FAQ & Insurance: BrainCore Neurofeedback Therapy

For more information visit: www.braincoretherapy.com
WHY HAVEN’T I HEARD OF NEUROFEEDBACK BEFORE?

The science of EEG Biofeedback has been around since the 1960’s but, until recently, was only available in large University laboratories.  Now with the advancements in computer technology we are able to bring it to the clinic level. In fact NASA has used neurofeedback for many years to improve mental acuity of their astronauts preparing them for extended space travel.

DO INSURANCE COMPANIES REIMBURSE FOR EEG BIOFEEDBACK?

Some do, however coverage varies depending on the details of your specific insurance plan.  For example, some Aetna policies have 100% coverage, while other Aetna plans have none.  Also, if your insurance does cover biofeedback, they may only reimburse for specific health conditions.

Our friendly staff is well trained on verifying insurance benefits for EEG Biofeedback and would be happy to call your insurance carrier on your behalf.  If, you would like to call yourself, dial the telephone number on your insurance card and ask the representative:

“Do I have out of network coverage for EEG Biofeedback (treatment code 90901)”

In addition, BrainCore of Manasquan, LLC is an out-of-network neurofeedback facility. That means coverage depends on your out-of-network benefits.  Though we are out of network our staff will submit claims to your insurance company on your behalf.  Patients pay for the session(s) up front and the insurance reimbursement, if any, will be sent directly to the insured from the insurance carrier.

Insurance companies that do NOT cover EEG Biofeedback at all include:

Medicare, Medicaid, Amerigroup, Americhoice and Qualcare.

CAN I USE MY HEALTH CARE SAVINGS ACCOUNT (HSA)?

Yes. Virtually all HSA accounts allow funds to be used for EEG Biofeedback. However, to be sure your HSA does not have any specific restrictions, it would be wise to check with the account administrator prior to beginning neurofeedback training.

WILL INSURANCE PAY UNDER THER AUTISM INSURANCE REFORM ACT?

On August 25, 2009 Governor Jon Corzine signed the autism insurance reform bill, S. 1651/A. 2238, into law. New Jersey became the fifteenth state to enact legislation which requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies.  Many patients diagnosed on the spectrum have been able to receive insurance coverage under this ruling even though their plan  does not normally pay EEG biofeedback.

Note: To best facilitate coverage under this law, a letter of medical necessity from the diagnosing physician may be required.  This is usually a pediatric neurologist or developmental pediatrician.

HOW MANY SESSIONS ARE REQUIRED?

Most patients start with a 25 session program.  During a typical training program several different sites/areas of the brain are trained.  Braincore therapy is not a “one size fits all” therapy.  All training programs are custom designed for each individual patient. Therefore 25 sessions are required to create a baseline to properly monitor treatment progress, as well as, address multiple areas of the brain that need to be trained separately or with a different type of feedback. And like all health conditions, not all patients are the same. The severity of the symptoms and the neurologic composition of the brainmap (qEEG) will most likely correlate to the total number of sessions needed to achieve the desired outcome.

IS THERE A PATIENT AGE MINIMUM OR MAXIMUM?

We typically accept neurofeedback patients ages 7 and up and there is no age maximum.  However, the maturity level of the patient plays a significant role.  Also, to train, one must be able to understand that he or she is controlling the feedback (video monitor, music, video game..etc).

HOW MUCH DOES IT COST IF I DON’T HAVE INSURANCE?

The average cost for a neurofeedback session is between $75 – $125.  Prices vary depending upon the details and complexity of each case.  Payment plans and financing options are also available.

HOW MUCH TIME DOES EACH TRAINING SESSION TAKE?

A typical training session lasts 35 – 45 minutes depending on the type of training that is being performed.

HOW FREQUENT ARE THE TRAINING SESSIONS?

Three neurofeedback sessions per week is the standard.  Twice per week is the minimum. There is no maximum.  Patients may train everyday if that best fits their upcoming personal schedule.

CAN I STILL TRAIN IF I AM ON MEDICATION?

Yes. Many of our patients begin neurofeedback therapy while taking prescription medication for the involved diagnosis.  However, as the patient begins to improve from training their symptoms become less intense and the prescribed dosage may become more than is necessary.  Therefore, it is important to keep regular contact with the prescribing physician to assure the dosage levels remain appropriate.  This office does NOT prescribe or advise on any patient’s drug prescriptions.

We understand that, for most, the goal is to eliminate the need for medication altogether.  However, that decision can only be made by the prescribing practitioner or other medical physician.

Inhibitors:  Other medications such as benzodiazepines, can inhibit the effects of neurofeedback training. Marajuana and other non-allopathic drugs may also slow or interfere with your training results as well.

WILL CONTINUOUS SESSIONS BE NECESSARY?

Once a training program is completed, a follow up qEEG is performed and compared side by side to the initial brainmap analyzing the overall percentage of improvement.  Additional sessions may be recommended if Dr. Stiso finds there is a statistical probability of further improvement based on the post brainmap results.

MAINTENTANCE

Once a new neurologic connection is made within the brain, it is permanent. However, it is important to understand that the old pathways are permanent as well and cannot be undone.  In some cases, a maintenance program of 4-12 sessions per year is recommended to reinforce the new neuropathways that were created during the Braincore training sessions.

A common analogy is the ability to ride a bicycle. A twelve year old is very good at riding a bike because it is their main mode of transportation and this action is reinforced daily.  Thirty years later, after that bicycle has been put away for many years, he or she still retains the ability to ride but due to the lack of reinforcement (practice) they are not as proficient as they used to be.

In addition, at-home therapies such as heart coherence biofeedback, acoustically modified music therapy or audio-visual entertainment may be recommended in addition to, or in place of, neurofeedback maintenance sessions.

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