Initial Evaluation
New clients and those who have not had an appointment in the past year will be scheduled for this type of appointment, which typically lasts 60-90 minutes. This assessment is rather detailed and is intended to clarify the onset and nature of the current problem as well as identify physical, situational, and psychological factors that may be affecting it. Because of how closely related physical and mental health are, I ask that you bring or have your doctor fax copies of recent lab tests. Following the information gathering portion of the appointment you and I will work together to set treatment goals and make a plan to help you reach those goals. This plan may include medications, behavioral strategies, therapy and/or referral to other specialists. My fee for this comprehensive assessment and treatment planning visit is $250-285.
Follow Up Assessments
These appointments are extremely important. At each appointment, we will check progress toward your treatment goals, review teaching points and coping skills, discuss any new questions or concerns, and revise our goals and treatment plan as necessary. These appointments are generally 20-30 minutes long, but can be as long as 60 minutes, if a client is experiencing new or more severe symptoms, has many questions, or if counseling is provided. I do my best to give each client the time that they need, but if you think you may need more than 30min, please call the office and ask for a longer appointment. Follow up assessment fees vary from $100-200 and are based on appointment length, severity of symptoms, and the type of service provided. I follow guidelines set by the American Medical Association to select the appropriate procedure code for each appointment.
Prescriptions
Prescriptions will be written with enough refills to last until your next appointment. I recommend scheduling your next appointment at the end of each session, so that we can be sure you are able to come in before you run out of medication. My strict policies primarily reflect my concern for my clients' well being. Self assessment of psychiatric symptoms can be difficult, and requires quite a bit of practice and feedback, especially early in treatment.
If you forget, or are unable to come in prior to running out of medications, please have your PHARMACY send me a refill request and call the office to schedule an appointment. Please note that these requests will incur a $25 fee, and may take up to 2 business days to approve the request.
Medications such as benzodiazepines and stimulants are tightly regulated by the DEA. These medications can be extremely useful, but require more monitoring and must be part of a comprehensive treatment plan. If you do not stick to the agreed upon treatment plan, I will continue to work with you, but will not continue to prescribe controlled substances.
Please note that I do NOT authorize early refills for controlled substances. Please keep your paper Rx and medications in a safe, secure location because I cannot replace lost, damaged, or stolen prescriptions.
If you forget, or are unable to come in prior to running out of medications, please have your PHARMACY send me a refill request and call the office to schedule an appointment. Please note that these requests will incur a $25 fee, and may take up to 2 business days to approve the request.
Medications such as benzodiazepines and stimulants are tightly regulated by the DEA. These medications can be extremely useful, but require more monitoring and must be part of a comprehensive treatment plan. If you do not stick to the agreed upon treatment plan, I will continue to work with you, but will not continue to prescribe controlled substances.
Please note that I do NOT authorize early refills for controlled substances. Please keep your paper Rx and medications in a safe, secure location because I cannot replace lost, damaged, or stolen prescriptions.
Cancellation
My goal is to help as many people as possible to not just live their lives, but thrive. To do that, I must be efficient with my time and minimize unplanned downtime. Except in extreme emergencies, there will be a fee of up to the full cost of the appointment for cancellations made less than 24 business hours in advance. Please note that most insurance companies will not reimburse for missed appointments and you will be responsible for payment.
Phone and Email Communications
Phone and electronic messaging cannot replace face to face interaction. In certain situations, they can be useful for quick questions. I rarely make medication changes outside of an appointment. I check my email, EHR messaging center, and voicemail daily M-F. I will do my best to respond within two business days, but urgent messages should directed to the office during normal business hours. If you are in crisis, and cannot wait until the next business day for a response from me, please call the King County Crisis Line at 1-866-4-CRISIS, go to the nearest ER, or call 911.
Phone and email communications requiring more than 15 minutes will incur a $25 charge that is generally not reimbursed by insurance companies.
Please remember that while I take precautions to protect your privacy, there are security risks inherent to email communication. Please choose what you include in email with this in mind. Messages sent through the electronic medical record system are secure.
Phone and email communications requiring more than 15 minutes will incur a $25 charge that is generally not reimbursed by insurance companies.
Please remember that while I take precautions to protect your privacy, there are security risks inherent to email communication. Please choose what you include in email with this in mind. Messages sent through the electronic medical record system are secure.
Completion of Forms
When possible, forms and other requested documentation will be completed in the appointment. In the event that this must be done outside of appointment time, due to scheduling or extensive documentation requirements a fee will be charged. That fee, typically $25, is not generally reimbursed by insurance companies. Higher fees may be assessed for lengthy forms.
Release of Records
Because of the highly sensitive information included in psychiatric chart notes, I release notes in certain circumstances, and following a specific procedure. Federal privacy laws allow me to communicate essential information with other members of your treatment team. I do this only when it is important to your health and safety, and usually talk directly to other providers in a telephone consult, or by sending memos or treatment summaries.
With your written and signed permission, I will provide copies of my notes to other providers free of charge as a professional courtesy. Records will only be released directly to you after we have reviewed them together in my office. There is a $75 fee for this 30-60min appointment, that is not typically reimbursed by insurance companies. In certain situations, I am legally permitted to refuse to release some or all records directly to you.
With your written and signed permission, I will provide copies of my notes to other providers free of charge as a professional courtesy. Records will only be released directly to you after we have reviewed them together in my office. There is a $75 fee for this 30-60min appointment, that is not typically reimbursed by insurance companies. In certain situations, I am legally permitted to refuse to release some or all records directly to you.
Legal Services
Please note that I do not do psychiatric evaluations to determine disability status, or evaluations that are court mandated, or for use court cases, including child custody cases. In the event that I am subpoenaed and must appear in court or communicate with members of your legal team, I will bill an hourly rate as well as an additional fee if this activity interrupts my ability to care for other patients. Please contact me for more information.