Clinical Neurology Specialists Clinical Neurology Specialists Diagnostics Hyperbaric Institute of Nevada

Frequently Asked Questions (FAQ)

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FAQ Table of Contents


Financial Obligations & Insurance Questions

Nerve Conduction Studies & EMG Questions

Appointment & Other Questions

Will a co-pay be collected at each visit?

It is our payment policy to collect the appropriate payment due from the patient at the time the service is rendered prior to being seen. This may only be your co-payment, deductible and/or co-insurance, but we do ask for payment at the time of your visit.

Because we are contracted with your insurance to help keep your insurance costs down, as part of that effort, our agreement with your insurance carrier states we will collect your co-pay at the time of each visit. Some co-pays differ according to the nature of the visit or test. If you have any questions about your co-pay, please call prior to your appointment.

Does your office participate with my insurance plan? Do you accept Worker's Compensation Cases or Injury Cases?

CNS participates with many of the major plans in Nevada; however, tt is the plicy holder's responsibility to verify that CNS is contracted with your specific carrier and plan. You can also call one of our billing staff and we will be happy to assist you at (702) 804-1574.

If you have an attorney, plan to litigate your case, or your medical case involves a Worker's Compensation Adjuster, then please provide this information to the New Patient Scheduling Department.

How will I be billed for services?

Our office sends out statements monthly on any balance that is due from you after your insurance has settled the claim for the services. You are billed for any deductibles, co-insurance, or other out of pocket expenses determined by your insurance carrier.

Do you submit insurance claims for us?

Our billing department will make two attempts to obtain payment from your insurance carrier. We submit your claim once you have been seen and then again in 30 days if no payment is made by your insurance carrier.  At 45 days if no payment is received by your insurance, we will then bill you and ask that you assist us in following up with your insurance carrier.

Why must I show my insurance card and photoidentification id at each visit?

It is CNS policy verify your insurance monthly.  Often, insurance plans can make small changes including, but not limited to the following: group number; claims payment address; Third Party Administrator (TPA); co-payment amount; reduced benefits based on work hours; etc. even though you stay with the same health insurance carrier. Your employer may also change plans. In order to most accurately bill your health insurance on your behalf, we strive to verify this information monthly. If something has changed please inform the front desk or call the Billing Department at (702) 804-1574 to update your account records.

CNS asks for your photoidentification at each visit to both verify your identify and review for any changes (i.e. Drivers License with new address change). If you come to your visit without photoidentification, then you will be provided the phone to contact your referring healthcare provider to fax over a clear large copy of your Drivers License or other photoidentification document.

If my insurance refused to pay for my service, will I be liable for the billing?

Yes, you are liable for any amount that is not payable by your health insurance and this may or may not be after CNS has taken the contracted discount based on the claims processing by your health insurance carrier. CNS accepts the major credit cards and patient medical loan financing (i.e. CareCredit, Discover, Master Card, Mymedicalloan.com, Visa). Please call the Billing Department at (702) 804-1574 for currently available patient financing options.

Your Health Plan does not pay for all of your health care costs even if medically necessary. For example, NCS/EMG procedures are a covered benefit by large medical claim payers like Medicare, a governmental sponsored health insurance plan and Nevada Medicaid. Also, NCS/EMG is an industry standard in the diagnosing of certain neurologic conditions. Please visit www.aanem.org for more information, but your health insurance plan may not cover this. Patients are required to call their health insurance carrier and verify office visits to a specialist office and specific procedures are a covered benefit. Call the Billing Department at (702) 804-1574 for assistance on obtaining the correct CPT codes for your specific procedure or visit. You may also find the CPT codes for your specific symptoms using the following table Table 1: Maximum Number of Studies. Please note that this table is a reasonable maximum number of studies per diagnostic category necessary for a EDX Physician to arrive at a diagnosis in 90% of patients with that final diagnosis based on the latest 2004 data by AANEM and your case may be more unique.

I was referred for outpatient Nerve Conduction Studies (NCS) and EMG but already had NCS. Can I just be seen for EMG?

No. CNS Neurodiagnostics follows AANEM guidelines to ensure your quality of testing:

"In some cases, an NCS study will be conducted by someone who is not a trained electrodiagnostic physician (or a trained technician under the direct supervision of a trained electrodiagnostic physician) and the patient is then referred to a trained electrodiagnostic physician for assistance in diagnosing the patient. In such cases, the physician trained in electrodiagnostic medicine will usually need to repeat the NCS prior to performing needle EMG to ensure a quality study. Retesting will also be necessary to conform to the AANEM policy that only one attending physician should perform or supervise all of the components of the electrodiagnostic testing (i.e., history taking, physical evaluation, supervision or performance of the electrodiagnostic test, and interpretation) for a given patient and that in most cases all testing should occur on the same date of service." AANEM Position Statement, Proper Performance and Interpretation of Electrodiagnostic Studies, Muscle Nerve 33: 436-439, 2006.

Why was I referred for Nerve Conduction Studies and EMG?

Below are AANEM Guidelines for common symptoms for referring for EDX Studies (NCS/EMG):

  • Generalized weakness
  • Facial weakness (including ptosis)
  • Facial pain and/or numbness, Involuntary facial movement
  • Dysphagia
  • Dysarthria
  • Respiratory insufficiency
  • Neck pain
  • Thoracic pain, Back Pain
  • Shoulder and arm pain, numbness, altered sensation (e.g., pins and needles), weakness, cramps, fasciculations, muscle atrophy or hypertrophy (focal or diffuse)
  • Hip and leg pain, numbness, altered, sensation (i.e., pins and needles), weakness, cramps, fasciculations, muscle atrophy or hypertrophy
  • Distal weakness
  • Proximal weakness

What is nerve conduction?

Follow the below link.

Nerve Conduction

How long does the EDX Testing take?

The EDX Testing usually take 20 to 90 minutes depending on how many limbs being tested, your unique physiology, and other factors. If indications for EDX Testing result in testing both your arms/hands, then please plan on atleast 60 minutes or more. You can do any of your normal activities, like eating, driving, and exercising, before the tests. There are no lasting side effects. You can also do your normal activities after the tests.

How should I prepare for EDX Testing?

Tell the EDX Team if you are taking aspirin, blood thinners (like Coumadin®), have a pacemaker, or have hemophilia. Take a bath or shower to remove oil from the areas to be tested. Do not use body lotion on the day of the test. If you have myasthenia gravis, ask your physician or healthcare provider if you should take any medications before the test.

What kind of Needle is used?

A small, thin Needle Electrode is inserted in several muscles to test their functioning. A new, sterile needle is used for each patient and it is placed in a special disposal container after your test. The majority of patients do not even feel the needle has been placed into the muscle. Some patients may experience a small amount of pain when the needle is put in.

Dr. Leo Germin

The EDX Physician tests only the muscles necessary according to your referral indications. The EMG test is considered a live test where the EDX Physician collects information during the test. As new information is obtained other muscles may be explored that were not in the original plan. The EDX Physician will look at and listen to the electrical signals that travel from the needle to the EDX equipment.

Watch a EMG

How should I prepare for an Awake & Drowsy EEG?

Plan on being in the office for atleast 60 minutes or more. Sleep 4-5 hours the night before and is best if someone drives you to your appointment. Hair should be unbraided, washed the morning of the test, and left clean and dry. Do not use hair sprays, oils, setting gels, or chemicals on your hair the day of the test. Wear a button down shirt. We ask that all hair pieces and wigs be removed during the test.

How should I prepare for an Ambulatory EEG?

There are no sleep requirements for this test so sleep as normal. Plan on being in the office for atleast 60 minutes or more. Hair should be unbraided, washed the morning of the test, and left clean and dry. Do not use hair sprays, oils, setting gels, or chemicals on your hair the day of the test. Wear a button down shirt. We ask that all hair pieces and wigs be removed during the test. Some patients have brought loose fitting hats to wear over the head to cover the electrodes. Additional instructions will be provided in the office.

For 24 Hour testing you will be carrying the electrodes and a very small electrode box at the waist or shoulder strap for up to 24 hours. This will allow us to collect electrical information of the brain during this time and review it in the computer. You will need to return the next morning, generally 7:00 - 7:30 AM to have the electrodes removed.

The 48 Hour testing is the same for 24 Hour testing noted above but you will need to return on the morning of the second day, generally 7:00 - 7:30 AM to have the electrodes removed.

How should I prepare for a Transcranial Doppler?

Have clean dry hair. No makeup on the face, eye lids, or around neck areas. Inform the technician if you had any recent eye surgery. Additional instructions will be provided in the office.

I am a new patient, what do I have to bring with me to my appointment??

New patients should plan on bringing the following to their appointment:

  • Insurance card(s)
  • Photoidentification (i.e. Drivers License, State ID Card)
  • Financial responsibility amount
  • For EEGs, please bring any recent imaging of the brain with you.
  • For EDX Testing, please bring a list of medications you are on incase you are unsure if you are a blood thinner-type medication.
  • Bring a copy of your referral and referral authorization (if required) incase this is not received yet by your referring healthcare provider or physician.

How much notice is required for cancellations and how soon can appointments be rescheduled?

Our office requires at the minimum a 24-hour notice for all cancellations. CNS appreciates a 3 day notice so that we can fill your slot with patients that may be interested in your appointment time. For rescheduling appointments simply ask the staff to reschedule you for the next available opening or available Saturday date. If you cancel and/or do not show for two or more consecutive appointments, then your case will be reviewed prior to rescheduling and your neurologic care may be trasnferred back to your referring healthcare provider.

What is your Appointment Policy?

CNS understands that not all appointments may be kept due to emergencies and changes in your personal schedule. CNS allows for up to a combination of two consecutive cancellations (or one cancellation and one no show) for the same appointment (or series of testing appointments) within 12 calendar months. After this, staff will be unable to assist you in rescheduling your appointment and your chart will be sent for review by Administration and your neurologic care may be transferred back to your referring healthcare provider.

How can I leave a message for your staff?

Please call during regular business hours 8:00 AM to 4:30 PM excluding some holidays. Patient hours may vary by location. If you are calling outside of business hours you can leave a non-urgent message with our answering service or email CNS at info@cnsnevada.com. Simply leave your full name, phone number(s), and what the message is about and we will return your call as soon as possible. Emails will be routed to the department that can assist you further. Please allow up to 3 business days for a return call for non-urgent requests. For urgent requests, please call your primary care physcian, local urgent care, or call emergency services if you are uncomfortable with your current condition.

When will I know about my test results?

If you were referred for Outpatient services only, then your results will be faxed to your referring healthcare provider. Your referring healthcare provider will review the testing results with you. If you provide advanced notice, then CNS can mail you a copy of the results once they become available. Results are not provided the same day as testing. If your referring healthcare provider requests an urgent report due to pending surgery or other, then your report will be expidited accordingly.

For established patients calling for test results, please be advised that our physicians will not be able to give you results over the phone. These results are typically discussed in your neurological follow up. If you do not have a follow up, then please call the office at (702) 804-1212 and schedule an appointment.

How do I get a copy of my medical records?

To obtain your medical records you are required to sign a medical records authorization release form provided by our office and located on this website giving CNS written consent to release your records to yourself, your identified family member, or your personal representative. You will be asked to provide a Drivers License or a photoidentification and pay for a copy fee of $.60 per page. A low cost alternative is to request your medical records on a secure cd for a flat fee of $5.00 for medical records 9 pages or more.

Payment Policy

It is our payment policy to collect the appropriate payment due from the patient at the time the service is rendered prior to being seen. This may only be your co-payment, deductible and/or co-insurance, but we do ask for payment at the time of your visit.

CNS accepts the folowing major credit cards and patient medical loan financing: