Please review the following so you are aware of the policies of my practice and contact me with any questions. 

Initial Consultation: Our first visit will be a consultation for the purpose of evaluation and assessment. At the end of the evaluation, I will offer some first impressions of what our work might include: a treatment plan, lab-work, considerations regarding psychotherapy, medications, and holistic approaches such as lifestyle modifications or nutraceuticals. You are welcome to use this information to make your decision as to whether you would like to pursue further treatment with me. If you do not feel comfortable working with me, or if I do not feel that I am able to help you for any reason, I will attempt to assist you with referral to others who may be able to meet your needs.

Confidentiality: Our sessions are confidential and what we discuss may not be revealed to anyone without your permission except where disclosure is required by law. Disclosure may be required where there is a reasonable concern of: 1) danger of harm to yourself or others, 2) suspected elder or child abuse or neglect, 3) grave disability, or 4) in the case of a legal proceeding. In the case that another person is paying for your treatment, that person will not receive any confidential information about your care without your explicit written consent. In certain cases I may find it helpful to consult other professionals about your case; however, neither your name nor any identifying information about you will be revealed.

Follow Up Appointments: Regular follow-up appointments are required in order to ensure good care. Follow-up appointments are scheduled for either 50 minutes or 25 minutes depending on the complexity of the issue and whether we are setting aside time for psychotherapy. If you miss or have to cancel an appointment, please reschedule within 30 days of that appointment. If there are 90 days without communication from you after a cancelled or missed appointment, I will assume you are receiving your care elsewhere and administratively discharge you from my practice. Please be aware that once discharged, I may not be able to accept you back into my practice should you desire to follow up with me in the future.  Re-establishment of care may require a full assessment to assure that adequate time is allowed to gather information regarding your progress since your last regularly scheduled appointment.

Medication Refills: Medication refills will be sent electronically to your pharmacy. Refills are typically sent during scheduled appointments, but as long as you are presenting for regularly scheduled appointments at a minimum of every three months I can provide medication refills between appointments should the need arise. Please allow three business days for me to respond to refill requests.  If you have not been seen in over three months, you will need to schedule an appointment to obtain a refill.  Please be aware than when prescribing medications for my patients I will routinely check medication prescription history via available platforms, including centralized databases such as PMPs, in order to ensure good care.

Controlled Substances: With the current setup of the practice being telehealth, I do not currently prescribe any controlled substances.  In the case of a future event where I move to a physical office space allowing full in-person examinations, I may prescribe controlled substances (such as benzodiazepines or stimulants) as part of care. It is important to take these medications as prescribed, and not to increase or change your dose without specifically discussing any change with me. In the case that you change your medication dose on your own and run out early, I will not provide an early refill and you may experience withdrawal symptoms.

Prior Authorizations: Most medications prescribed are covered by insurance, but insurance companies sometimes require prior authorizations for certain expensive or brand name medications. I can not guarantee a medication will be covered by your insurance, but I will do what I can to make it as likely as possible by submitting medical justification to your insurance company should they need a prior authorization. This can be a process with a lot of time involved, so I bill for it at the rates indicated below.

Contact & Follow Up: I am available by phone or email during business hours. I will return messages in a timely fashion, typically within 48 hours. If you need assistance more urgently, please go to your local urgent care. In case of an emergency, please call 911 or go to your nearest emergency room. A messaging system is available for appointment reminders but should not be used for complex inquiries.  Should you opt into SMS messaging, you may reply "STOP" at anytime to be removed from messaging.  I am not available during evenings or on weekends. 

Cancellations and Missed Appointments: Appointment times are specifically reserved for you, so it is important that you are on time. If you are late, your appointment will still conclude at the end of your scheduled appointment, or your appointment may have to be forfeited. Should you need to cancel, please do so at least 24 business hours in advance. Business days are considered weekdays, and exclude holidays. Cancellations made with less than 24 business hours notice, or missed appointments, are charged the full appointment fee. For example: an appointment scheduled for 2 p.m. on Monday must be cancelled by 2 p.m. on Friday to avoid incurring a fee.

Email Communication: I am available to communicate with patients via email during business hours as a convenience.  Email is not always considered a completely secure method of communication by way of improper email addresses or improper storage or transmission. I do not receive emails after hours, on the weekends, or on vacation. In the case that I am on vacation, I will have a colleague providing coverage for me. Complex clinical questions should only be discussed during appointments as opposed to over email.

 

BILLING AND PAYMENT POLICY

 

Billing and Payment Policies: Payment is expected at the time the service is provided and will automatically be billed to the credit card on file after your appointment.
 

Fees Structure:
Billing for appointments:
Initial Psychiatric Assessment: 90 minutes, $585
Focused Follow-Up Sessions: 25 minutes, $175
If the last appointment was over 3 months previous, a 50 minute follow-up appointment is required: $345
Multi-faceted Follow-Up Session: 50 minutes, $345
Multi-faceted Follow-up Session (If the time since last appointment is over 3 months): $445
If the last appointment was over 6 months previous, I request another psychiatric assessment to re-establish care: 90 minutes, $585

Late cancellations and missed appointments are billed at the rate of the scheduled appointment. Fees are subject to increase on an annual basis. You will be notified in advance of any fee increases.

Fees for services between appointments:
Clinically-related services provided between scheduled appointments are billed at the rates listed below, although for brief or limited services (less than 10 minutes), fees are generally waived. Note: Non-clinical phone, email, or text contact (such as schedule or billing questions) are not subject to fees.

Paperwork such as letters, forms, or prior authorization paperwork:
Time spent preparing medical records to transfer between providers: $70 per 10 minute increment.
(Please be aware that you have a right to request a copy of your own medical records at any time, although I require we set up a follow up appointment to review and discuss your records prior to releasing them to you). Charges are based on the fees allowed by Colorado Revised Statute Title 25. Health § 25-1-801.

Phone calls with family members or other providers and clinical questions answered over email: $70 per 10 minute increment

Specific lab testing
Discussed during our sessions and ordered as clinically indicated based on your symptoms and needs.
Basic lab work: Cost of lab testing  - varies based on labs ordered but often can be billed to insurance (copay may apply).
Previous Labs Review Fee $75

Insurance Coverage: I am not in-network for any insurance panels, including Medicare, and am considered an “out of network provider." While I do not contract with insurance companies, I do provide a "superbill" that you can submit to your insurance carrier for possible reimbursement. Please be aware that your insurance provider may not reimburse you for any, or may only reimburse you for a part of, the charges for my services. Insurance companies generally do not reimburse for administrative services or missed appointments. I am not able to negotiate or submit claims with insurance companies.

Under Section 2799B-6 of the Public Health Service Act, out of network providers and healthcare facilities are required to inform individuals upon request or at the time of scheduling healthcare items and services for out-of-network services, a "Good Faith Estimate" of expected charges for the year.  During treatment planning of the initial assessment, we will discuss recommended a recommended follow-up schedule that will allow calculation of a good faith estimate.  

Limits of Service: I do not provide worker's compensation evaluations, forensic evaluations, or provide legal services or testimony.  I do not provide disability evaluations. Should you require legal testimony at some point during your treatment with me, you will need to retain an independent forensic psychiatrist.