FAQ

Frequently Asked Questions

Question: How do I schedule an appointment?

Lester: Follow these links below:

Schedule a NEW PATIENT visit at the ASR Program now: click here to complete Intake Forms and schedule an appointment

Schedule a FOLLOWUP visit at the ASR Program here: click here to complete a Followup Form and schedule an appointment

Question: How do I get to Headway Neurology?

Lester: You can find the location on your navigation app or follow the driving instructions below:

1. From I-90 going west: Take exit 127 toward Newton. Drive along Washington Street going west. Turn right on Crafts Street. Turn right on California Street. Turn right on Nevada Street, and then immediately take a left turn into the driveway under a large oak tree. Park in one of the available parking spots (in the gravel portion of the driveway) on the right. If you have very limited mobility, you can park directly facing one of the garage doors at the end of the driveway.

2. From I-90 going east: Take exit 127. Stay in the right lane and turn right onto Centre Street. Turn right on Church Street (second street). Continue on Church Street and cross over I-90. At the traffic light, turn left onto Washington Street going west. Turn right on Crafts Street. Turn right on California Street. Turn right on Nevada Street, and then immediately take a left turn into the driveway under a large oak tree. Park in one of the available parking spots (in the gravel portion of the driveway) on the right. If you have very limited mobility, you can park directly facing one of the garage doors at the end of the driveway.

3. Using any navigation program: Type in "206 Nevada Street, Newton, MA" into your navigation app. This will bring you directly to the driveway entrance to Headway Neurology. Park in one of the available parking spots (in the gravel portion of the driveway) on the right. If you have very limited mobility, you can park directly facing one of the garage doors at the end of the driveway.

4. Public Transit: Take the Framingham/Worcester Line (from South Station) to the Newtonville stop. Follow signs for Newtonville - Walnut Street. Take the stairs. Exit via Newtonville - Walnut Street. Head north on Walnut Street toward Washington Street. Turn right on Linwood Avenue. Turn left on Nevada Street. Approaching the corner of Nevada Street and California Street, walk into the driveway to the right passing under a large oak tree. Head to the end of the driveway towards the garage. When you reach the garage, turn left and walk up the five steps to the deck at the entrance of Headway Neurology. The walk is approximately 1 mile in length.

Question: Do you see patients with other brain injuries besides stroke?

Lester: Great question. At the ASR Program, I only take care of people who have had a stroke. If you have had a different type of brain injury (e.g. concussion, traumatic brain injury, anoxic brain injury, brain tumor-related etc.), I can give you some suggestions regarding who can help you with your recovery.

Question: Why did you start this practice?

Lester: For many reasons! 

First and foremost is for my patients: as a doctor with expertise and experience in the care of people with stroke throughout all stages of the disease, I want to be able to support them throughout the entire journey. Many pressures on large health care systems limit the ability for doctors to work with patients in the long term, so I want to be able to make good on a promise I make to my stroke survivors who choose to see me at Headway Neurology: I know your story, and I will always be here for you.

Secondly, I would like to deliver a health care experience for my patients, their supports, and myself that is more personal, less stressful, and more focused on what matters most to them: finding a way to move forwards towards a better life, unbound by disabling deficits and symptoms in the wake of a stroke.

Finally, on a personal note, I own a rental property, and I would like to use this beautiful space — a home — for a good purpose that can serve many people who may appreciate a visit to a quiet, peaceful sanctuary from the busy, loud, chaotic experience of our daily modern lives. 

Question: Should I see you at Headway Neurology or at your hospital practice?

Lester: Really good question. These are two separate practices with no direct connection between them. As a patient, you are allowed to choose where you see me, provided that you have sufficient financial means AND are not enrolled in Medicare or MassHealth (Medicaid). Medicare and MassHealth (Medicaid) do not allow clinicians to accept direct payments for services from patients. However, if you are covered by one of these plans (or a Medicare/Medicaid managed plan), you may have someone else sponsor your visit to Headway Neurology by covering the cost of the visit (or covering part of the cost if you are eligible for a Headway Neurology scholarship).

Generally speaking, if you just had a stroke and there are questions about the cause of the stroke and what to do about it, it is better to see me at my hospital based practice. There, I will have better integrated Electronic Health Record (EHR) access, can easily order diagnostic tests, can easily message and engage with other on-site colleagues who may be able to help you, and have greater nurse, pharmacist, and administrative support, including clinicians who can answer the phone when I am away or if there is an emergency and pharmacists/admins who can help with prior authorizations for expensive medications or diagnostic tests.

If you had a stroke a while ago (e.g. 6+ months or even years ago) and your main interest is in working with me on improving your recovery or having longitudinal care, then seeing me at the ASR program or SAYA-C program at Headway Neurology is likely a better fit. Here, the interactions with me are more direct, I can prescribe medications (usually relatively inexpensive), I have fewer documentation requirements (e.g. more time to engage with you), and the experience for you overall will probably feel easier. I will be able to review imaging studies if you bring them to me on a CD/DVD (or if you have them mailed to Headway Neurology), but I will generally not be ordering extensive diagnostic tests or lab studies from this location. I will not have any administrative support, so the email address and phone number for the ASR program and SAYA-C program at Headway Neurology should not be used for emergencies.

Question: I have seen a Neurologist or a Physiatrist already. Does it make sense for me to see you?

Lester: In many cases, yes!

Many of my colleagues who are Vascular Neurologists (stroke specialists) are very skilled at identifying causes of stroke and helping you reduce risk of future strokes. However, most do not have much experience (or the bandwidth) to help continue to guide stroke survivors along the journey to maximal recovery. Most stroke centers take care of many people with stroke (a common disease), and yet there are relatively few Neurologists (let alone Vascular Neurologists) to help stroke survivors after the initial hospitalization. As such, most people with stroke are only seen once or twice in a clinic setting by a Neurologist following their strokes because of the mismatch in need and availability.

Physiatrists (Physical Medicine and Rehabilitation physicians) are very skilled at helping to identify deficits (loss of function) related to neurological disorders including stroke, and they have useful tools and abilities to help address those deficits. For example, some Physiatrists effectively treat spasticity (increased muscle tone after a brain or spinal cord injury) with botulinum toxin injections. However, most Physiatrists do not have a detailed understanding of the specific neurological aspects of the original injury (like the location in the brain and the severity), which means that they may have trouble identifying and treating neurological barriers to recovery. 

As a result, my work with you can complement the care you receive from other Neurologists, Physiatrists, and certainly rehabilitation therapists (Physical Therapy, Occupational Therapy, Speech Therapy, and more). For many, I can be a coach that helps you figure out play-by-play what the best strategy (therapy, treatment, or activity) would be at each stage to unlock more potential for recovery. 

Question: Why are you running a direct pay practice and not taking insurance? How much does it cost to see you?

Lester: Great question. I am running a micropractice, meaning everything is done by me. I respond to every message, write every prescription, call in every referral, write every clinic note, welcome every patient at the entrance, and even clean and maintain the clinic. While it may seem inconvenient for people who have insurance to have to pay for my services separately, not submitting services for reimbursement minimizes the administrative burden of my practice, which otherwise would require multiple employees just to navigate the insurance reimbursement system. That means, the only person you have to "deal with" is me: no receptionists, no call center, no calls to your insurance carrier. 

Notably, you may not be used to seeing the charges that are typically connected to a doctor's visit. The charges for my visits here at Headway Neurology are approximately 40-60% what would otherwise be charged to your insurance carrier, not including any additional charges that come from specialized assessments that I may perform during the visit. Here at Headway Neurology, anything that happens during your time with me is included: you are paying for my time, expertise, skill, attention, and compassion. Because forms typically require more time beyond the visit, I do charge extra for forms (e.g. FMLA, disability insurance, etc.). The charges likely are more than what you have paid for if you pay your primary care provider directly because I am a specialist and give you more of my time. Everything is transparent; there are no hidden fees.

One useful financial strategy to consider is to plan ahead and set aside money for visits with me at Headway Neurology in a Flexible Spending Account (FSA), Health Savings Account (HSA), or Health Reimbursement Arrangement (HRA), ideally tied to a credit card or debit card for easy payment processing.

One limitation of this practice model is that I cannot bill patients on Medicare or Medicaid directly for my services. However, if you are covered by one of these plans, you can have someone else sponsor your visit to Headway Neurology by covering the cost of the visit (or covering part of the cost if you are eligible for a Headway Neurology scholarship).

Please see the fee schedule below to see the current charges for each service. The optimal process is to pre-pay for your visit for a lower charge via credit or debit card online. Otherwise, you can pay by cash, check, credit/debit, or via electronic pay methods (Apple Pay, Google Pay, Cash Pay) in person at the start of the visit, but this may take up part of your visit duration. 

Question: What should I expect when I come to Headway Neurology?

Lester: First, I hope that the experience is enjoyable. I want you to have a visit that is relaxing and comfortable, almost as if you were visiting a neighbor's home. You will notice when you drive into the large driveway that there will be multiple available parking spaces on the right. When you walk from the driveway to the entrance of Headway Neurology (unit #1) between the house and the garage, you will be greeted by blooming flowers, bird song, and a gorgeous Japanese maple tree (if you visit during the spring or summer). When the weather is nice, feel free to walk around the fenced-in yard or relax in one of the chairs on the covered deck if you arrive well in advance of your appointment. There are five steps from the ground to the deck, so please use the railing or have someone assist you up the steps if you need it. Otherwise, you can ring the doorbell when you are ready to come in. I will greet you at the door and guide you to the waiting room. If you would like some water, I can get some for you from the kitchen. There is a bathroom connected to the waiting room if you need it. Once I am ready to see you, I will guide you to one of the clinic rooms on the first floor. The rooms are large, have lots of windows, and are air conditioned and heated. The neighborhood is relatively quiet, except briefly when the school day ends (at which point you may hear the sound of children and their parents chatting as they walk along the sidewalks).

There are no examination tables. I will be there with a computer and a few neurological examination tools. During the portion of the visit that involves a neurological exam, I will examine you while you are seated. You will not be expected to remove any clothing, except maybe your orthotic (if you have one) and shoes. As such, please wear loose clothing if possible so that I can examine the tone of your muscles, reflexes, and check your blood pressure (if needed). 

I do have to take some notes on the computer during the visit so that I can quickly get the clinic note to you. In general, I will address all of the notes to you in language that I will help you understand, not your other health care providers. If you would like me to send the note to another clinician, please provide me with their name, facility, and fax number. 

Following the visit, I will electronically provide you with the clinic note and an invoice for the services provided. If desired, you can submit these to your insurance carrier for Out of Network provider reimbursement. I cannot guarantee that your insurance carrier will honor the request and reimburse the services.

Question: What should I bring to my visit?

Lester: Here's a brief checklist:

1. Comfortable, loose clothing - to make it easier for me to examine the tone and reflexes in your arms and legs, check blood pressure, etc.

2. Payment means - if you did not pre-pay for the visit, please bring sufficient cash (exact amount), a check, or the credit/debit card you intend to use.

3. Imaging scans on a disc - If this is your first visit (or a follow-up visit where you had a recent scan), please go to the Radiology department of the hospital or facility where the scan was performed that identified your stroke and ask for your brain and blood vessels scans on a CD/DVD. Bring that disc to the appointment. The scan types may be called:

   1. CT Head

   2. CTA Head and Neck

   3. MRI Brain

   4. MRA Head

   5. MRA Neck

   6. Diagnostic cerebral angiogram

   7. Carotid ultrasound

   8. Transcranial doppler ultrasound 

4. Relevant medical records - if there are any notes, reports, or laboratory tests that you would like me to review, please bring them with you to the visit, securely email them to me at lester.leung@headwayneurology.com, or fax them to me before the visit at (888) 374-8786. If you provide me with the name of the hospital/practice and the dates when you received care in advance of our visit, then I will send a request to obtain those records at no cost to you.

5. Company - You are welcome and encouraged to bring partners, family members, or anyone else who is supporting you in the recovery journey. If you have young children (including babies), it is perfectly fine to bring them along. If you do not speak English (well or at all) but have a partner or family member who can effectively translate (i.e. is fluent in English and your language), I would be happy to see you.

Question: Is Headway Neurology wheelchair accessible?

Lester: Yes! There is a ramp from the ground level to the deck and then a shorter ramp from the deck to the entrance to the interior of the clinic. If you are coming to this visit via wheelchair, please let me know in advance so that I can prepare the ramps.

Question: Is Headway Neurology accessible to people who do not speak English?

Lester: I am only fluent in English. However, if you have a partner, family member, or caregiver who accompanies you to the visit and is bilingual with fluency in English, than I would be happy to see you. I am experienced with simplifying medical terms and making translations as easy as possible in my work with interpreters.

Question: Do you provide telemedicine visits?

Lester: In limited circumstances, yes. The nature of the care that I am providing is better face-to-face. However, telemedicine can be requested as an option under certain circumstances including (but not limited to):

• Either you or I have symptoms of an infectious illness (e.g. the flu, COVID, etc.).

• Other life circumstances has made it difficult to obtain transportation to Headway Neurology.

If one of these circumstances emerges, please notify by email as soon as possible.

Question: Can my visit at Headway Neurology be paid for by someone else?

Lester: Yes. You can have someone sponsor you to receive care at Headway Neurology. Your sponsor (e.g. partner, family member, friend, etc.) can pre-pay for your visit after filling out this form here.

Question: What is a Headway Neurology scholarship?

Lester: An early adopter patient of Headway Neurology kindly raised money through a fundraiser to help stroke survivors access services at Headway Neurology. The fund has a limited supply, but it is intended to partly cover the cost of visits to Headway Neurology, especially for people who have Medicare or MassHealth (Medicaid) for medical insurance coverage or who have limited financial means. In order to apply for the scholarship, please email me to express your interest and provide a brief explanation of your medical need and financial limitations.