Keeping Your Costs Down
(original 2003; revised 9/2004)

Here is a list of services which may be charged at the per-minute rate, and some ways to keep that time down.  Remember also that you can send information in advance before your visits here, which is a very efficient way to use time.  

#1. Questions or concerns between visits

1. It's an emergency: no charge. 
2. It's some minor logistics problem I caused: no charge. 
3. Write an email. 
4. Avoid voicemail: it's slow, and a written note has to be composed afterward reflecting both what you said and what I said in reply.  
5. Make an appointment.   I'll keep extra appointment times available for this, and if necessary, we'll get you in somehow.  

#2.  Avoiding prescription refill charges

1. Keep track of when you'll need another set of refills, and get them during a scheduled visit (generally there is a reason why your refills will run out:  I either need to see you or need a lab test or something like that). 
2. Call the pharmacy, have them contact me:  it's quicker if I do this through them.  This will still cost you a by-the-minute charge, however, so (a) above is much better.
3. Stop taking the medication until you have a problem: very bad idea.  At the very least you should send an email indicating you're thinking about this!  I'm always willing to look at whether you really need to continue a medication.  If in doubt, schedule an appointment.  

 #3.  Rescheduling established appointments.

Most psychiatrists charge for missed appointments.  I don't, unless this is a recurring problem.  If you need to reschedule frequently, I'll just charge you for the time it takes to do so.   

#4. Laboratory and other data management

1. We can decide how detailed we want your records to be.  If we're watching your thyroid tests over time, for example, it makes things efficient to have a "flow sheet".  When we're not watching closely, it may be more efficient to look at results only when they arrive.  
2. Ask the lab to send you a copy of your results (the lab slip will authorize this in advance). Make your own flow sheets and bring in a copy. 

#5. Preparation of reports

Some people need these, some don't.  If you need one, and can prepare as much of the information as possible (e.g. lab reports, progress notes, medication records)  yourself, that helps shorten my time required.  

#6. Insurance company review 

Insurance companies want information frequently.  If you're in charge of sending it, you'll know just what they're getting, and also keep your costs down. 

1. Use your copy of your medical record for this. 
2. When your company requests information to "authorize sessions", you can complete much of that form, with some guidance from me.  

#7. Negotiating with your insurance company

If you have difficulty getting your insurance company to reimburse you please let me know.  Until they are responding to the receipts you're sending them with a check to you (this takes at least a month in most cases), I won't charge you for time spent trying to get them to do what they're supposed to do.