GENERAL INFORMATION

(Effective January 2013)

APPOINTMENT HOURS:

Please call 585-256-1105 for an appointment. Telephone messages can be left anytime, 24 hours a day.

CONFIDENTIALITY:

In general, all communications between patient and doctor are privileged and confidential. Exceptions:
Insurers often require information about your diagnosis, prognosis, medications, treatment plan, etc. You will need to sign a Release of Information form for these situations.:

• Imminent risk of physical harm to yourself or others (suicidal or homicidal plans, inability to function). I may need to involve family members or authorities to ensure safety.
• Confidentiality does NOT apply if you are in the hospital emergency room for risk assessment or in the hospital about to be discharged from inpatient care.

E-MAIL:

Sometimes I send information of general interest to patients during his or her visit from a Yahoo! address. However, please use only the @frontiernet.net address for personal/confidential information. There is NO guarantee that this information will be confidential, especially as other members of your family, employers, and/or co-workers may be able to access your account. If there is something you want me to see immediately, please leave a message on my office phone, as I don’t check office e-mail every day. If related to care and treatment, e -mail to and from me will be considered part of your medical record. Please use e-mail only for previously discussed symptoms or complaints, and not related to sensitive information such as STDs, sex-related, and/or substance abuse treatment. I cannot provide medical advice, diagnostic test results, or respond to lengthy or complicated messages.

EMERGENCIES:

If you are unable to reach me immediately, go to the hospital emergency room closest to you by any appropriate means (e.g. driving yourself, having a family member or friend drive you, or calling 911 for an ambulance), depending on the nature and severity of your condition.

EVENINGS AND WEEKENDS:

For urgent questions that need to be addressed before the next business hours, try to reach me through my home office or alternative phone number in Rochester.

HOSPITAL ADMISSION:

The need for inpatient care occurs rarely in my practice. If and when the need arises, I will help facilitate your admission. I will NOT be the inpatient admitting/attending psychiatrist, but am willing to coordinate your admission and discharge care with the hospital staff.

MEDICATIONS:

Please bring up your prescription needs at the beginning of your appointment And schedule your next appointment so that you will not run out of your medications.

No refills of controlled substances sooner than the expiration date of your last prescription!

PAYMENTS:

Fees vary by insurance. My normal and customary rates range from $75 (simple med management) to $300 (new patient initial evaluation). Fees now include an evaluation and management medical fee in addition to psychotherapy. You may request a complete listing of these fees.

Aetna and Excellus: IN-network. You are responsible for your co-pay only. IF you have a deductible plan, you must pay the fees listed until your deductible payment is met.

All other insurances: OUT of network. Unless you have obtained a single case agreement, you must pay the fees listed. You may then submit your bill to your carrier.

Full payment or co-payment or entire amount is due at the time of service by cash or check*. Failure to do so may result in a service charge of $20. Returned Check Fee: $30 plus bank charges.

Honor your commitment to your own healing and our therapeutic relationship through prompt payment of your fees.

Late cancellation, no shows and/or out of office (not face to face) medication and psychotherapy services are NOT billable to insurance. You are responsible to pay the entire normal and customary fees yourself, just as you would if uninsured.

UNPAID BALANCES:

Patients who owe me a co-pay or the entire amount (if self-pay) for more than one past visit cannot be seen again until that bill has been paid. Balances must be paid at least $25 per month. A 15{dc23547e179066457f4e2a54e39fc4765a04ef7e29f700860738b24e2c573c4e} annual interest rate will be charged on accounts over 30 days past due. Balances over 90 days with NO payment are sent to collection.

REPORTS:

You may request that a draft be sent to you so that you can make any necessary changes. You will automatically get a copy of these consultations, either addressed to the referring person, “To Whom It May Concern,” or entitled “Psychiatric Evaluation” for your own records only. For more than minor changes, see the section other billable situations above. If I have not heard back from you within 2 weeks of my sending the draft, the final copy is sent out to you and anyone for whom you have signed a Release of Information form. NO reports can go to anyone else without a specific signed agreement, with the exceptions stated under Confidentiality above.