Payment Information
The full evaluation fee is due on the day of the appointment. Payees are responsible for settling the balance at that time. While we do not accept insurance or offer payment plans, we accept all major credit cards, cash, and checks. A Super Bill will be provided for you to submit to your insurance company for potential partial reimbursement.
We Are ESA Vendors
Payments Using ESA Debit Card
We will provide you with an invoice that complies with ESA program criteria.
Important Note
The ANC does not have access to the ESA system and, therefore, cannot estimate reimbursement times, pending payments, balances, eligible categories, or account and patient profile information. For any inquiries, please get in touch with the ESA department for further assistance.
For more information on ESA, please refer to the link below.
Payment Options via ESA Class Wallet Funds
The ANC offers two payment options using ESA Class Wallet Funds:
The evaluation fee is due in full on the day of the appointment.
We will provide you with an invoice that meets the ESA Class Wallet requirements. You must submit it to receive reimbursement.
What is a proforma invoice?
“A proforma invoice is a preliminary bill or estimated invoice sent to a buyer before goods or services are delivered. It outlines the details of a transaction, including the price, quantity, and terms, giving you a clear overview of the costs before finalizing the transaction. Once approved, it allows us greater flexibility to move your appointment up if an earlier slot becomes available, ensuring you get the service as soon as possible.
1 – Complete the patient’s demographic inquiry through the ANC website.
Start by completing the demographic Inquiry on the “Schedule Now” page.
2 – Receive the Proforma Invoice from our practice via email:
After submission, you will receive a pro forma invoice based on the Class Wallet criteria, your selected practitioner’s credentials, and an estimated evaluation date.
3 – Submit the Invoice to the Class Wallet.
Important Note:
“To avoid denial from Class Wallet, please request the amount listed on the Proforma Invoice. The requested amount should match the total invoice without adding the percentage fee.”
Following their instructions, upload the proforma invoice and the provider license to the Class Wallet website. The ANC will be listed on the class wallet vendors list as “Arizona Neuropsychology Centers.”
4 – Provide the Order ID number.
After uploading the required documents to the class wallet website, you will receive a request receipt. Please reply to the ANC email with a screenshot of the receipt with the Order ID number so we can link the payment to the patient’s name after approval.
5 – Finalize the Scheduling process.
Once the order ID Number is provided and payment is linked, the scheduling process via Class Wallet funds will be complete.
For more details on how to submit the invoice, please refer to the link below.
https://classwallet.my.site.com/classwallet/s/article/How-to-pay-a-vendor
ANC professionals cannot access individual ESA accounts. Therefore, we cannot provide families with information regarding their reimbursement timeframes, pending payments for services, ESA account balances, the ability to use ESA funds for an evaluation, or account and patient profile information.
For more information, click on the link below.
ClassWallet | Digital Wallet Solution
The ANC does not offer direct guidance on how to begin with the ESA/Class Wallet system. We recommend contacting the non-profit organization Love Your School for comprehensive information and assistance.
For further details, please visit the link below.
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