- Dr. D. G. Amen Clinic
- Niacin / Mental Illness
- Niacin / Vitamin B3
- Niacin Deficency
- Schizophrenia
- Real Story of Niacin
- -----------------------------
- Lithium Orotate
- -----------------------------
- Anxiety
- Anxiety / 2
- Can Autism Be Cured
- Gut and Mental Illness
- Heal Depression
- Help for Mental Illness
- -----------------------------
- Dr. Abram Hoffer
- Dr. Hoffer's Vitamins
- Dr. Andrew Saul Videos
- Shocking Effects
- -----------------------------
- Mental Health / Gluten
- Mental Health & Wheat
- Medication Withdrawal
- List of SSRI Medication
LOCATIONS
AMEN CLINICS ORANGE COUNTY
ADDRESS3150 Bristol St., Suite 400
Costa Mesa, CA 92626
CONTACTTelephone: (888) 564-2700
Fax: (949) 266-3750
AMEN CLINICS SAN FRANCISCO
ADDRESS1000 Marina Blvd. Suite 100
Brisbane, CA 94005
CONTACTTelephone: (650) 416-7830
Fax: (650) 871-8874
AMEN CLINICS D.C.ADDRESS10701 Parkridge Blvd. Suite 110
Reston, VA 20191
CONTACTTelephone: (703) 880-4000
Fax: (703) 860-5760
AMEN CLINICS NORTHWESTADDRESS616 120th Ave NE, Suite C100
Bellevue, WA 98005
CONTACTTelephone: (425) 455-7500
Fax: (425) 454-7845
AMEN CLINICS ATLANTAADDRESS5901-C Peachtree Dunwoody Rd N.E. Suite 65
Atlanta, GA 30328
CONTACTTelephone: (678) 367-2810
Fax: (678) 805-8125
AMEN CLINICS NEW YORK
ADDRESS16 East 40th St 9th Floor
New York, NY 10016
CONTACTTelephone: (646) 736-3110
Fax: (646) 255-1095
AMEN CLINICS ORANGE COUNTY
ADDRESS3150 Bristol St., Suite 400
Costa Mesa, CA 92626
CONTACTTelephone: (888) 564-2700
Fax: (949) 266-3750
AMEN CLINICS SAN FRANCISCO
ADDRESS1000 Marina Blvd. Suite 100
Brisbane, CA 94005
CONTACTTelephone: (650) 416-7830
Fax: (650) 871-8874
AMEN CLINICS D.C.ADDRESS10701 Parkridge Blvd. Suite 110
Reston, VA 20191
CONTACTTelephone: (703) 880-4000
Fax: (703) 860-5760
AMEN CLINICS NORTHWESTADDRESS616 120th Ave NE, Suite C100
Bellevue, WA 98005
CONTACTTelephone: (425) 455-7500
Fax: (425) 454-7845
AMEN CLINICS ATLANTAADDRESS5901-C Peachtree Dunwoody Rd N.E. Suite 65
Atlanta, GA 30328
CONTACTTelephone: (678) 367-2810
Fax: (678) 805-8125
AMEN CLINICS NEW YORK
ADDRESS16 East 40th St 9th Floor
New York, NY 10016
CONTACTTelephone: (646) 736-3110
Fax: (646) 255-1095
| 18 Ways Spect Can Help You |
| Amen Clinics Info Packet |
| Location in Orange County |
| Amen Clinic |
18 Ways SPECT Can Help You
How do you know unless you look? Psychiatrists are the only medical specialists who rarely look at the organ they treat. Psychiatrists continue to make diagnoses the same way they did 100 years ago, based on clinical exams and symptom clusters. There is a better way. SPECT imaging is a clinically useful way to look at brain function.
Real answers. SPECT helps provide answers to mental health problems and helps clinicians ask better and more targeted questions, such as about ADHD, head injuries, toxic exposure and past emotional traumas.
Tailor treatment to your brain. Imaging plus detailed histories help us better understand your brain, so treatment can be individually tailored, rather than just diagnosing and treating vague diagnostic categories such as depression or ADHD.
Check the health of your brain. Even if you are not having trouble, SPECT scans can help check the health of your individual brain. Scans can be used as a screening tool to know your vulnerabilities. They can also serve as a baseline if you develop problems in the future.
Most experience. ACI has the world’s largest database of brain scans related to behavior (nearly 50,000) and the most experience. We have been ordering and performing brain SPECT scans for over 16 years. ACI has seen patients from all 50 states and 71 countries.
How do you know unless you look? Psychiatrists are the only medical specialists who rarely look at the organ they treat. Psychiatrists continue to make diagnoses the same way they did 100 years ago, based on clinical exams and symptom clusters. There is a better way. SPECT imaging is a clinically useful way to look at brain function.
Real answers. SPECT helps provide answers to mental health problems and helps clinicians ask better and more targeted questions, such as about ADHD, head injuries, toxic exposure and past emotional traumas.
Tailor treatment to your brain. Imaging plus detailed histories help us better understand your brain, so treatment can be individually tailored, rather than just diagnosing and treating vague diagnostic categories such as depression or ADHD.
- Help prevent mistakes. More information prevents clinicians from prescribing the wrong treatments, such as unnecessarily stimulating an already overactive brain or calming one that is underactive.
- Early detection to prevent Alzheimer’s. SPECT scans can tell up to 9 years before you have symptoms whether or not you are vulnerable. Treatment and prevention strategies work early, not late.
- Whole person approach. ACI takes a whole person approach and uses scans to help guide not only medication interventions, but also natural supplements and other innovative treatments.
- See if your treatment is working. Follow up scans can help see which treatments are effective and which are not. It is critical to know if your treatment is helping or hurting your brain.
- Help understand and treat addictions. A SPECT scan can help understand the reasons that underlie addictions and help guide treatment.
- Identify brain trauma. A SPECT scan can identify specific areas of the brain hurt by trauma to better target treatment and help deal with insurance, legal and rehabilitation issues.
- Know your type. ADD, anxiety and depression are not single or simple disorders. One treatment does not fit everyone. Dr. Amen has described 6 types of ADD, 7 types of anxiety and depression and 3 types of violence. Imaging helps you see the underlying brain problems so treatment can be more targeted.
- Help for families. A SPECT scan can help families understand the underlying medical reasons for a problem, which helps decrease shame, self blame and conflict.
Check the health of your brain. Even if you are not having trouble, SPECT scans can help check the health of your individual brain. Scans can be used as a screening tool to know your vulnerabilities. They can also serve as a baseline if you develop problems in the future.
Most experience. ACI has the world’s largest database of brain scans related to behavior (nearly 50,000) and the most experience. We have been ordering and performing brain SPECT scans for over 16 years. ACI has seen patients from all 50 states and 71 countries.
- Pioneer. Through research and education ACI has helped to pioneer brain SPECT imaging in clinical psychiatric practice.
- Improve compliance. Pictures are powerful and can help influence a patient’s willingness to accept and adhere to a treatment program.
- Decrease shame and stigma. SPECT scans help patients better understand their problems, decreasing shame, guilt, stigma and self-loathing.
- Legal issues. Scans may be helpful in a number of legal situations, such as helping judges and juries understand difficult behavior and directing treatment.
- The future now. SPECT scans can help you obtain individualized care for your brain. Thomas Insel, MD, PhD, Director of the National Institute of Mental Health, said “Brain imaging in clinical practice is the next major advance in psychiatry.”
| Amen Clinics Info Packet |
Welcome to Amen Clinics, Inc.
The enclosed packet contains information regarding your upcoming visit to the Amen Clinics.
Please review this information prior to your first appointment.
“Change Your Brain, Change Your Life”
Amen Clinics, Inc. Information Packet
Quantitative electroencephalography (qEEG) - only performed in the Orange County,
Reston and New York clinics.
The Full Evaluation
The full evaluation is comprehensive, thorough processes that will give us the best information in helping our medical professionals develop a treatment plan that is specific to your individual needs.
The full evaluation will span over several days, and require the work of several highly trained professionals.
There are seven appointments that make up the full evaluation: 1. Clinical history
2. Concentration SPECT scan
3. Resting SPECT scan
4. Comprehensive assessments
5. Final evaluation with one of our physicians
6. Aftercare appointment one week after the evaluation 7. Follow up appointment with your ACI physician
For those who decide to add on a Quantitative electroencephalography (qEEG) which are performed only in the Orange County, Reston and New York clinics, this will be done with a follow up appointment to go over the results.
The final evaluation is the last appointment to be scheduled. The clinical history, two brain scans and qEEG (if applicable) can occur in any order. The information gathered in these appointments is given to your ACI physician, who will then review it and meet with you in the final evaluation and subsequent follow-up appointments.
The following is a summary of what you can expect at each of these appointments, as well as important information you should know and be prepared for to ensure a smooth visit at our clinics. Remember, if you ever have any questions or concerns; please do not hesitate in contacting one of our patient care coordinators at (888)564-2700.
Clinical History
One of the first appointments you will have at our clinics is the clinical history. This is an important appointment, as it gives your ACI physician a detailed and thorough history of your symptoms, medical conditions, behavioral and emotional patterns, head injuries, family history, drug and alcohol use, past medications, and anything else relevant to your current struggles.
It is important that you are well prepared for your history. You will be completing a detailed questionnaire which will take a couple of hours to complete. In order to avoid rescheduling your history, please have the questionnaire completed before your first appointment.
For approximately the first thirty minutes, you will remain in the waiting area while the historian goes through your intake paperwork. For the remaining hour or so, the historian will meet with you and go into greater detail about your medical/psychiatric history, as well as ask specific questions in relation to the symptoms you are experiencing at this time. During the clinical history, your historian will be typing the information into your report as he/she is speaking with you. Everything that is written on your intake and/or discussed during this appointment may be included on your final report, unless otherwise specified by you.
The clinical history involves questions and discussions about symptoms, traumatic events, and struggles that can be difficult to discuss in detail. Your honesty and willingness to be open about your struggles and past history are key to an accurate and complete history that will allow the doctor to prescribe the best treatment plan possible. Remember, imaging the brain itself cannot provide a cure or treatment plan for your life. It does add another dimension of information that, when used properly with your clinical history, can make a significant difference in the effectiveness of care.
Online Questionnaire, Assessments and Inventories
Online Intake Questionnaire
No fasting is required for the brain scans, unless you are pre-scheduled for a conscious sedation.
You should not eat any food or chew gum within thirty minutes of your appointment. Use of illicit drugs should be avoided within 24-hours of a scan appointment. In addition, please avoid ingesting caffeine (e.g. cola drinks, chocolate, coffee, tea, etc.), aspirin, or cold medications on the day of your scans. In order to decrease the radiation exposure, you should also drink water before and after each brain scan. The recommended amount of water for most adults, teens, and larger children is 32ounces in the hour before and after each scan. Smaller children will require less (usually about 16-20 ounces).
For a full evaluation, two brain scans are ordered, and done at least 24 hours apart (longer is perfectly fine). One of these scans is a “baseline” scan, and the other is a “concentration” scan. The reason for using two brain scans is that it allows our physicians to evaluate the changes in brain blood flow patterns from a resting state to a concentration state. This information then allows our medical professionals to provide a more complete diagnosis.
Due to the highly complex nature of our brain scan procedure, situations sometimes occur that may result in the delay of your actual scan from its original scheduled appointment time. Our scan technicians are highly trained and efficient, and will only approve scans with the highest quality and resolution. Because of this, patients may need to be re-scanned due to movement or other unforeseen circumstances.
This may ultimately result in a delay for your appointment. Though these delays are rare, we appreciate your patience in this matter should it occur; and we apologize in advance for any inconvenience it may cause you.
When your scan begins, you will be placed in a quiet room and a small IV line will be inserted into your arm. For those who have sensitive skin or are afraid of needles, we offer Emla (Lidocaine) cream to numb the area of the arm where the injection is administered. If you would like to use this option, the patient must arrive at least ONE (1) HOUR prior to the scan. During the “concentration” scan, you will take a 15-20 minute computerized test that measures your attention and focus. For the “baseline” scan, you will be instructed to sit quietly and relax. During this period of time (whether you are taking the computer test or relaxing), the imaging solution is then injected through the IV, which travels to your brain.
Once the imaging solution has been given time to be absorbed, you will be taken to the scan machine.
The machine itself (Picker Prism 3000, shown above) has three cameras that will rotate around your head. The process is typically 20-25 minutes and requires you to be completely still. Because the temperature is typically cool in the scan room, it would be advisable to bring a sweater/light jacket to keep you warm.
During these appointments, the scan technician will guide you through the process and will be available to answer any questions you may have. Once the scan’s data has been collected and approved, the technician will then walk you back to the front office.
SPECT Scans and Medication
We know some patients worry they may not get accurate scans on medication, but many of our patients are scanned on their medications and the scans are still very valuable.
Never discontinue any medication or nutritional supplement necessary to your physical health. These include, but are not limited to, blood pressure medications, blood thinners, diabetes medicines, thyroid medications, and medications that treat heart or lung problems.
If you decide to be scanned off all medications and supplements, ALWAYS check with your healthcare provider. In general we recommend patients:
The results of the qEEG provides additional information the clinician can use to help in guiding treatment, such as with medication, supplements or neurofeedback.
As with the SPECT Scan, use of illicit drugs should be avoided within 24-hours of a qEEG appointment. In addition, please avoid ingesting caffeine (e.g. cola drinks, chocolate, coffee, tea, etc.), cold medications on the day of your qEEG. We would like to inform you that gel is used during the qEEG. The gel will get in your hair. It is odorless and colorless, not damaging and can be washed out with water. We attempt to get as much out as possible; however, some may remain.
The technician will review your results with you and forward them to your evaluating clinician. You will receive your brain maps in your final notebook with the SPECT results.
Final Evaluation
After completing your scans, qEEG (if applicable) and history appointments, you will meet with your assigned physician for your final evaluation. Though you will not meet with Dr. Amen personally, you can be confident in knowing that each of our physicians has been individually trained by Dr. Amen. In addition, Dr. Amen often consults with our medical professionals in complex cases.
For the first thirty minutes of your appointment, you can expect to wait in the patient waiting area while your physician is reviewing your clinical history and scans. For the next hour or so, you will meet with your physician. During this time, additional information and questions may be necessary to help correlate your clinical history with your individual SPECT findings. The medical professional will then review your SPECT images with you and develop an individualized and comprehensive treatment plan that is catered to your needs.
Although your treatment plan may include recommendations for prescription medications, we cannot guarantee that you will receive a written prescription from one of our medical professionals. During your final evaluation, your assigned medical professional will discuss whether or not it is possible to continue treatment with him/her in our clinic.
If you are coming to our clinic from out-of-state, we strongly recommend that you find a health practitioner in your area (prior to your visit with us) that is willing to work with us in collaboration with your care. In these cases, we can provide prescription treatment recommendations; however, they must be agreed upon and implemented by your local treating doctor. Unfortunately, we cannot write prescriptions for out-of-state patients, as that would constitute practicing medicine in another state without a license.
It should be noted that ACI is often utilized by people around the world as an ongoing consultation service. In addition, our recommendations often include treatments other than prescription medications (e.g. natural supplements, biofeedback, diet/nutrition plans, exercise, various forms of therapy, etc.).
Your ACI physician will then use the remaining thirty minutes of your final evaluation appointment to work on your written report.
Aftercare
The aftercare appointment is 45 minutes long and scheduled one week after the final evaluation with a clinic Aftercare Provider. The provider will help the patient process their feelings about their results and treatment plan, implement their treatment recommendations, trouble shoot potential barriers and collaborate with the patient to create an action plan and effective goals. All of which are intended to accelerate treatment implementation and increase treatment success.
You can schedule this appointment by phone or in person. This appointment is included in our evaluation package; however, there will be a $100 charge to reschedule a cancelled appointment without 24 hour notice.
Follow-Up Appointment
The follow-up appointment is typically scheduled 2-4 weeks after your final evaluation. Continuing patients of ACI can use this appointment as their first follow-up appointment, and may be required to be physically present in our office for this visit.
Patients who are not continuing patients of ACI (e.g. out-of-state patients) utilize this follow-up appointment in a variety of ways. You may coordinate this appointment with your local treating physician so that he/she can address any questions/concerns regarding our medical professional’s recommendations. Patients may also schedule this appointment as a phone appointment to discuss treatment progress, as well as address any remaining questions/concerns.
Policies
Initial Deposit
Due to the complex nature of our evaluation process, a non- refundable deposit is required to make and hold your appointments. This initial deposit must be paid at the time appointments are scheduled, and it is then applied to the complete payment of services.
Payment Information
We are a fee for service clinic and require that you pay before (or at the time of) a scheduled appointment. Personal checks, cashier’s checks, Visa, MasterCard, American Express, and Care Credit are accepted. We do not accept cash.
Rescheduling & Cancellations
Changes or cancellations of full evaluation appointments must be made a minimum of 2 business days before the first scheduled appointment time in order to apply the deposit for rescheduled
appointments. ACI is committed to providing quality and timely service to our patients. Therefore, due to the complicated nature of scheduling several appointments and holding appointments to accommodate the needs of our patient’s, cancellations made less than 2 business days before the first scheduled appointment, will be subject to forfeit the deposit to the clinic. If a cancellation is made 5 or more business days before the first scheduled appointment, and you do not plan on rescheduling, you qualify for a refund of your initial deposit.
Changes or cancellations of consultations, medication checks and therapy appointments must be made a minimum of 24 business hours before their scheduled time. Please note that 24 business hours would
require that an appointment for 9:00am on Monday be cancelled no later than 9:00am the prior Friday to avoid being charged.
Missed Appointments
Patients who miss their appointments will be charged a “Missed Appointment Fee,” which equals the cost of the missed appointment.
Insurance / Medicare
Amen Clinics, Inc. does not bill insurance. Additionally, we are not Medicare, Medicaid, or Medi-Cal providers. At the end of the evaluation, patients are given a “walk-out statement” containing applicable diagnosis and billing codes, which can then be submitted to insurance companies for possible reimbursement. Our doctors and therapists are not affiliated with any insurance plans or networks. As a result, insurance carriers will regard fees and treatment incurred at the Amen Clinics, Inc. as an out-of- network procedure. Please check with your insurance provider for any mental health benefits. **Please note that you cannot submit your superbill to Medicare, Medicaid or Medi-Cal.**
Discounts
Amen Clinic, Inc. provides patients with a 10% Friends and Family discount for the full evaluation when bringing in another patient. The first full evaluation will be full price and the 10% discount will apply to each additional family member or friend. If more than one patient is scheduled for an evaluation at the same time, we will honor the 10% discount for both.
Fees and Other Evaluation Options
Below is a list of the different types of evaluation options and the fees associated:
Full Evaluation: clinical history, two brain SPECT scans, WebNeuro, SCID assessment, evaluation with an ACI physician, aftercare appointment with an ACI staff, as well as a 45- 50 minute follow-up appointment with your ACI physician is $3,750
Partial Evaluation (same as full but only concentration scan performed): $2650
Clinical Evaluation (no scans performed): $1275 Add On to any evaluation:
o qEEG available in Orange County, Reston and New York. Priced by local market
o Comprehensive Labs and Review with Director of Integrative Medicine: $600 Half sessions appointments (20-25 minutes) are $175.
Full session appointments (45-50 minutes) are $350.
Medical records copy fee is $30.
CPT-4 Procedure Codes
Tax ID: 91-2055998
The following CPT procedure codes are primarily used and have been provided for your reference. Additionally, the fees associated with each procedure are also listed. Fees are subject to change without notice.
CPT Code Description Fee
(SPECT Scans)
78607 Tomographic (SPECT) x 2 Concentration and Resting 96103 Psych. Testing (computer assisted)
(Clinical History)
99205 Initial Comprehensive and Management Evaluation 90889 Preparation of Initial Report
(qEEG)
95812 qEEG 40-60 minutes 90887 Explanation of Results
(Doctor’s Evaluation)
90792 Psychiatric Diagnostic Evaluation
90885 Psychiatric Evaluation of Records, Reports, and Tests 90887 Interpretation or Explanation of
Results
90889 Preparation of Final Report
(Follow-Up)
99242 Office Consultation (45-50 minutes) 99214/90833 Med Management/Therapy (45-50 minutes)
*a $50 discount applies when qEEG and at least one SPECT scan are completed
Frequently Asked Questions
What is SPECT Imaging (Single Photon Emission Computer Tomography)?
$1,100 $100
$300 $100
varies by market*
$350 $100 $150 $100
$350 $350
Brain SPECT imaging is a nuclear medicine procedure that evaluates cerebral blood flow. It evaluates areas of the brain that work well, areas of the brain that work too hard, and areas of the brain that do not work hard enough. The information from the scans, along with a detailed clinical history, helps us understand the underlying brain patterns associated with our patients’ problems and help pinpoint the right treatment to balance brain function.
What is the injection and are there side effects?
Since a SPECT scan is a nuclear medicine procedure, it requires the injection of a very small amount of a radioisotope through a small needle into a vein in the arm. The medicine we inject is not an iodine based dye; therefore people typically do not have allergic responses to it.
How many days do I need to be at the clinic?
You should allow at least three days for the complete evaluation process.
What is the success rate?
We recently finished our analysis of a six month follow up study and 76% of our patients showed highly significant improvements. However, our success rate varies with each case. We see children from two years of age to elderly adults. Therefore, the question is variable and depends on many factors. Many people get better because we have more to offer than traditional psychiatrists who never look at the brain. In addition to clinical history, we look at the underlying physiology. Taken together (history and scans), we are much more thorough in diagnosis and more targeted in treatment plans. In a nutshell, Dr. Amen says he believes that patients get better faster because we have more information.
Will I be seeing Dr. Amen personally for the evaluation?
No. Due to his writing, research, and teaching duties, Dr. Amen has very limited clinical time.
Does insurance cover this? How can I find out?
Some insurance companies will reimburse for the procedures, however, some do not. In this packet we have included the procedure codes that apply to our services. Your insurance will determine if you will be reimbursed.
Do you offer any discounts, payment plans, or financial assistance?
We offer a 10% discount for friends and family members that schedule an appointment with our clinics as long as the original patient had a complete evaluation with SPECT scans. All payment plans are done through the third party, Care Credit. You apply with Care Credit by calling (866) 893-7864. Their website is www.CareCredit.com.
Do you offer phone consultations prior to scheduling an appointment?
Yes. If you would like to schedule a consultation with a physician, you can do so by calling any or our clinic locations. The charge for a half-session (not to exceed 30 minutes) is $175.00 and a full session (over 30 minutes and not to exceed one hour) is $350.
Can you give me the name of a doctor or therapist in my area for treatment?
We have a list of professionals throughout the country listed on our referral database on the “For Patients” section of our website at: www.amenclinics.com.
Can my Amen Clinic physician become my regular doctor?
If you live close by and would like us to provide ongoing treatment for you or your family member, we will consider it, if it is appropriate. However, if you are already working with another physician, we ask that you discuss this decision with your doctor.
Will I work with anyone other than my Amen Clinic physician?
As part of our treatment teams we have certified nurse practitioners and physician assistants who can also manage medications. If you would benefit from psychotherapy, we offer therapy with licensed professionals.
How often will I need to come into the office?
Doctor visits vary in frequency depending upon your needs. When medications are changed, your visits will be frequent. Even if you are stable, our doctors or other licensed clinicians must see you in person a minimum of once every 3 to 6 months. This is our clinics standard of practice for psychiatry and our policy.
Can I have my visits via telephone or by e-mail?
While we may schedule phone visits for minor adjustments and check-ups most decisions must be made during in-person visits. E-mails may be used to pass along routine information and questions to your doctors but this does not take place of a visit nor will any decision be made via e-mail correspondence.
What is the cost of follow up care?
The cost of your evaluation includes one full session (45-50 minute) follow up visit in person or via phone. Any subsequent follow up visits are billed at a rate of $175.00 per half session with the doctor or $125.00 per half session with our nurse practitioner or physician assistant. This includes in-person visits,
phone visits, writing of additional reports, letters, and in some instances e-mails. If you are late for your appointment or if you miss your appointment you will still be charged for the full session. If you arrive more than 10 minutes late, the office may have to reschedule your appointment and you may still be charged for the missed session.
What do I do if I have an emergency?
If you have a negative reaction to medication or a serious symptom, please call us. We have an after- hours paging system available for urgent matters. However, should you have a life threatening emergency, we ask that you call 911 or go to your local emergency room.
What if I need a refill of medication before my appointment?
Because our doctors’ schedules vary we request that all medication refills be ordered through your pharmacy. Call your pharmacy and ask them to fax a refill request to the clinic or send it through our e- prescribing system. Please plan ahead and allow 3-5 working days for refills. Be aware that many states do not accept phone refills for controlled substances. Stimulant drugs such as Adderall and Ritalin cannot be called in at all. We do not send prescriptions for controlled substances through the mail.
What if I have questions after my evaluation?
In your initial evaluation we make every effort to provide step by step treatment recommendations.
We are always happy to provide a consultation to you or your doctor in the future should additional questions arise. We act as ongoing consultants for many of our patients.
If you have any further questions, please call us toll free at 1 (888) 564-2700.
The enclosed packet contains information regarding your upcoming visit to the Amen Clinics.
Please review this information prior to your first appointment.
“Change Your Brain, Change Your Life”
Amen Clinics, Inc. Information Packet
Quantitative electroencephalography (qEEG) - only performed in the Orange County,
Reston and New York clinics.
The Full Evaluation
The full evaluation is comprehensive, thorough processes that will give us the best information in helping our medical professionals develop a treatment plan that is specific to your individual needs.
The full evaluation will span over several days, and require the work of several highly trained professionals.
There are seven appointments that make up the full evaluation: 1. Clinical history
2. Concentration SPECT scan
3. Resting SPECT scan
4. Comprehensive assessments
5. Final evaluation with one of our physicians
6. Aftercare appointment one week after the evaluation 7. Follow up appointment with your ACI physician
For those who decide to add on a Quantitative electroencephalography (qEEG) which are performed only in the Orange County, Reston and New York clinics, this will be done with a follow up appointment to go over the results.
The final evaluation is the last appointment to be scheduled. The clinical history, two brain scans and qEEG (if applicable) can occur in any order. The information gathered in these appointments is given to your ACI physician, who will then review it and meet with you in the final evaluation and subsequent follow-up appointments.
The following is a summary of what you can expect at each of these appointments, as well as important information you should know and be prepared for to ensure a smooth visit at our clinics. Remember, if you ever have any questions or concerns; please do not hesitate in contacting one of our patient care coordinators at (888)564-2700.
Clinical History
One of the first appointments you will have at our clinics is the clinical history. This is an important appointment, as it gives your ACI physician a detailed and thorough history of your symptoms, medical conditions, behavioral and emotional patterns, head injuries, family history, drug and alcohol use, past medications, and anything else relevant to your current struggles.
It is important that you are well prepared for your history. You will be completing a detailed questionnaire which will take a couple of hours to complete. In order to avoid rescheduling your history, please have the questionnaire completed before your first appointment.
For approximately the first thirty minutes, you will remain in the waiting area while the historian goes through your intake paperwork. For the remaining hour or so, the historian will meet with you and go into greater detail about your medical/psychiatric history, as well as ask specific questions in relation to the symptoms you are experiencing at this time. During the clinical history, your historian will be typing the information into your report as he/she is speaking with you. Everything that is written on your intake and/or discussed during this appointment may be included on your final report, unless otherwise specified by you.
The clinical history involves questions and discussions about symptoms, traumatic events, and struggles that can be difficult to discuss in detail. Your honesty and willingness to be open about your struggles and past history are key to an accurate and complete history that will allow the doctor to prescribe the best treatment plan possible. Remember, imaging the brain itself cannot provide a cure or treatment plan for your life. It does add another dimension of information that, when used properly with your clinical history, can make a significant difference in the effectiveness of care.
Online Questionnaire, Assessments and Inventories
Online Intake Questionnaire
- This questionnaire is essential to ensure the quality of your evaluation and serves as the basis for
your meeting with your historian - It covers your past psychiatric, medical and family history
- It can take a couple hours to complete so please make sure you give yourself ample time to
complete it; it does not have to be completed in one sitting - It must be completed prior to arrival at the clinic
Web Neuro Online Testing
- An objective, web-based test to give us more information on how your brain functions. It will ask you about how you have been feeling and functioning over the past week or so. There is no pass or fail.
- This test can be completed from home or while at the clinic
Structured Clinical Interview for DSM-IV (SCID)
The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) is a semi-structured interview for making the major DSM-IV Axis I diagnoses. The SCID-II is a semi-structured interview for making DSM-IV Axis II: Personality Disorder diagnoses. All patients 18 and over will take this questionnaire in the clinic and will take approximately 30 minutes to complete.
Inventories
After your history appointment or SCID you will be asked to fill out the following inventories. Depending on the age of the patient, these inventories may include: Quality of Life Inventory (QOLI), Brief Symptom Inventory (BSI), Beck Depression Inventory (BDI-II) and/or Childhood Depression Inventory (CDI).
SPECT Scans
SPECT, single photon emission computed tomography, is a nuclear medicine procedure that is widely used to study heart, liver, thyroid, bone, and brain problems. Here at ACI, we use SPECT imaging as a tool in the diagnostic and treatment process. Brain imaging with SPECT is a proven, reliable measure of cerebral blood flow. Because brain activity is directly related to blood flow, SPECT effectively shows us the patterns of brain activity. It allows physicians to look inside the brain to observe three things: areas of the brain that work well, areas that work too hard, and areas that do not work hard enough. This information is analyzed, and the results then given to the medical professional you will be meeting with during your final and follow-up appointments. The information from these scans, along with a detailed clinical history, helps us understand the underlying brain patterns associated with our patients’ problems and help pinpoint the right treatment to balance brain function. For detailed information on SPECT imaging and its benefits for physicians, clinicians, patients, and families, please visit our website at www.amenclinics.com.
No fasting is required for the brain scans, unless you are pre-scheduled for a conscious sedation.
You should not eat any food or chew gum within thirty minutes of your appointment. Use of illicit drugs should be avoided within 24-hours of a scan appointment. In addition, please avoid ingesting caffeine (e.g. cola drinks, chocolate, coffee, tea, etc.), aspirin, or cold medications on the day of your scans. In order to decrease the radiation exposure, you should also drink water before and after each brain scan. The recommended amount of water for most adults, teens, and larger children is 32ounces in the hour before and after each scan. Smaller children will require less (usually about 16-20 ounces).
For a full evaluation, two brain scans are ordered, and done at least 24 hours apart (longer is perfectly fine). One of these scans is a “baseline” scan, and the other is a “concentration” scan. The reason for using two brain scans is that it allows our physicians to evaluate the changes in brain blood flow patterns from a resting state to a concentration state. This information then allows our medical professionals to provide a more complete diagnosis.
Due to the highly complex nature of our brain scan procedure, situations sometimes occur that may result in the delay of your actual scan from its original scheduled appointment time. Our scan technicians are highly trained and efficient, and will only approve scans with the highest quality and resolution. Because of this, patients may need to be re-scanned due to movement or other unforeseen circumstances.
This may ultimately result in a delay for your appointment. Though these delays are rare, we appreciate your patience in this matter should it occur; and we apologize in advance for any inconvenience it may cause you.
When your scan begins, you will be placed in a quiet room and a small IV line will be inserted into your arm. For those who have sensitive skin or are afraid of needles, we offer Emla (Lidocaine) cream to numb the area of the arm where the injection is administered. If you would like to use this option, the patient must arrive at least ONE (1) HOUR prior to the scan. During the “concentration” scan, you will take a 15-20 minute computerized test that measures your attention and focus. For the “baseline” scan, you will be instructed to sit quietly and relax. During this period of time (whether you are taking the computer test or relaxing), the imaging solution is then injected through the IV, which travels to your brain.
Once the imaging solution has been given time to be absorbed, you will be taken to the scan machine.
The machine itself (Picker Prism 3000, shown above) has three cameras that will rotate around your head. The process is typically 20-25 minutes and requires you to be completely still. Because the temperature is typically cool in the scan room, it would be advisable to bring a sweater/light jacket to keep you warm.
During these appointments, the scan technician will guide you through the process and will be available to answer any questions you may have. Once the scan’s data has been collected and approved, the technician will then walk you back to the front office.
SPECT Scans and Medication
We know some patients worry they may not get accurate scans on medication, but many of our patients are scanned on their medications and the scans are still very valuable.
Never discontinue any medication or nutritional supplement necessary to your physical health. These include, but are not limited to, blood pressure medications, blood thinners, diabetes medicines, thyroid medications, and medications that treat heart or lung problems.
If you decide to be scanned off all medications and supplements, ALWAYS check with your healthcare provider. In general we recommend patients:
- Discontinue stimulants four days prior to your first scan appointment.
- For other psychiatric medications it depends on the particular half-life of each medication. Always check with your doctor before reducing or discontinuing your medication. Only reduce or stop your medication under your doctor’s supervision.
If helpful, you can arrange a phone consultation with one of our doctors to help you and your personal physician with questions about discontinuing medication and supplements prior to your scans.
Most importantly, STAY on your medications and supplements as usual if you are not able to discontinue them within these guidelines. DO NOT reduce the dose a few days prior to your scans, which could confound your scan results.
Quantitative electroencephalography (qEEG) is the measurement of electrical patterns at the surface of the scalp which primarily reflect brain activity or “brainwaves.” Color maps are used to represent the Quantitative electroencephalography (qEEG) - only performed in the Orange County, Reston and New York clinics activity.
- You can then see which areas of the brain are under active or overactive and how the neurons in the brain are communicating with each other.
The results of the qEEG provides additional information the clinician can use to help in guiding treatment, such as with medication, supplements or neurofeedback.
As with the SPECT Scan, use of illicit drugs should be avoided within 24-hours of a qEEG appointment. In addition, please avoid ingesting caffeine (e.g. cola drinks, chocolate, coffee, tea, etc.), cold medications on the day of your qEEG. We would like to inform you that gel is used during the qEEG. The gel will get in your hair. It is odorless and colorless, not damaging and can be washed out with water. We attempt to get as much out as possible; however, some may remain.
The technician will review your results with you and forward them to your evaluating clinician. You will receive your brain maps in your final notebook with the SPECT results.
Final Evaluation
After completing your scans, qEEG (if applicable) and history appointments, you will meet with your assigned physician for your final evaluation. Though you will not meet with Dr. Amen personally, you can be confident in knowing that each of our physicians has been individually trained by Dr. Amen. In addition, Dr. Amen often consults with our medical professionals in complex cases.
For the first thirty minutes of your appointment, you can expect to wait in the patient waiting area while your physician is reviewing your clinical history and scans. For the next hour or so, you will meet with your physician. During this time, additional information and questions may be necessary to help correlate your clinical history with your individual SPECT findings. The medical professional will then review your SPECT images with you and develop an individualized and comprehensive treatment plan that is catered to your needs.
Although your treatment plan may include recommendations for prescription medications, we cannot guarantee that you will receive a written prescription from one of our medical professionals. During your final evaluation, your assigned medical professional will discuss whether or not it is possible to continue treatment with him/her in our clinic.
If you are coming to our clinic from out-of-state, we strongly recommend that you find a health practitioner in your area (prior to your visit with us) that is willing to work with us in collaboration with your care. In these cases, we can provide prescription treatment recommendations; however, they must be agreed upon and implemented by your local treating doctor. Unfortunately, we cannot write prescriptions for out-of-state patients, as that would constitute practicing medicine in another state without a license.
It should be noted that ACI is often utilized by people around the world as an ongoing consultation service. In addition, our recommendations often include treatments other than prescription medications (e.g. natural supplements, biofeedback, diet/nutrition plans, exercise, various forms of therapy, etc.).
Your ACI physician will then use the remaining thirty minutes of your final evaluation appointment to work on your written report.
Aftercare
The aftercare appointment is 45 minutes long and scheduled one week after the final evaluation with a clinic Aftercare Provider. The provider will help the patient process their feelings about their results and treatment plan, implement their treatment recommendations, trouble shoot potential barriers and collaborate with the patient to create an action plan and effective goals. All of which are intended to accelerate treatment implementation and increase treatment success.
You can schedule this appointment by phone or in person. This appointment is included in our evaluation package; however, there will be a $100 charge to reschedule a cancelled appointment without 24 hour notice.
Follow-Up Appointment
The follow-up appointment is typically scheduled 2-4 weeks after your final evaluation. Continuing patients of ACI can use this appointment as their first follow-up appointment, and may be required to be physically present in our office for this visit.
Patients who are not continuing patients of ACI (e.g. out-of-state patients) utilize this follow-up appointment in a variety of ways. You may coordinate this appointment with your local treating physician so that he/she can address any questions/concerns regarding our medical professional’s recommendations. Patients may also schedule this appointment as a phone appointment to discuss treatment progress, as well as address any remaining questions/concerns.
Policies
Initial Deposit
Due to the complex nature of our evaluation process, a non- refundable deposit is required to make and hold your appointments. This initial deposit must be paid at the time appointments are scheduled, and it is then applied to the complete payment of services.
Payment Information
We are a fee for service clinic and require that you pay before (or at the time of) a scheduled appointment. Personal checks, cashier’s checks, Visa, MasterCard, American Express, and Care Credit are accepted. We do not accept cash.
Rescheduling & Cancellations
Changes or cancellations of full evaluation appointments must be made a minimum of 2 business days before the first scheduled appointment time in order to apply the deposit for rescheduled
appointments. ACI is committed to providing quality and timely service to our patients. Therefore, due to the complicated nature of scheduling several appointments and holding appointments to accommodate the needs of our patient’s, cancellations made less than 2 business days before the first scheduled appointment, will be subject to forfeit the deposit to the clinic. If a cancellation is made 5 or more business days before the first scheduled appointment, and you do not plan on rescheduling, you qualify for a refund of your initial deposit.
Changes or cancellations of consultations, medication checks and therapy appointments must be made a minimum of 24 business hours before their scheduled time. Please note that 24 business hours would
require that an appointment for 9:00am on Monday be cancelled no later than 9:00am the prior Friday to avoid being charged.
Missed Appointments
Patients who miss their appointments will be charged a “Missed Appointment Fee,” which equals the cost of the missed appointment.
Insurance / Medicare
Amen Clinics, Inc. does not bill insurance. Additionally, we are not Medicare, Medicaid, or Medi-Cal providers. At the end of the evaluation, patients are given a “walk-out statement” containing applicable diagnosis and billing codes, which can then be submitted to insurance companies for possible reimbursement. Our doctors and therapists are not affiliated with any insurance plans or networks. As a result, insurance carriers will regard fees and treatment incurred at the Amen Clinics, Inc. as an out-of- network procedure. Please check with your insurance provider for any mental health benefits. **Please note that you cannot submit your superbill to Medicare, Medicaid or Medi-Cal.**
Discounts
Amen Clinic, Inc. provides patients with a 10% Friends and Family discount for the full evaluation when bringing in another patient. The first full evaluation will be full price and the 10% discount will apply to each additional family member or friend. If more than one patient is scheduled for an evaluation at the same time, we will honor the 10% discount for both.
Fees and Other Evaluation Options
Below is a list of the different types of evaluation options and the fees associated:
Full Evaluation: clinical history, two brain SPECT scans, WebNeuro, SCID assessment, evaluation with an ACI physician, aftercare appointment with an ACI staff, as well as a 45- 50 minute follow-up appointment with your ACI physician is $3,750
Partial Evaluation (same as full but only concentration scan performed): $2650
Clinical Evaluation (no scans performed): $1275 Add On to any evaluation:
o qEEG available in Orange County, Reston and New York. Priced by local market
o Comprehensive Labs and Review with Director of Integrative Medicine: $600 Half sessions appointments (20-25 minutes) are $175.
Full session appointments (45-50 minutes) are $350.
Medical records copy fee is $30.
CPT-4 Procedure Codes
Tax ID: 91-2055998
The following CPT procedure codes are primarily used and have been provided for your reference. Additionally, the fees associated with each procedure are also listed. Fees are subject to change without notice.
CPT Code Description Fee
(SPECT Scans)
78607 Tomographic (SPECT) x 2 Concentration and Resting 96103 Psych. Testing (computer assisted)
(Clinical History)
99205 Initial Comprehensive and Management Evaluation 90889 Preparation of Initial Report
(qEEG)
95812 qEEG 40-60 minutes 90887 Explanation of Results
(Doctor’s Evaluation)
90792 Psychiatric Diagnostic Evaluation
90885 Psychiatric Evaluation of Records, Reports, and Tests 90887 Interpretation or Explanation of
Results
90889 Preparation of Final Report
(Follow-Up)
99242 Office Consultation (45-50 minutes) 99214/90833 Med Management/Therapy (45-50 minutes)
*a $50 discount applies when qEEG and at least one SPECT scan are completed
Frequently Asked Questions
What is SPECT Imaging (Single Photon Emission Computer Tomography)?
$1,100 $100
$300 $100
varies by market*
$350 $100 $150 $100
$350 $350
Brain SPECT imaging is a nuclear medicine procedure that evaluates cerebral blood flow. It evaluates areas of the brain that work well, areas of the brain that work too hard, and areas of the brain that do not work hard enough. The information from the scans, along with a detailed clinical history, helps us understand the underlying brain patterns associated with our patients’ problems and help pinpoint the right treatment to balance brain function.
What is the injection and are there side effects?
Since a SPECT scan is a nuclear medicine procedure, it requires the injection of a very small amount of a radioisotope through a small needle into a vein in the arm. The medicine we inject is not an iodine based dye; therefore people typically do not have allergic responses to it.
How many days do I need to be at the clinic?
You should allow at least three days for the complete evaluation process.
What is the success rate?
We recently finished our analysis of a six month follow up study and 76% of our patients showed highly significant improvements. However, our success rate varies with each case. We see children from two years of age to elderly adults. Therefore, the question is variable and depends on many factors. Many people get better because we have more to offer than traditional psychiatrists who never look at the brain. In addition to clinical history, we look at the underlying physiology. Taken together (history and scans), we are much more thorough in diagnosis and more targeted in treatment plans. In a nutshell, Dr. Amen says he believes that patients get better faster because we have more information.
Will I be seeing Dr. Amen personally for the evaluation?
No. Due to his writing, research, and teaching duties, Dr. Amen has very limited clinical time.
Does insurance cover this? How can I find out?
Some insurance companies will reimburse for the procedures, however, some do not. In this packet we have included the procedure codes that apply to our services. Your insurance will determine if you will be reimbursed.
Do you offer any discounts, payment plans, or financial assistance?
We offer a 10% discount for friends and family members that schedule an appointment with our clinics as long as the original patient had a complete evaluation with SPECT scans. All payment plans are done through the third party, Care Credit. You apply with Care Credit by calling (866) 893-7864. Their website is www.CareCredit.com.
Do you offer phone consultations prior to scheduling an appointment?
Yes. If you would like to schedule a consultation with a physician, you can do so by calling any or our clinic locations. The charge for a half-session (not to exceed 30 minutes) is $175.00 and a full session (over 30 minutes and not to exceed one hour) is $350.
Can you give me the name of a doctor or therapist in my area for treatment?
We have a list of professionals throughout the country listed on our referral database on the “For Patients” section of our website at: www.amenclinics.com.
Can my Amen Clinic physician become my regular doctor?
If you live close by and would like us to provide ongoing treatment for you or your family member, we will consider it, if it is appropriate. However, if you are already working with another physician, we ask that you discuss this decision with your doctor.
Will I work with anyone other than my Amen Clinic physician?
As part of our treatment teams we have certified nurse practitioners and physician assistants who can also manage medications. If you would benefit from psychotherapy, we offer therapy with licensed professionals.
How often will I need to come into the office?
Doctor visits vary in frequency depending upon your needs. When medications are changed, your visits will be frequent. Even if you are stable, our doctors or other licensed clinicians must see you in person a minimum of once every 3 to 6 months. This is our clinics standard of practice for psychiatry and our policy.
Can I have my visits via telephone or by e-mail?
While we may schedule phone visits for minor adjustments and check-ups most decisions must be made during in-person visits. E-mails may be used to pass along routine information and questions to your doctors but this does not take place of a visit nor will any decision be made via e-mail correspondence.
What is the cost of follow up care?
The cost of your evaluation includes one full session (45-50 minute) follow up visit in person or via phone. Any subsequent follow up visits are billed at a rate of $175.00 per half session with the doctor or $125.00 per half session with our nurse practitioner or physician assistant. This includes in-person visits,
phone visits, writing of additional reports, letters, and in some instances e-mails. If you are late for your appointment or if you miss your appointment you will still be charged for the full session. If you arrive more than 10 minutes late, the office may have to reschedule your appointment and you may still be charged for the missed session.
What do I do if I have an emergency?
If you have a negative reaction to medication or a serious symptom, please call us. We have an after- hours paging system available for urgent matters. However, should you have a life threatening emergency, we ask that you call 911 or go to your local emergency room.
What if I need a refill of medication before my appointment?
Because our doctors’ schedules vary we request that all medication refills be ordered through your pharmacy. Call your pharmacy and ask them to fax a refill request to the clinic or send it through our e- prescribing system. Please plan ahead and allow 3-5 working days for refills. Be aware that many states do not accept phone refills for controlled substances. Stimulant drugs such as Adderall and Ritalin cannot be called in at all. We do not send prescriptions for controlled substances through the mail.
What if I have questions after my evaluation?
In your initial evaluation we make every effort to provide step by step treatment recommendations.
We are always happy to provide a consultation to you or your doctor in the future should additional questions arise. We act as ongoing consultants for many of our patients.
If you have any further questions, please call us toll free at 1 (888) 564-2700.