Successful Private Practice in Neuropsychology and Neuro-Rehabilitation

Successful Private Practice in Neuropsychology and Neuro-Rehabilitation

A Scientist-Practitioner Model

2nd Edition - October 10, 2014

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  • Author: Mary Pepping
  • Paperback ISBN: 9780128002582
  • eBook ISBN: 9780128004883

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This second edition (of the original Successful Private Practice in Neuropsychology) provides an updated overview of key principles and processes for establishing, maintaining and developing neuropsychology practice and neuro-rehabilitation program (NRP) treatment in medical center and/or private practice settings. Essential elements of an entrepreneurial model that work well in the medical center context and the necessary role of variety and peer review in the private practice setting are also discussed.

Key Features

  • How to gather and report NPE and other evaluation findings with a neuro- rehabilitation focus that lead to specific neuro-rehabilitation recommendations. Benefit: this will make your evaluations and reports more desirable and sought after in the setting and community where you work.
  • Updated billing/diagnostic code recommendations to accurately capture the actual time spent in evaluating and/or treating patients. Benefit: increased appropriate billing and collections for your time
  • Recommendations for clinical neuropsychology postdoctoral fellowship training of a Navy psychologist. Benefit: you may be able to obtain funding for an experienced Navy clinical psychologist who wants formal training in neuropsychology. This can expand your clinical services, increase variety and quality of your training program and ultimately support improved care for returning American military personnel.


Regardless of practice setting, (academic medical center, private medical center, outpatient clinic, private practice, university settings) active military or Veterans’ Administration settings, the practice recommendations in this book will be useful to neuropsychologists, rehabilitation psychologists, clinical psychologists, speech and language pathologists, and occupational therapists.

Table of Contents

    • Dedication
    • Foreword to the Second Edition
    • Preface
    • Chapter 1: The Challenges of Practice in Neuropsychology: Overview of Key Issues and Effective Solutions
      • Abstract
      • Pros and Cons of the Institutional Setting
      • Maintaining High-Level Skills
      • The Interdisciplinary Network
      • Do Not Go Gently into That Research Decline
      • Creating Educational Opportunities
      • Productively Managing Anxiety: Income
      • Protectively Managing Anxiety: Malpractice
      • Personality Factors in Private Practice
      • Ego Needs and Decreased Prestige
      • Ongoing Consultation: Are You Willing to Seek It? The Buck Stops Here
    • Chapter 2: Other Potential Indignities
      • Abstract
      • No Paid Sick Leave or Holidays
      • No Additional Reimbursement for Professional Fees
      • No Guaranteed Salary or Health-Care Benefits
      • Overhead Expenses
      • Billing, Collections, and Taxes
    • Chapter 3: The Good News
      • Abstract
      • Integrating Skills and Interests in Patient Selection
      • Creating the Optimal Schedule
      • Design Your Own Contracts
      • Setting Your Own Fees
      • Determining Salary
      • Choosing Your Own Support Services
      • Office Location, Space, and Atmosphere
      • Developing Your Own Letterhead and Brochures
      • Personalized Report Formats
      • Test Selection
      • Tax Advantages
    • Chapter 4: Getting Started: Practical Preliminary Questions
      • Abstract
      • Are You Experienced Enough to Be on Your Own?
      • Individual or Group Practice
      • Interdisciplinary Practices
      • Full-Time or Part-Time Private Practice
      • Consultation or Supervision Practices
      • Teaching
      • Medical–Legal Work
      • Neuropsychological Evaluations and Expert Witness Work
      • Hospital and Clinic Affiliations
      • University or Medical School Positions
      • Adjunct Appointments
      • Part-Time Clinical Faculty
    • Chapter 5: A Practical Guide for Opening Your Business
      • Abstract
      • Don’t Burn Bridges
      • Clinician, Know Thyself
      • A Moveable Feast: The Menu of Practice Options
      • Maintain a Part-Time Practice with Your Previous Employer
      • Developing a Safety Net: Starting with a Group
      • Offering Contract Services to Inpatient Rehabilitation Units
      • Offering Contract Services to Private Clinics
      • Membership in Managed Care Panels
      • Obtaining Adjunct or Clinical Teaching Appointments
      • How to Determine Fair Fees
      • How to Find Good Help
      • Developing a Business Plan and Practice Management Statistics
    • Chapter 6: Marketing and Other Matters
      • Abstract
      • First: The Other Matters
      • Next: The Marketing Piece: The Introductory Letter
      • Develop Seminars and Workshops
      • Give Guest Lectures
      • Offer a Memory Course to the Public
      • Contact Local Physicians and Fellow Neuropsychologists
      • Contact Independent Nurse Case Managers
      • Contact Private Vocational Firms
      • Attend Weekly Hospital Teaching Rounds
      • Supervise Residents, Interns, and Postdoctoral Fellows
      • Obtain Graduate Student Help for Research
      • Conference Participation: Yours and Other Related Professions
      • Publish
      • Final Comment
    • Chapter 7: Creative Approaches to Financial Issues
      • Abstract
      • Next Steps
      • Trading Consultation Time for Office Space
      • Sharing Testing Materials
      • Advice on Billing and Collections
      • Obtaining Basic Data from Your Patients
      • Obtaining Insurance Authorization
      • Contract and 50% Down for Private NPE
      • ICD-9 and CPT Codes
      • How to Bill and Collect for Legal Work
      • Reduced Cost Malpractice Insurance
      • Contract Assistants
      • Tax Deductions, a Good Accountant, and Type of Business
    • Chapter 8: Medical–Legal Work
      • Abstract
      • The Problems with Legal Work
      • True Believer Polemics in the Absence of Strong Scientific Data
      • Integrity and Reputation—Are You a Plaintiff or a Defense Expert?
      • Potential War of the Clinical and Legal Worlds
      • Subtle Influence and Examiner Drift
      • Inadvertent Promotion of a Litigious Zeitgeist
      • The Benefits of Forensic Work
    • Chapter 9: Consultation and Supervision Practice
      • Abstract
      • Clinical Psychologists, Primary Care Physicians, Nurse Practitioners, Physician Assistants, and Neurology or Rehabilitation Nurses
      • Neuropsychologists Who Wish to Augment Their Training
      • Therapists in Social Work, Counseling, or Pastoral Counselors
      • Rehabilitation Therapists, Occupational Therapists, Physical Therapists, Speech Pathologists, Vocational Counselors, Rehabilitation Specialists, Recreational Therapists, and Case Managers
      • Consultation with Psychologists Preparing for Licensure
    • Chapter 10: Psychometric Concerns
      • Abstract
      • The Interview: Who Should Be Present and Why?
      • The Collateral Interviews: When, Why, and with Whom?
      • Preparing the Patient to Be Tested
      • Test Selection
      • Selective Additional Testing: Divided by Specific Areas of Concern
      • Evaluating Personality in Neuropsychological Assessment
      • Cross-Cultural Issues
      • Use of Psychometrists
      • Report Formats
      • Review of Test Results
      • Dictation Versus Typing it Yourself
      • Dissemination of Reports
      • Preservation of Testing Files and Raw Data
    • Chapter 11: Treatment Practices for Neuropsychologists
      • Abstract
      • Your Training Background and Future Training Needs
      • What Kind of Practice do you Want?
      • Other Parts of Good Clinical Practice Development: Outpatient Psychotherapy
      • Establishing Short-Term and Long-Term Groups
      • Individual Treatment in a Neuropsychology Practice
      • Billing and Reimbursement Issues
      • Other Practice Options: Employee Assistance Program Contracts
      • Other Practice Options: Case Management Services
    • Chapter 12: Nuts and Bolts of Your Evaluation Practice
      • Abstract
      • Referrals
      • Educating Referral Sources
      • Purpose of Testing
      • Mechanisms of Feedback to Referral Sources and Patients
      • Insurance Preauthorization of Services
      • Timely Billing and Collections
    • Chapter 13: Neuro-Rehabilitation Program Treatment: Principles and Process
      • Abstract
      • Introduction
      • What Is Milieu-Based Treatment?
      • The Value of Work in the Lives of Humans
      • Why Is the Traditional Versus the Milieu-Based Rehabilitation Distinction Important
      • What Is Traditional Outpatient Rehabilitation?
      • Why Is Milieu-Based Treatment Needed for the “Medium-Severe?”
      • Guiding Philosophy and Principles of the Milieu Model
      • Some Implications of Psychological Factors in Evaluation and Treatment
      • Practical Considerations for Neuro-Rehabilitation
      • Key Practical Program Components
      • Fundamental Relationship Between NPE and NRP Treatments
      • How Can the Milieu-Based Model Be Modified for Your Practice?
    • Chapter 14: How to Design and Implement a Cognitive Group
      • Abstract
      • Introduction
      • Which Patients?
      • Basic Clinical Rules and Procedures
      • Basic Billing and Documentation
      • One Model for Cognitive Group Treatment
    • Chapter 15: The Value and Use of the MMPI in Neuropsychological Practice
      • Abstract
      • Introduction and Background
      • Challenges to Providing Balance: Identifying Personality Strengths
      • MMPI Profile Case Examples
    • Chapter 16: Designing and Implementing a Clinical Neuropsychology Fellowship
      • Abstract
      • Introduction
      • Design of the Fellowship: Three Key Components
      • Implementation of the Key Components
      • Training Content to Meet General Knowledge Requirements for Our Fellow
      • Specific Skills to Master per Houston Guidelines
      • Our Practice and Training Components
      • Organizing the Training Schedule
      • Feedback from the Fellow After Return to Active Military Service
      • A Final Word on Selection of Trainees
      • A Final Comment on How to Make This Happen in Your Locale
      • Supervisor Time Required for Fellowship Training
    • Chapter 17: Research as a Daily Reality
      • Abstract
      • What Are Your Research Interests?
      • Grants
      • Conference Presentation
      • Journal Articles
      • Chapters
      • Journal Groups
      • Collaborations
    • Chapter 18: Summary and Conclusions
      • Abstract
      • The Importance of Relationships and Mutual “Best Interest”
      • What Sort of Work Do You Want to Do?
      • Where and How Do You Want to Begin?
      • What are the Best Ways for You to Minimize Costs and Maximize Income?
      • What Sort of Financial Floor Do You Need?
      • How Will You Monitor and Promote Growth of Your Practice?
      • What Do You Do If Plan A Isn't Working as You Expected?
      • What are Your Short-Term, Intermediate, and Long-Term Goals?
      • Practical Ways to Vary Your Practice
      • Periodic or Long-Term Contract Work
      • Clinical Faculty Appointments
      • Be Alert to Clinical, Teaching, and Research Opportunities
      • Enjoying Your Practice
    • Appendices
      • Appendix A
      • Appendix B
      • Appendix C
      • Appendix D
      • Appendix E
      • Appendix F
      • Appendix G
      • Appendix H
      • Appendix I
      • Appendix J
      • Appendix K
      • Abodes
      • Note-Taking Strategies (Cognitive Group)
      • Appendix L
      • Appendix M
      • Appendix N
      • Appendix O
      • Appendix P
      • Appendix Q
      • Appendix R
    • Index

Product details

  • No. of pages: 320
  • Language: English
  • Copyright: © Academic Press 2014
  • Published: October 10, 2014
  • Imprint: Academic Press
  • Paperback ISBN: 9780128002582
  • eBook ISBN: 9780128004883

About the Author

Mary Pepping

Dr. Mary Pepping is a board certified neuropsychologist with 33 years of experience evaluating and treating working-age people and older adolescents with various forms of acquired brain injury. These include people with traumatic brain injury, brain tumor, stroke, multiple sclerosis, anoxic injuries, residual effects of neurological conditions such as meningitis, encephalitis, Huntington Disease, early-onset Parkinson disease, lupus, normal pressure hydrocephalus, and various forms of dementia. Dr. Pepping has long-standing involvement in neuro-rehabilitation of these populations of individuals. This includes an emphasis on detailed neuropsychological evaluations as a foundation for treatment, cognitive rehabilitation and psychotherapy in a milieu model context, and the role and functions of interdisciplinary teams to achieve good outcomes.

With her PhD in Clinical Psychology completed 1981 from Washington State University she went on to a postdoctoral fellowship in Clinical Neuropsychology at the University of Washington School of Medicine. After fellowship she spent six years in the Section of Neuropsychology, Department of Neurosurgery, at HCA Presbyterian Hospital in Oklahoma City, OK, directing the milieu-based treatment program there in her final two years. This was followed by a return to Seattle to work for five years in the Physical Medicine and Rehabilitation Department at Virginia Mason Medical Center, continuing with evaluation, treatment and clinical research.

After a subsequent six years in private practice, Dr. Pepping was recruited by the Department of Rehabilitation Medicine at the University of Washington Medical Center to serve for 14 years as Director of their Neuropsychology Service and outpatient interdisciplinary Neuro-Rehabilitation Program. Her years at the University of Washington School of Medicine gave her additional opportunities to provide teaching and training to interns, residents, fellows and practicum students from a range of disciplines, as well as shared research and scholarly writing projects with interdisciplinary colleagues. These fields included clinical psychology, neuropsychology, rehabilitation psychology, rehabilitation medicine, psychiatry, speech language pathology, occupational therapy, physical therapy, vocational rehabilitation and cognitive neurosciences.

With retirement from direct clinical practice in July 2013, Dr. Pepping shifted to Professor Emeritus within her department to create more time for scholarly writing, research and a return to a private consultation practice.

Affiliations and Expertise

University of Washington Medical Center, Seattle, Washington, U.S.A.

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