Ph: 646-812-5355 Fax: 844-888-8981
Mindfulness Based Therapy and Psychopharmacological Treatment.
Welcome to my practice and thank you for choosing me! When you have confirmed an appointment with me, please mark this important date on your calendar, as I look forward to seeing you at that mutually agreed upon time, as this time has been reserved especially for you.
The purpose of the initial consultation is to get to know one other, to discuss my diagnostic impression and to work together to establish a preliminary treatment frame and plan. Payment for the comprehensive psychiatric evaluation and admission to the practice is required at the time of booking in order to ensure attendance and to confirm your slot. At the conclusion of the consultation, if we agree we are a good fit, we then establish a formal doctor-patient relationship and agree on fees and frequency of future appointments. If I find that I am not able to meet your treatment needs or that you require a more specialized care, Patient-Provider relationship will not be initiated in that case and I will be happy to provide some referral source for the same.
My practice is a fee for service model. I am credentialed with Aetna insurance only. If you have any other insurance, please check with your policy, as you may have an out-of-network benefit. If so, you will directly pay me, and I will provide you with an invoice (super bill) and receipt that you can send to your insurance company for any available re-imbursement. Out-of-network benefits typically pay 50-70% of fees, after an annual deductible is met, but please check with your insurance plan about your particular rate of re-imbursement.
You can pay by quick pay/Zelle, cash or credit card. But I require each patient to keep a credit card on file, which will be charged at the time of service if other preferred mode of payment is not chosen.
Patient Cancellation Policy:
It is understood that some cancellations may be inevitable. So, should such a situation arise for you, please take the time to call and cancel your appointment no less than 24 hours in advance of your previously scheduled appointment time. Otherwise, the time you have booked cannot be scheduled for another patient and you will be automatically charged the full fee for the missed session.
All appointments will start and end as scheduled. In case you arrive late you will be seen for the remaining time available for your appointment. If you arrive more than 15 minutes late for a medication visit or more than 30 minutes late for a therapy visit, you will be asked to reschedule so that an appropriate amount of time and attention may be devoted to your care. You will be charged the full fee for the missed session. Please make an effort to call and inform if you are running late and would like the provider to wait for you (schedule permitting) for the reasonable amount of time.
As per NYS law all prescriptions are transmitted electronically. If possible, bring the information of your preferred pharmacy and obtain a price list/preferred medication list from your prescription drug program to minimize costs to you. I bill at my hourly rate for time spent seeking authorizations from prescription benefit plans.
Once your medication management is optimized and you achieve satisfactory symptom control without any medication changes for the 2 consecutive follow up visits I will be happy to provide you with medication refills.
In order to continue receiving treatment under my supervision you will need to be seen for a follow up appointment and reassessment at least once every 90 days. Any patient not seen in the office for more than 90 days is not eligible for any kind of medication refill.
Controlled Substances Prescriptions and Refills:
Prescriptions for federally controlled substances (DEA) require office visit. You will only be given up to a maximum of 30 day supply of these medications and any refills require an office visit.
All patients may contact this practice at all times via e-mail at email@example.com or via phone 646-812-5355 during the business hours 8 AM- 7 PM Monday to Friday for administrative contact, scheduling or refill purposes. You may choose to leave a voice mail if you prefer. Reasonable effort will be made to return all e mails and phone calls as soon as possible however please allow up to 2 business days for the office to respond. Please be aware that you should not use e-mail for complicated medical and/or psychiatric concerns or urgent/emergency situations. Please use caution when transmitting information you wish to remain strictly confidential via email and other electronic means.
I will charge your credit card for unscheduled calls or emails regarding clinical care outside of appointments, pro-rated based on your appointment fee for the time of handling your call. Phone calls before 8 AM and after 7 PM on weekdays and anytime on holidays or weekends will incur an additional $50 charge per call.
Legal matters that require opinion or testimony of a mental health professional are not in the scope of this practice. You are advised to obtain independent forensic psychiatric services if you may require this type of evaluation, opinion or testimony.
Tele Psychiatry (Video Conferencing services):
HIPPA compliant video session platform available now for initial and follow up visits on case to case basis after establishing doctor-patient relationship.
If it is an emergency and you feel a threat to yourself or others or have a medication reaction, please call 911 and or go to the nearest hospital’s emergency department for immediate care. You may provide my contact info to the emergency treatment team to help further your care optimally. If possible, leave me a voice message after your safety has been established. this practice is unable to provide urgent or emergent care and is beyond the scope of this practice.
I will not reveal to any third party any information about your treatment without your explicit consent in writing. Third parties include other physicians, family members and insurance companies, among others. Only in emergencies might I waive this privilege. Please be aware that I am mandated by law to report any suspicion of child or elder abuse that may arise in the course of my professional practice.
Access to Your Chart:
Your medical record is your property, and you have the right to obtain copies at your request. I charge a nominal fee of $75 to cover the cost of reproduction.