possibility that their brain functioning may have been compromised by a mild closed head injury (mTBI) or a diffuse brain injury that is not easily detected in brain imaging studies such as CAT Scan or MRI, but caused enough brain damage so as to alter their cognitive functioning.  Children and adults who have a history of child abuse, early malnutrition and/or neglect, low birth weight, toxic exposure, developmental delays, unexplained and severe reactions to environmental factors that are usually innocuous to others, learning issues that have failed to improve with conventional remediation programs, severe behavioral problems, including ADHD-like symptoms that have been unresponsive to psychiatric interventions such as psychotherapy, ABA, and medication; could also benefit from a thorough Neuropsychological Assessment so as to clarify the origins or root-causes for their difficulties, and identify the necessary interventions to achieve meaningful changes in functioning.

The examinee or his/her representative (parent, spouse, adult offspring, or guardian) should provide me with all school and medical records available for my review.  Questionnaires should be carefully completed and returned to me prior to the initial appointment.  The information you make available before your visit, will help me develop some hypotheses of what the underlying issues may be and tailor the testing session with the inclusion of psychometric measures that will evaluate the targeted areas pertinent to your case with greater depth and specificity.  Children should be reassured that the visit will not involve any painful procedures such as shots, and be informed that different activities will be presented such as drawing pictures, building things, doing puzzles, answering questions, and listening to stories.  Make sure that you have a good night sleep and eat a good meal prior to the appointment.

The examinee should bring:

• Eye glasses and/or hearing aid
• MRI’s or other brain scans.
• Insurance cards
• List of medications
• Updated school and/or medical reports
• A snack or lunch, if the examinee plans to remain in the office during the lunch break.

As mentioned above, the assessment begins with the collection of all pertinent school and medical records and the completion of the questionnaires.  During our first face-to-face appointment I will meet with the examinee, and when appropriate his/her representative, and conduct a thorough and comprehensive clinical interview so as to gain an in-depth understanding of the relevant historical data and the problems at hand.  After the interview is completed, I will begin administering the different psychometric measures which involves a variety of tasks that ranges from completing puzzles, building blocks, drawing complex designs, answering ambiguous questions, etc.  The testing per se will be completed in 2 to 8 hours depending on the complexity of the presenting problems and the kind of assessment that was agreed upon. Usually, for a comprehensive Neuropsychological Assessment, the data collection will be accomplished in two sessions lasting 3 to 4 hours.  However, if the examinee has a condition, medical or behavioral, that precludes him/her from performing the examination for an extended period of time, a greater number of sessions of shorter duration may be scheduled.

After the testing is completed I will prepare a written report with the results, discussion of my impressions, and specific recommendations for treatment and interventions to be pursued, including rehabilitation, educational and vocational services, as well as referral to other specialists when warranted such as neurologists, psychiatrists, mental health professionals, educational specialists, or vocational counselors, occupational therapists, physical therapist, speech and language pathologists. The examinee and/or representative will be scheduled for a face-to-face meeting when I will explain the contents of the report in detail and be available to answer any questions. For students in grades 12 and below, at parental request, I will participate in the first scheduled IEP meeting following the completion of the assessment, at no additional cost, so as to advocate for the services and accommodations that I believe should be provided by the school.  My attendance at subsequent IEP meetings could be arranged but at an additional fee.  For examinees that are residing in out-of-home placements such as nursing homes, residential treatment programs, etc. I will gladly meet with administrators and staff at the facility, to help determine appropriate care and address any behavioral concerns.  I will be available for consultation to other professionals and health care providers who would like to discuss the findings and recommendations, once the proper consent forms authorizing me to exchange information is signed.  

A Neuropsychological Assessment will be covered under your Medical rather than your Mental Health coverage.  It is important to know the distinction, especially when pre-authorization is required by your insurance carrier.  Because a Neuropsychological Assessment is covered under your Medical coverage, it usually requires a Referral from a Physician (your Primary Care Physician, Neurologist, or Pediatrician) and a letter stating Medical Necessity where the Physician establishes that the referral is needed in order to provide the most appropriate care (i.e. differential diagnosis, baseline testing prior to intervention, guide treatment plan).  A Learning Disability Evaluation will NOT be covered by most insurance companies since this service is viewed as the responsibility of the public school system under the IDEA regulations.  However, a Pediatric Neuropsychological Assessment will be covered under the Medical coverage if the child is believed to be experiencing academic issues due to a medical condition that affects brain development or the appropriate functioning of the Central Nervous System.

I am a Medicare Provider and I accept most insurance coverage including Blue Shield of California, Blue Cross of California, Anthem Blue Cross, Cigna, United Health Care, and Delta Health Systems.  However, since I do not belong to any Network, your  must have PPO coverage and, in that case, your insurance company will pay for part of the cost of the evaluation and/or Cognitive Rehabilitation Services, which most of the time will range between 50 to 75% of the total balance depending on your policy. If you anticipate having difficulties paying for your portion of the cost, arrangements for quarterly or monthly payments can be put in place.  Before you commit to proceeding with any of the services we provide, with your permission, our personnel will contact your insurance company and take the steps necessary to obtain authorization and information regarding the amount that you may be held responsible for.   As a consumer you should be aware that different costs are associated with different levels of assessment. The administration of the psychometric measures that are usually included in a comprehensive Neuropsychological Assessment usually requires 6 to 8 hours to be completed.