Initial Intake and Fit
Our first appointment together will be your intake session, typically lasting 60-90 minutes. There are many tasks involved at this session, balancing development of a treatment plan for your current issues with exploration of a comprehensive background assessment including your psychiatric history, medical history, family background, substance abuse history, and personal history (relationship status, employment history, education, upbringing, etc). On rare occasion this intake may need to extend into multiple sessions such as when diagnosis is less certain and more history is needed, or when the treatment plan is exceptionally complex.
At the conclusion of the intake if it is mutually agreeable we will collaborate together on a treatment plan, and schedule follow up appointments, initiate medications, etc. If either party feels there is not a good fit between us, we will part ways at that point with no further therapeutic relationship.
Given the sensitive nature of this kind of work fit is very important. In my experience, poor fit within the therapy relationship is almost certain to end in treatment failure as it becomes difficult to share and explore deep spaces without a healthy and trusting patient-therapist connection. Fit is a two way street, and requires both you and I to share this connection. To that end, patients may terminate treatment at any time for any reason, ending our relationship immediately. Similarly, I may terminate treatment with you at any time for any reason; in these instances I will offer you 30 days of additional coverage as well as assist you with referrals while you establish alternative care with a different provider.
If we decided to pursue treatment together I will meet with you regularly. If psychotherapy is indicated we will typically meet once a week for 45-60 minutes, though frequency and length of treatment can vary. For medication management (without therapy) sessions will typically be 30 minutes. When first initiating treatment we will meet more often, as starting new medications is complicated work in psychiatry and not as straightforward as it is in many other medical specialties. Upon reaching a place of stability with your mental health we are generally able to smoothly transition to meeting on a quarterly basis for routine follow up care. An exception to this rule is that we will meet on a monthly basis when controlled substance prescriptions are required due to the strict DEA/FDA regulations that supervise these classes of medications.
It is a requirement of my clinic that we do not go any longer than 3 months between appointments as I do not want to lose touch with you and the changes and challenges life may bring. This means that I do not schedule routine follow up appointments for only once or twice a year. Every patient in my clinic always has an active future appointment scheduled. The size of my clinic is intentionally quite small for this reason (less than 75 active patients at any given time); I want to actually get to know you and cultivate a long term relationship. I can’t do that if I have a clinic that is hundreds of patients large, a fact which is commonplace these days in many other practices.
There are other important clinic policies as well; I will email them to you for your review and our discussion prior to our initial appointment. This will allow us plenty of time to process any questions you might have.
Billing & Insurance
.My practice, like many in DC, does not accept insurance and is fee for service only, meaning all payments are due at the start of every session. I accept cash, check, HSA, Venmo, and all major credit cards. There is an additional fee when using a credit/debit/HSA card (to directly offset the fee charged by the credit card merchants). Additional information regarding billing and fees will be provided to you in writing before our initial intake appointment.
I do not participate in Medicare.
I will provide you with an invoice for each session that you may submit to your insurance company for reimbursement, typically within 24 hours of our appointment. I regret that I cannot directly assist you with the reimbursement process, though I will be happy to give you the information regarding the procedure codes and other billing information your insurance company might need ahead of time if you wish to get an idea from them about what your out-of-pocket reimbursement for a typical session would be.
Regarding the No Surprises Act of 2022: I provide, in writing, each prospective patient at the time of initial evaluation for mutual fit with documentation that includes a specific breakdown of my rates/fees by type and length of appointment. All questions will be answered to the best of my estimation before treatment begins, and can be most fully answered at the completion of the intake process when the treatment plan is developed.
Cancellations must be made at least 21 days in advance of your next appointment. If you are unable to provide this advanced notice, or do not show for a scheduled appointment, you will be responsible for the cost of the session in full (or, in the case of an initial intake appointment, you will be charged a cancellation fee). Please be mindful that insurance companies generally do not offer reimbursement of any kind for missed sessions, nor late fees. No exceptions will be made to this policy.