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1. Why should I choose Square One for my child’s care?
Square One is the first private practice in Louisville solely devoted to managing both the medical and psychological needs of children. Our highly trained clinical staff thoroughly evaluates and treats children, teenagers and families struggling with developmental, behavioral, emotional and/or learning concerns.
As a parent, you want the best for your child. At Square One, we start at the beginning to develop the best possible plan for your child’s specific needs. In addition to addressing your child’s needs directly, we equip families and school personnel with the necessary guidance and support to ensure your child’s continued success in the home and school settings. [Back to top]
2. Why is a medical evaluation necessary if my child sees a pediatrician regularly?
As a Developmental-Behavioral Pediatrician, Dr. Judith Axelrod is trained to interpret nuances in a child’s development particularly looking for the subtle differences that can develop into problems in learning, emotions, and behavior. The evaluation addresses the physical well being, emotional status, educational profile and behavioral presentation of the whole child within the family system. Dr. Axelrod’s expertise allows her to serve as a consultant for the family with schools and other professionals to determine the best intervention for the child.
Dr. Stephanie Eken offers her expertise and training as a Pediatrician and Child Psychiatrist to provide specialized evaluation and treatments, such as psychiatric therapy or medication management. [Back to top]
3. How do you determine the best course of treatment for my child?
You may have been referred to Square One for a specific service in mind already, which may be scheduled accordingly. However, in many cases, parents and/or school personnel are unsure of where to begin. In these cases, based on preliminary information we receive from you, our doctors will start with a thorough, three hour team evaluation performed by Dr. Judith Axelrod, a Developmental-Behavioral Pediatrician or Dr. Stephanie Eken, Pediatrician Child Psychiatrist, in conjunction with Dr. David Causey, Child Psychologist. This neurodevelopmental and psychological analysis provides essential clues to your child’s constellation of needs and the specific topics to be addressed, such as developmental, behavioral, emotional issues and/or learning disabilities. We consult with parents, school personnel, and physicians to determine how interactions in various settings affect behavior. In necessary cases, we also offer speech-language evaluation and therapy, where speech-language needs are indicated. [Back to top]
4. Why is the “Team Evaluation” so helpful to understanding my child and is it really worth the expense ?
Our team evaluations combine the expertise of a pediatric specialist physician (Developmental Pediatrician or Child and Adolescent Psychiatrist) and a clinical child psychologist. In addition to obtaining a clinical history, the physician examines your child and applies extensive medical knowledge that will provide a more complete clinical picture of factors that could be impacting on your child’s adjustment or development. This is then combined with the information directly assessed with your child by the psychologist and may include cognitive development, educational functioning, emotional or behavioral struggles, etc. For example, a child presumed to have an attention problem due to Attention Deficit Hyperactivity Disorder may actually have a sleep disorder, diabetes, or an underlying seizure disorder. A pediatric specialist physician can provide the insight and guidance that can help differentiate these types of issues. When necessary, a speech and language assessment can also be added to the team evaluation if concerns regarding language development are detected.
Regarding the expense, many people do not realize that the cost of our team’s evaluation is very comparable to what they might pay to have just a psychological assessment completed without the input of a physician. [Back to top]
5.
What should I expect at my first appointment ?
Your child's appointment type will be determined by our team of doctors
after we've received the Patient Information
application and Parent and Teacher questionnaires mailed to you when you
first contacted Square One for services. A staff member will contact you to
schedule the recommended appointment with the appropriate professional best
suited to your child's needs.
When you and your child arrive, our staff will provide our privacy policy terms and acceptance for you to sign. With your signed authorization, a staff member will photograph your child for the doctors’ reference in the medical record.
Initial Medical Evaluation: The developmental-behavioral pediatrician or child and adolescent psychiatrist will meet with parents only for the first 1 ½ hours of the appointment for an extensive clinical interview. During the remaining 30 minutes, she will perform a neurological and physical examination of your child. You may be present during this time.
Psychological/Educational Assessment: The psychologist will greet you in our lobby and lead your child to the testing office. During the evaluation, he or she will work with your child on a variety of tests which include assessments of IQ, academic performance, and emotional and behavioral adjustment. The length of the assessment is generally two to three hours. Parents remain in the lobby for the duration of this process. If your child needs to take a break to use the restroom or to briefly visit you in the lobby, he or she may do so at any time.
Speech-Language Assessment: Coming soon.
Team-Based Evaluation: During this type of appointment, your family will be seen by both the pediatrician or psychiatrist and the psychologist. The appointments are embedded in that the clinical interview with the pediatrician/psychiatrist will take place while the psychologist evaluates your child. When the psychological evaluation is complete, the neurological and physical evaluation begins with the pediatrician or psychiatrist as listed above. If the doctors determine that a speech-language evaluation is necessary, this appointment will be scheduled with our staff at the end of your appointment.
Medical, Psychological, Team Consultations: These appointments generally take place two weeks after your child's medical, psychological, or team evaluation. During your consultation appointment, you will receive your child’s testing results, treatment recommendations, and resource options. Report copies are available two weeks after the consultation. You have the option of receiving both copies or having a copy mailed to a facility authorized by you. This appointment is vital to the interpretation and your understanding of our doctors' findings and recommendations and should be scheduled at the same time that you schedule our evaluation to ensure timely reporting.
Psychological intake appointment: Dr. David Causey will meet with either parents only at the first appointment or with parents first and then the child, as discussed when the appointment was initially set with our staff. At the end of your appointment, you will discuss appointments to schedule for the future. These appointments are scheduled by a staff member at the time of payment. [Back to top]
6. What does a medication evaluation include?
A medication evaluation appointment includes a 30-45 minute update session and physical examination of your child with the developmental pediatrician or psychiatrist; up to 10 minute periodic phone call updates on your child's progress and prescription adjustment as necessary between appointments; extensive medical notes on your child's developmental progress; consultation with professionals involved in your child's care. [Back to top]
7. What are your specific areas of expertise?
8. What is the best age for my child to be evaluated?
We offer thorough medical, psychiatric, psychological and speech-language evaluations (all or singly) for children – newborn through adolescence. Ideally, you would enlist our services at the beginning sign of a problem. [Back to top]
9. Do you regularly refer to specialists?
The value in developing a relationship with Square One is that you no longer have to spread your child’s care over a variety of specialists. Our highly trained clinical staff is equipped to handle your child’s immediate needs and ongoing care on-site. In the rare case when a referral to a specialist is necessary, our staff will work with you to determine the best possible fit. [Back to top]
10.
Are your services covered under my existing insurance plan?
Square One is a fee-for-service practice and does not contract with
insurance companies. In other words, our providers are "out-of-network" with
all insurance policies. However, families may submit directly to their
insurance companies for reimbursement through out-of-network benefits.
We provide the necessary information for your claim, including our federal
tax identification number, diagnosis (DSM/ICD) codes, and procedure (CPT)
codes. Our doctors will provide signatures or other documentation on a
requested basis.
Accepted forms of payment include Health Savings Account (HSA) and Flexible Spending Account (FSA) funds, most major credit cards, checks, and cash. [Back to top]
11.
Why don't you contract with insurance companies?
At Square One, your family's treatment is our primary concern.
Unfortunately, insurance
companies often interfere in the treatment of patients by complicating
allowable services and covered providers. In addition, insurance companies
routinely pay only a portion of doctors' fees. Many doctors' offices resort
to double-booking appointments in order to compensate for the reduced
payment. At
Square One, we do not book multiple patients for the same appointment slot:
your appointment time is uniquely for you. Furthermore, we provide you the
services best suited to your needs, regardless of insurance coverage.
Instead of practicing under insurance guidelines, our doctors focus on their
mission to support families and to help
develop realistic and comprehensive care options.
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12.
What is your cancellation policy ?
Cancellations for emergent sudden illness can and will be rescheduled.
It is important to note
that we do not book multiple patients for the same appointment slot:
your appointment time is uniquely for you. We ask that families call
with a cancellation with as much notice as possible, as we maintain a
waiting list for patients seeking appointment openings. In general,
appointments cancelled with less than 24 hours notice are treated as missed
appointments.
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13.
What is your missed appointment policy ?
For your convenience, we place a reminder call
to you the day before your appointment. Our policy is to charge for no
shows and
appointments cancelled without at least 24 hours notice. This fee is the same as the amount
charged for the scheduled appointment.
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14.
How does the waiting list work ?
In general,
there is not a waiting list for new patient evaluations. Under the
rare circumstances that we cannot provide an evaluation appointment time in
your desired time frame, we will schedule you for the next best time and
place you on the waiting list, to be contacted in the event that we have a
cancelled evaluation appointment. However, it is necessary to have an
evaluation scheduled in order to be put on a waiting list for another
desired appointment time.
For current patients, in the event that we cannot schedule you at your desired day or time, we will put you on our waiting list with your preferred appointment day/time specifications and contact you in the case that a cancellation which coincides with your desired appointment day/time occurs. You can be on the waiting list for as little or as long a time as you wish. [Back to top]
15.
How do I request a prescription refill for my child ?
To request a prescription refill for your child, simply call Square One at
(502) 896-2606 and an office representative will take your request for the
doctors to complete. For controlled medications, you have the option of
picking up the prescription from our office or having it mailed to you. For
uncontrolled medications, you have the option of providing us with your
pharmacy's contact information and we will call
in the prescription for you. You should allow five days of processing
time for all prescription refill requests so that any insurance
preauthorizations or other processes may be completed before your child's
medication runs out. [Back to top]
16.
Are telephone messages and emails answered over the weekend ?
All emergency calls should be directed to 911 for prompt
service in dire situations. In the case that you must speak with one of our
doctors about a change in your child's behavior or other worrisome
circumstances related to treatment, these concerns may be left on voicemail and
will be answered in a timely manner. If you must speak with a doctor right
away, there are automated instructions for how to leave a voicemail for the
individual doctor to be retrieved remotely. Your call will be returned as
soon as possible - this is in the case that you must speak with the doctor
immediately, and that it absolutely cannot wait until business hours.
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FAQ