Neurological Diagnosis and Treatment for Learning Disabilities

    (415) 561-6755 | 350 Sansome Street, Suite 680, San Francisco, CA 94104

  At Bright Minds Institute Each Child is Unique  
 
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Bright Minds offers Neurological Examinations Tailored for each Child
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Treatment from age 2

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Frequently Asked Questions (FAQs)



Approach


Is your approach medial or biomedical?
Medical. Our chief neurologist Dr. Fernando Miranda, M.D., F.A.A.N., has proven himself through decades of public service at Johns Hopkins Hospital Neurology Department, Baltimore City Hospitals, Lovelace Clinic in Albuquerque, NM, CHW/Dignity St. Francis Memorial Hospital and many private clinics. He is Associate Professor at UCSF.


What is your medical approach to diagnosing and treating Autism, ADHD and other brain disorders?
We base our therapy on four distinct evaluations:
1-Neurological: Our neurologist will interview and evaluate your child - and family - after reviewing your child's medical records and reports including relevant histories, neuropsych workups and lab results.

2-Neurophysiological: Digital EEG and Evoked Potentials (DEEP) Assessment as per Harvard Medical School/ Children's Hospital Boston. We have licensed and pilot tested this Brain Electrical Mapping (BEAM) and DEEP Assessment technology which as part of a four-part evaluation system is available solely in our clinic. Standard EEG, simple and straight forward is available everywhere. Even in most hospitals in Africa.

3-Neuroanatomy: MRI using a 3 Tesla scanner

4-Neuropsychology: when appropriate

This "four legged stool" methodology gives us factual medical evidence to evaluate your child and, when needed, prescribe treatments and provide therapy directives.

Our methods are not magical - we simply apply them to each and every patient for optimal results based on evidence. Not guesswork. Our trailblazing approach is becoming more and more mainstream: a good thing!

We also treat our patients, unlike some clinics who merely diagnose them, then refer out to other doctors for additional costly testing. The buck stops here.


Why is medication a part of your treatment plan?
Since we are Western Medical practice, we use all the tools available within this medical model. Neuropharmacology can be, and often proves to be, very effective in targeting certain areas of the brain for improvement where connections may be lacking, where seizure foci are disrupting normal neuron development and interaction, and so on.

What is your stance on diet and nutrition?
We do not handle diet issues, including gluten-free or casein-free (GFCF) diets. However, we know that diet can play a role in children's overall well-being or discomfort, and support parents' efforts in general to work through any potential allergies their children may have, including to foods, pets, environment.

How do I get started?
The first step is to call us at +1.415.561.6755 or complete our Appointment Request Form to schedule an initial evaluation.


How are people referred to Bright Minds Institute?

People are referred to the Bright Minds Institute in many ways, including by their physicians, mental health professionals, family members, friends, or by learning about us through lectures, Dr. Miranda's television appearances, and the Internet. You can refer yourself or someone you love to the clinic.


What if I don't have a doctor to refer me?

People who are self-referred first speak to one of our Intake Coordinators to make sure we are the appropriate place for help. A phone consultation with one of our professionals is recommended before an evaluation or brain scans are scheduled.

Which test results do you want to see for children diagnosed with Autism, before or after my initial evaluation?
The following blood tests. After determining that this testing is actually necessary, after your initial evaluation, we will provide you with a script.

  1. chromosomal analysis
  2. fragile X
  3. organic and aminoacids in blood
  4. lead and mercury in blood
  5. mitochondrial panel
  6. thyroid function studies
  7. serotonin levels
  8. immunoelectrophoresis in serum
  9. CBC and general chemistry panel

How long is the initial interview/evaluation?
Your clinical evaluation with a neurologist will last one hour. During this time we will interview your family and evaluate your child. We also diagnose and treat teenagers and adults for a wide variety of brain disorders.

Which office locations perform the BEAM/DEEP Assessment?
We currently have two flagship offices that offer the BEAM/DEEP Assessment: San Francisco, California and Vero Beach, Florida.

Do we provide the option for phone follow-ups?
Many of our patients are from out-of-state or overseas and for that same reason, we do offer phone and/or Skype follow-ups. Phone follow-ups are provided as a convenience for the patient and are another way for us to monitor the safety of your child. Knowing the status of your child helps us re-evaluate and revise treatment as needed. The same rates apply for follow-ups whether in-person, by phone/skype or by email ($195 per 15 minutes).

How often do you require follow-ups? Why?
Following laws around central neurvous system medications, we require follow-ups once every 4 months, or three times per year. Check-ups every three months (quarterly) is preferable. We recommend that patients schedule follow-ups one year in advance. Generally, staff will provide a one-week prescription refill if the patient has not had a follow-up within the last 4 months. This is to insure that our treatments are working properly and safely. Our bodies experience changes and fluctuate, so knowing the status of each patient helps us re-evaluate and revise treatment as needed.

How often do we recommend patients get blood levels checked?
As mentioned in the Patient Service Agreement, blood levels should be checked and the results made available to our doctors before or by the time of your next follow-up. This helps to monitor patient health and to ensure that treatment is within therapeutic and safe ranges.



How much do your services cost?

All services are prepaid before or on the day of your appointment. We require a 25% deposit for patients receiving our signature DEEP Assessment two weeks prior to date of service to reserve an appointment.

$395 - Medical records review, including MRI analysis, EEG data and reports, relevant prior history. (Up to 1" of reports.) Materials, fee and completed BMI intake packet required before or day of your child's first visit.

$695 - First visit. Full one hour initial clinical evaluation or initial phone/Skype consultation. Account setup.

$3,995 - P300 DEEP Assessment. Brain activity mapping and cross-function scan; digital analyses and comparison with our proprietary, Harvard Medical School/Children's Hospital Boston-developed BEAM (Brain Electrical Activity Mapping) database. Serves as baseline against improvements in future DEEP test results.

$3,395 - Follow-up DEEP Assessment. Repeat of your original test protocol. Recommended one year after initial diagnosis to quantitatively assess progress. More often for difficult cases. Especially recommended upon or after onset of adolescence.

$195 - Follow-up appointments and consultations. Per 15 minutes. (One hour = $780.) Includes in person, phone/Skype or email consultations of a medical nature involving any of our neurologists.

$5,085 - Everything. Full one hour initial clinical evaluation or initial phone/skype consultation with records review (including MRI analysis) plus our custom P300 DEEP Assessment brain scan and comparison with our proprietary, Harvard Medical School/Children's Hospital Boston-developed BEAM (Brain Electrical Activity Mapping) database. Add $195 per additional 15 minutes of follow-up. Initial DEEP follow-ups are usually 45 minutes to one hour for results follow-up and consultation with recommendations.

We require one follow-up visit or consultation per quarter, or once every four months, to follow up your child's status and progress properly, especially if s/he is using neuropharmacological therapies. These visits are usually 15 to 30 minutes in length unless you have extensive questions or if an unusual situation has occurred.


Does my insurance cover the services provided by Bright Minds Institute?
This depends on your health insurance company, your employer's benefits plan, and each family or individual. We provide you with Current Procedural Terminology (CPT) codes as part of our co-payment service fee schedule. List in hand, you may inquire directly to your insurance company how much they will reimburse you for our services.
It is the patient's responsibility to submit reimbursement claims for all services except our signature DEEP Assessment.

We are out of network with all insurance companies as even eight years later, our approach and technology are considered "experimental" by health insurers. We accept and can bill most PPO plans towards out-of-network benefits and MediCare but unfortunately do not accept MediCal, Healthy Families, or Healthy San Francisco at this time.

Do you offer financial assistance?
We accept CareCredit as a form of financial assistance. We encourage parents to utilize Flexible Spending Account (FSA) and Health Savings Account (HSA) pre-tax forms of payment to maximize your family's healthcare budget.

What is CareCredit?
Bright Minds Institute does not offer financial plans but we do accept CareCredit. Available to US patients only, this personal line of credit spreads out your healthcare costs over a more manageable 18 months, interest-free (0%), instead of one lump sum payment.

  • "CareCredit is a personal line of credit for healthcare treatments and procedures for your entire family, including your pets. It is a credit card but it has two advantages. It can only be used for healthcare services and you can get No Interest if paid in full within the promotional period on purchases made with your CareCredit credit card. Interest will be charged to your account from the purchase date if the promotional purchase is not paid in full within the promotional period or if you make a late payment. Minimum Monthly Payments Required and you may pay off purchases before end of the promo period."
Please note that we will add a 14% surcharge to all procedures you pay for using CareCredit. We will verify your pre-approval for CareCredit before you decide to pursue treatment.
There is a one page application online offering immediate approval that you can pursue at your leisure. There are no up-front costs, prepayment penalties or annual fees. Visit www.carecredit.com or call 1-800-677-0718.



BMI imageWhen/why is an MRI needed?
An MRI provides an anatomical overview of the brain which shows the physical structure. Typically, this is used to rule out any symptoms due to any physical anomalies, for example: lesions. Our medical staff will make a determination of whether you or your child needs an MRI scan after your initial evaluation.

Do you perform the MRIs?
We do not conduct any MRI testing at our facility. We will recommend local facilities as needed. If you live out of state or overseas, it may be best for you to make full use of your insurance and local knowledge by using an in-network imaging facility. Ideally this will be easier and cheaper for you.

Currently our local recommendations include California Pacific Medical Center for young children under age 10 (sedation usually recommended). Otherwise Health Diagnostics/Simon Med works well for teenagers and adults who can remain still for 25-45 minutes.

Please note that the MRI machine is quite loud with beeps and miscellaneous noises even with earplugs, and patients must lay absolutely still without moving their heads or jaws for the duration of the MRI scanning procedure.

What are your requirements for MRIs?
As mentioned in our New Patient Overview Packet:

  1. MRI must be performed on a machine that uses 1.5-3 TESLA resolution (3 TESLA power machines are preferred, 1.5 TESLA power scans are acceptable.) Both must be performed under some form of sedation because the slightest physical movement ruins MRI scans.
  2. MRIs should be completed without contrast.

How recent should my child's MRI be?
We accept MRI scans performed within the last year for reading and analysis. If you have already had one performed please bring your data CD for our review. If you have NOT YET had an MRI performed, do not worry. We will help you obtain one if we determine it is medically necessary after your initial evaluation.


Visiting our San Francisco Office

How do we get to your San Francisco office?
We are located in San Francisco's downtown financial district at 350 Sansome Street. Our office is conveniently located six blocks away from two MUNI and BART public transit stations. The BART train connects directly to both San Francisco and Oakland International Airports. Check airfares at HotWire or Kayak.

You may also take Amtrak to our region (Oakland) and then hop onto an Amtrak chartered bus to San Francisco.

Is parking available in your office's vicinity?
There are ample paid underground parking garages in our neighborhood, including in our building and across the street. Rates tend to run up to $26-30 USD per day. Street parking including metered street parking is highly restricted in downtown San Francisco and we apologize for any inconvenience this may cause you. If driving, carefully check for parking restrictions posted on street poles and on meters to avoid parking tickets.

Please take a look at this helpful website that shows parking garage rates (the red star is our SF location): SF Best Parking.

Are there kid-friendly restaurants in the area?
Depending on your needs, there are many options.

We recommend San Francisco Soup Company because many locations offer sit-down space and it is generally healthy.

Updated 8/13/2012.

 
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San Francisco (415) 561-6755 ** Vero Beach (772) 231-1155
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