We understand the importance of this testing for you and your family, and how it is tinged with worry and concern. In the interests of full disclosure and no unwanted surprises, this page will inform you about the costs associated with APD testing.
It is routine to verify that the person to be tested has normal peripheral hearing, before APD testing commences. Any audiologist can complete a regular hearing test for you. We can help you find an audiologist close to where you live. You can bring a copy of that hearing test with you to the APD evaluation, or a copy can be faxed to Portland APD. (Our fax number is 503-234-4227.)
Some have asked it is necessary to do this before the APD testing. “Can’t the hearing test just be done at the same time as the APD evaluation?” If a sensorineural or conductive hearing loss is found, the APD testing cannot be done. Portland APD does not want anyone to take time off work, take a child out of school, or drive a long distance only to be told after the first fifteen minutes that the APD testing has to be postponed or cancelled. It is easy to avoid that scenario by having the basic hearing test done by a qualified audiologist at a location closer to you prior to the APD testing.
An appointment is set for testing by telephoning 503-806-1498 or emailing email@example.com
On the day of testing, demographic information is collected, and a questionnaire about behaviors is filled out. (Driver’s license and insurance card are photocopied.)
The evaluation begins with a background interview with the person to be tested, or with parent(s) if a child is to be tested.
APD Test Battery. The testing is done in two parts:
The first part (behavioral testing) is done in the sound booth, and involves listening to test stimuli and repeating what was heard. This can take 30-45 minutes.
The second part of the testing (electrophysiological testing) takes 1 to 1 ½ hours and is called complex ABR. It is a form of Auditory Evoked Potentials. This test involves placing four electrodes on the head, and recording the brainwaves resulting from the test stimuli (heard through an earphone). It is not necessary to pay attention to the complex ABR stimuli, but the person being tested is expected to stay awake. It is most important to sit quietly without talking (movement disturbs the testing, and talking adds unwanted sound into the testing). The person to be tested usually watches a DVD during this part of the testing.
Post-evaluation conference. Conclusions that can be drawn immediately are discussed, and some recommendations for remediation are made.
Report.Writing the formal report takes at least three hours, often more. A draft of the full report is usually written within one week of testing.
Written report. After discussion, a hard copy of the report with an original signature is sent to parents, and an electronic copy is also mailed.
[On average, an Auditory Processing evaluation involves at least eight hours of professional time per evaluation.]
A typical APD evaluation is billed out at $1205 to $1345, depending upon specific testing done. Clients paying up front (check or cash) where there is no necessity to bill a health insurance plan are given a generous cash discount (sometimes as high as 50%). If a health insurance plan is billed, Portland APD has a contractual obligation to collect the client’s co-payment, co-insurance and/or remaining deductible on the date of service (day of the evaluation). Portland APD collects demographic and insurance information on the date that the evaluation is scheduled, so that we can check the health insurance’s website, and report back to you before the evaluation date, our best estimate of the amount you would need to pay on the date of service. We want to avoid any surprises on the day of the evaluation about what payment is expected.
Portland Auditory Processing Diagnostics (Portland APD) is in network with some, BUT NOT ALL, third-party payers or insurance plans:
Providence EPO and PPO plans (and PEBB)
Regence Blue Cross/Blue Shield (and other Blue Cross/Blue Shield plans, such Anthem or Premara)
First Choice Health PPO Network
Managed Healthcare NW/Caremark
(Aetna and HealthNet consider APD testing to be a “non-covered service.”)
Please note: Kaiser Insurance has always maintained that auditory processing disorders are not health-related, and APD evaluations are, therefore, not covered by any Kaiser Insurance Plan (including employer plans administered by Kaiser).
Sorry: no Medicaid funding for APD testing. Unhappily (it is not the choice of Portland APD), no Oregon or Washington Medicaid program will reimburse for APD testing (this includes Family Care, Oregon Health Plan, Apple Care, Columbia United Providers, Willamette Valley Health Care, etc.). It does not matter if you were referred by your physician or not, none of the Medicaid programs pay for the testing. To make it more confusing, the APD procedure codes are “good” codes, but they are “non-payable codes.”
If you have an insurance plan that does not have a relationship with Portland APD, you will be responsible for the full charges for the evaluation. Payment will be required at time of testing. Portland APD will furnish you with documentation (invoice and statements) so that you can request reimbursement for an out-of-network evaluation from your insurance company, or to access funds in your Health Savings Account. If you are planning to submit the statement to an insurance company or third-party payer not on the above list, it is advisable to obtain pre-authorization. It may be necessary for you to provide the insurance company or third-party payer with a referral from your primary care physician for the testing. You will be responsible for procuring the referral if it is necessary.
Portland APD has a strong preference for payment by check or cash, but can accept payment via credit cards via SquareUp.com. There may be a small surcharge to cover the credit card fee.
Because we are essentially scheduling a day’s worth of professional time to prepare, evaluate and report on your child, Portland APD requires a minimum of 72 hours notice if an unforeseen emergency makes it necessary for you to cancel or reschedule your appointment. Portland APD reserves the right to charge a $150 cancellation fee for no-show appointments or appointments cancelled with less than 72 hours notice.
Contact Dr. Polich or Portland APD
1827 NE 44th Avenue, Suite 130
Portland, OR 97213-1344
Office telephone: 503.806.1498
Office email: firstname.lastname@example.org
Office FAX: 503.234.4227