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Most of the common questions we receive are answered in these FAQ, organized by general topic. We are happy to answer additional questions by phone or in writing - please complete our New Client Contact Form if you would like us to reply, or to schedule.

  • What is Dr. Shapiro's availability?
    Dr. Shapiro is available by appointment, only. Hours vary by day and other professional commitments, with some limited evening and weekend availability. Due to the nature of her services, she does not provide on-call support. She makes every effort to respond to calls and Portal messages within 2 business days, excluding holidays. In case of emergency, call 911 or go to the nearest emergency room.
  • I live in ______. Can you see me via telehealth?
    Dr. Shapiro is licensed to provide psychological services in Iowa, Georgia, Nebraska, and North Carolina. She is also a Florida telehealth provider. Most states require licensure in the state in which the client is located at the time of services. Some states allow some limited practice by psychologists licensed in other states, while others require a full application for licensure in order to provide services to someone in that state.
  • Do I need a referral or pre-authorization?
    You will need to contact your insurance company to get answers specific to your plan and contract. Our office manager may be able to advise you on how to navigate that process with your insurance company, or if an initial appointment is needed to obtain the preliminary information needed to complete pre-authorization paperwork.
  • How do I get started or learn more?
    Reach out to us by completing a New Client Contact Form. Dr. Shapiro or our office manager, Julie Overbaugh, will follow-up to schedule or answer any questions you may have. Dr. Shapiro is happy to schedule a brief call prior to scheduling if you are unsure of how best to proceed or if she can meet your needs.
  • I meant, how quickly can I schedule an appointment?
    It depends on the nature of the services you're requesting. Concussion appointments are usually scheduled fairly promptly, and within a couple of business days for acute (very recent) injuries. More chronic concussion-related and sleep-related appointments can usually be scheduled within a few weeks since Dr. Shapiro's Iowa private practice is still fairly new. She aims to schedule intakes for more comprehensive evaluation appointments fairly quickly, and within a few weeks if possible; she has found that sometimes individuals may fare better with symptom-specific interventions before (or instead of) completing more lengthy evaluations. Since her Iowa testing practice is still growing, she can still schedule testing appointments within a few months, or sometimes sooner. The more quickly clients can collect all requested records, the more quickly their testing appointment(s) can be scheduled.
  • Do you test for learning disabilities, ADHD, or things like that?
  • Since it's not in-person, do I need to attend my teen's appointment?
    Please discuss this with Dr. Shapiro in advance. She typically wants parents present for at least part of the initial appointment to help provide a context for the current concerns and/or to facilitate implementation of follow-up, but it also depends on the reasons for which you are seeking care. Note, too, that parents and their children can log in to the appointment from different locations.
  • What are your fees?
    Our consent forms provide detailed information about fees. Dr. Shapiro charges an hourly rate of $260 for most clinical services, with initial 1-hour intake appointments starting at $325, and a higher rate for medicolegal services. Services after the initial hour are pro-rated for self-pay clients. A flat fee is charged for self-pay comprehensive evaluations in Charlotte and Atlanta. We will provide you with a written Good Faith Estimate of expected charges at the time the initial appointment is scheduled if you do not plan to submit to insurance for reimbursement.
  • Do you accept insurance?
    She accepts insurance for Iowa and Nebraska residents with BCBS that she can process through Wellmark/Blue Cross Blue Shield of Iowa. She does not accept other insurance for Iowa/Nebraska clients, or any insurance for residents of other states due to decreasing reimbursement rates with increased barriers to care. For all other (self-pay) clients we can provide a superbill to submit to your insurance company if you're eligible for out-of-network reimbursement. We accept payment via credit, debit, and HSA cards.
  • Do you text? Is email or telehealth secure? How do you protect my privacy?
    We make every reasonable effort to safeguard your privacy with use of a HIPAA-compliant Electronic Health Record (EHR) system, integrated with secure payment processing and telehealth platform. We use our EHR system and its Client Portal, rather than email, for routine communications. Our EHR can send appointment reminders by text, or email at your request, but we do not respond to text messages sent to the office phone number. Our consent forms have more information about this.
  • What is a sports neuropsychologist?
    Sports Neuropsychologists are doctoral level health care professionals - doctors - who have more specialized training in how the brain functions than any other kind of doctor. Not only can concussions affect physical functioning - the symptoms that your medical doctor or physical therapist will assess and may treat - concussions also affect all the aspects of functioning that sports neuropsychologists are trained to evaluate and manage - thinking (attention/memory), behaviors, emotions, and sleep. Thus, sports neuropsychologists have unique skills to provide individualized care to help individuals recover from concussion quickly and safely and return to optimal performance.
  • Don't these things just take time?
    Yes...and no! Everyone recovers at their own rate, but recovery should take days or weeks, not months. Recovery should continue to progress quickly and when it doesn't, Dr. Shapiro screens for barriers to recovery and known risk factors for prolonged recovery. A standard 20- or 40-minute medical exam is not going to allow enough time, or yield the information that is needed, to expedite recovery. Dr. Shapiro provides individualized recommendations for supports in home, classroom, and workplace to help manage symptoms in a way that allows clients to return to life while facilitating recovery. When needed, she refers to related providers in your area with the right training and specialized skills to help you, too.
  • My doctor said I need neuropsychological testing, but I've heard it can take up to a year to be seen!
    Many doctors recommend that, but just as a medical doctor decides what kinds of tests - blood tests or imaging - is needed to evaluate an injury or illness, Dr. Shapiro decides what kind of testing or evaluation is needed for her clients. She uses many sources of information to evaluate functioning, but she does not always need hours and hours of the traditional neuropsychological testing that your doctor may be thinking of, either. It all starts with intake questionnaires and an initial 1-2 hour initial evaluation - usually via telehealth. From there Dr. Shapiro will work with clients to determine the best next steps.
  • How long should recovery take?
    Everyone recovers at their own rate because of all the factors that can affect symptoms and recovery. Most healthy individuals recover fully in a few weeks. If recovery seems slow, is taking longer, or you have a history of anxiety, depression, learning or attention problems, poor sleep, prior concussions, dizziness, migraine or other chronic pain, you want a sports neuropsychologist involved to help manage those risk factors associated with longer recoveries. Sooner vs. later never hurts, as we can usually help speed recovery at any age or stage, but work with sports neuropsychology is not always needed.
  • But I have to pass my concussion test to return to play! What about that?
    Neuropsychologists are often regarded as testing experts, and we have many tools to choose from. Common computerized concussion tests are just one tool for determining if you're 100% back to your pre-injury functioning, but those tests also have drawbacks and there's no such thing as a "passing score." When needed, Dr. Shapiro can administer some tests via telehealth or in-person, assist your local Athletic Trainer or physician with interpretation, or refer you to someone else. Working as a team is essential.
  • How many doctors do I need to see? And which kind?
    A concussion - a metabolic injury to the brain - affects our thinking, sleep, emotions, behaviors, and physical functioning. Since it affects functioning in so many different ways, there isn't any one doctor or specialist who has enough training to effectively treat all of those areas - it takes a team. Having a team member who has years of training in how the brain works - and how to manage brain injuries behaviorally - is key to recovery and especially when recovery is delayed or when individuals present with known risk factors associated with longer recoveries.
  • How long should someone stay out of school, or home from work?
    In most cases, no more than a couple of days, tops. Many doctors will recommend a slower return to school or work because going back to the regular schedule can make people feel worse. They do the best they can, but many just don't have the time, or the training of a Sports Neuropsychologist, to develop the individualized Accommodations Plans and Care Plans that can help people return to (modified) normal activities without making symptoms worse.
  • My doctor has already tested me. Are you going to give more tests?
    Sports neuropsychologists are experts in understanding brain-behavior relationships and how an injury to the brain - and its symptoms - affects functioning in all aspects of life. We don't need computerized tests to help us to understand, assess, and treat your injury because we have many other tools for that, and we also know that those tests are not always helpful, nor do they tell us all we need to know.
  • Do you administer baseline testing?
    International guidelines for management of sports-related concussions have not recommended widespread baseline testing for years, though many teams, schools, and parent groups think it's important, thanks to strong marketing efforts from for-profit test publishers, marketing strategists, and related healthcare providers who are sold on weekend workshops and given certificates of completion. That said, baseline testing is used routinely for NCAA and professional athletes. It can be useful for some people when it is administered correctly. Dr. Shapiro is happy to meet and discuss this with you, and to consult with your Athletic Trainer, Coach, Athletic Director, or team to help you decide if it may be helpful and, if so, what kind of testing would be useful. Here, too, you want to be sure that whatever tests are chosen are developed for this purpose, and with the target age range to whom it will be administered. There are also other kinds of tests that Athletic Trainers are well-trained to administer - other than computerized cognitive tests - that can also screen for pre-season risk factors like poor balance or oculomotor functioning that they can proactively address to minimize injury risk.
  • What can you really do besides telling me to rest and "no screens?"
    What does "rest" mean? And why would anyone tell you to stop using your cell phone or computer? Rather, we help clients understand what, exactly, a concussion is, and how to modify activities at home, work, and classroom, to minimize symptom triggers. We focus on what matters most to you and things you can DO instead of emphasizing what NOT to do, to help you get better faster. Rest doesn't mean doing nothing, and screen use doesn't have to derail recovery!
  • So how do you treat insomnia? Do you prescribe medication?
    The American Academy of Sleep Medicine (AASM) and other organizations strongly recommend CBTi (Cognitive Behavior Therapy for Insomnia) as the most effective treatment for insomnia. Medications like Ambien, Lunesta, and more - that Dr. Shapiro does not prescribe - are intended for short-term use and do not provide a cure. CBTi is usually 5-8 sessions that includes education and individualized recommendations to gradually change sleep habits and other related factors.
  • Isn't everyone a little sleep deprived anyway?
    The Sleep Foundation offers good information about how much sleep most people need at different ages and stages of life. There are a variety of other factors that can affect sleep need as well. The risks of insufficient sleep - and how insomnia can affect mental and physical health - are, nonetheless, much greater than most realize. Insufficient sleep has been been characterized as a public health crisis, and the incremental healthcare costs associated with sleep disorders are surprisingly quite high.
  • What exactly is insomnia?
    Insomnia is defined as difficulties falling asleep, staying asleep, and/or waking up too early, for 3 months or more and when given sufficient opportunity for sleep, and with significant functional challenges or symptoms associated with insufficient or disrupted sleep.
  • How do I get started or learn if this could really help me?
    Complete our New Client Intake Form and we can call you to schedule an appointment or a brief phone call with Dr. Shapiro if you are unsure and want to speak with her briefly before scheduling. If you would like to schedule an initial consultation, we will send intake forms to complete and return prior to an initial video conference. Some people benefit from just 1 or 2 consultations, with insomnia treatment typically 4-8 sessions. There's no one-size-fits-all.
  • What is behavioral sleep medicine?
    Behavioral Sleep Medicine focuses on the evaluation and treatment of sleep disorders by addressing behavioral, psychological, and physiological factors that interfere with sleep. This can include treatment of insomnia, childhood bedtime problems, determining optimal sleep schedules for shift-workers and individuals who frequently travel across time zones, acclimation to CPAP/BiPAP, and more.
  • How can you help if my sleep problems are caused by ________________?
    While some people have "never been good sleepers," others are ok until some event (such as stress, depression, pain, illness, etc.) triggers insomnia. Disrupted sleep, in turn, can make those things worse. Research strongly indicates that not only can treatment improve sleep anyway, the improvements to sleep can help reduce those other symptoms.
  • How do I know if behavioral sleep medicine can work for me?
    There's a very strong, well-established evidence base to show that cognitive and behavioral strategies - helping to educate, or change beliefs about sleep, and to change sleep-related behaviors - work well for just about everyone. Initial screening (intake) helps to define that more precisely and to be sure that Dr. Shapiro is a good fit for you and your particular sleep-related needs and challenges. If additional, or different referrals are needed, Dr. Shapiro is happy to assist with that.
  • What's the difference between Psychoeducational vs. Psychological vs. Neuropsychological testing?
    Psychoeducational testing focuses on learning-related questions and is usually not covered by health insurance. School psychologists licensed to work only in schools, or persons with educational degrees might examine just academic skill levels, whereas licensed psychologists can also include measures of ability and formally diagnose learning disabilities. Psychoeducational evaluations typically focus on how a student is functioning compared to age-peers, but not as consistently on the why. ​ Psychological testing is conducted by a licensed doctoral-level psychologist with years of training comparable in length and depth to that of a medical doctor. Psychological testing can diagnose and identify psychiatric and developmental disorders such as anxiety, depression, ADHD, and autism spectrum disorders. Recommendations typically address multiple domains of functioning. Not all clinical psychologists have explicit training in working with educational settings and learning, however. ​ Neuropsychological testing is typically more broad, comprehensive, holistic, and integrated, appropriate for medical or neurological diagnoses. Neuropsychologists have 2 full years of post-doctoral fellowship training in brain-behavior relationships. Knowledge of neuroanatomy and brain functions guides evaluation and diagnostic determinations. By examining underlying neurocognitive processes in greater detail, it can also provide deeper insight into why individuals may be having certain difficulties.
  • Do I really need to send you all those records for testing?
    In a nutshell, YES! Formal in-person testing captures performance at one point at time. Many referral questions and diagnoses focus on patterns of behavior over time, however. ADHD, for example, is a developmental disorder related to attention control. Although testing can occur at any age, it is important to look for symptoms dating back to childhood to confirm or rule out a developmental disorder like ADHD. We ask for those records to examine patterns of performance over time, and not just the presence of "big problems." So yes, every bit of historical information is important for me to consider, and regardless of whether or not you may think there is or is not something relevant in those records. Even the absence of significant difficulties - and the reasons for it - are important considerations.
  • What happens after testing?
    A final 1-hour wrap up feedback session is scheduled within 1-2 weeks after testing is completed. At that time we discuss the highlights of the evaluation reports and primary recommendations. After that, Dr. Shapiro spends a few more hours preparing a final written report of findings and recommendations. 
  • What about those computerized concussion testing-you can even take those at home!
    Yes you can - but it doesn't mean that you should! Without appropriate conditions, those test results may not be very reliable or valid. And, you want to be sure the person interpreting the testing has appropriate training. Just as you wouldn't ask a podiatrist to read a mammogram, you wouldn't want someone without the appropriate degree and training giving and interpreting tests measuring brain functioning. A weekend workshop isn't a substitute for 6-8 years of training, and there are no good shortcuts.
  • But what about sports neuropsychology testing? Is that different?
    Sports neuropsychologists are clinical neuropsychologists with additional training related to sports, athletes, and concussions. Although all neuropsychologists receive basic training in the evaluation and management of structural brain injuries (such as a bruise, bleed, stroke, tumor, etc.), not all have the additional specialty training for management of concussions.
  • What records exactly do you need?
    Please contact our office to receive a comprehensive, updated list. In general, however, we ask for just about every scrap of relevant information! This includes, for example, all educational records - report cards, all K-12 standardized testing, conference reports, any other standardized testing like PSAT/SAT, AP, IB, ACT tests (and records of accommodations, if provided), and any post high school transcripts. If school-based supports were provided, we would need copies of all of that, such as 504 Plans and meeting notes, IEP's, Special Education Evaluation data, college accommodations documentation, etc. If the person to be tested ever received speech/language therapy, or participated in psychotherapy (even for unrelated reasons) we would want a treatment summary that includes approximate dates of service, number of sessions, treatment goals, and progress towards those goals. If there was any formal testing, like from a speech/language pathologist (SLP) or occupational therapist (OT) we would also want formal evaluation data in addition to the treatment summary. Again, please ask for a copy of our updated Evaluation Checklist - we have one for K-12 students and one for adults (ages 18 and older) who are beyond the high school years.
  • What tests do you use? Do you give [name a test]?
    We use whatever tests seem appropriate for the individual to be tested in order to best address the referral concerns. In general, though, evaluations typically include tests tapping verbal & nonverbal reasoning skills (ability), problem-solving, processing speed, memory, language, attention, fine-motor skills/motor planning, and executive functioning. Questionnaires examining personality, interests, and social-emotional/behavioral functioning are usually included as well. The evaluation also includes more than just in-person testing, too. The evaluation itself also includes a review of historical data such as medical and educational records, in addition to clinical interviews to better understand the concerns for which someone is seeking testing.
  • How do I get started?
    Complete our New Client Contact Form. We will follow-up with you to get a little more information and schedule an initial telehealth intake interview. We'll also send you our intake questionnaires and standardized rating scales to complete before we meet. That initial interview is sometimes scheduled even before formal testing is scheduled, or a week or 2 beforehand. Sometimes in that initial interview Dr. Shapiro identifies interventions that would be more helpful than proceeding with testing at that time. In those cases, she often recommends interventions first, before or instead of testing.
  • How much does testing cost?
    If you are in-network with Wellmark/Blue Cross Blue Shield I will submit your claims on your behalf and charge you only your copay, deductible, or whatever amount your plan says you owe. Even if your deductible is not met, I am not allowed to charge you a higher fee per hour than they allow. If I am out of network for you (that is, you use different insurance), or if the referral reason is just for an academic problem related to reading or math, or if comprehensive academic testing is needed or requested, insurance may not cover all or part of my fees. If insurance covers all but the academic testing, you would be billed my full fee for probably no more than 1-2 hours of service. If you are responsible for paying for the entire evaluation out of pocket, I can provide a more accurate estimate of the number of hours anticipated after our initial 1-hour intake. In general, though, a comprehensive evaluation can involve 8-15 hours that are billed at my standard hourly rate (as described above in the General Policies FAQ). This would include, for example, an initial 1-hour intake interview with parents or the adult client, in-person testing of usually 4-6 hours (with up to an additional hour to finish scoring all tests), then another 3-7 hours to meet with clients formally to review my diagnostic impressions and primary recommendations and to complete the evaluation report. Generally speaking, the older the individual to be tested, and the more complex the medical, developmental, academic, and/or social-emotional and behavioral history, the longer the process. I can also provide brief evaluation summaries on request in lieu of more traditional longer reports, and that can save clients a few hours' worth of fees. Overall it is a highly individualized process. If clients are paying out of pocket and not submitting to insurance, they will receive a written Good Faith Estimate of expected fees before we get started. I am happy to provide estimates for other clients, too; just ask.
  • How long does testing take?
    Formal in-person testing is scheduled for up to 4-5 hours or so, including breaks to rest, recharge, and have a snack.. Since many tests are untimed, it is often not possible to predict exactly how long testing will take. Additional time is spent after testing to score and interpret testing.
  • What exactly is involved? Hours of testing sounds hideous.
    These aren't like tests you take in school. Most clients - even teens - are surprised that it wasn't as painful as they may have expected. For many, it's a nice change of pace to sit with someone who listens and to receive positive reinforcement just for trying. Test-takers aren't given a grade, or typically told if their answers are right or wrong. Tests are intended to capture strengths and weaknesses and to help us understand how people approach different kinds of tasks, and to assess relative proficiency in skills related to learning, work performance, and social-emotional and behavioral functioning.
  • So is concussion testing different from regular neuropsychological testing?
    Neuropsychological testing for concussions is not nearly as extensive as “traditional” neuropsychological testing, since functioning is expected to change rapidly over time. Even in cases of chronic or persistent post-concussion symptoms, more than 1-2 hours of formal testing is rarely needed, with evaluations typically including extensive clinical interviewing and symptom assessment, with some oculomotor and/or vestibular screening.
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