Keeping Your Costs Down

Here is a list of services which will 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.  Note that this will use up one of your insurance-paid sessions, unless you choose to use a Pay-for-what-you-use approach, billed by the minute, and thereby save your insurance session for something longer. 

#2.  Prescription refills

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.  Instead, I'll just ask you to pay for the time it takes me to reschedule one, either before you miss it, or after.   

#4. Contact with your primary care provider as needed

1. Take a copy of each visit's record from me and send it to your primary care doc's office. 
2. Keep a copy, paper or electronic -- I can provide both easily --  for your own records.  Then when some doctor or insurance or someone wants a record, you can send it without involving me. 

#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.  
3. We have to scan paper into your record; electronic documents we have to virus-scan.  By 2004 I hope to have a means of sending information from this website, so no further scanning would be needed.  

#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

We'll see, using this new system, how much negotiating is required.  For patients moving with me from Samaritan Mental Health, I will provide this service for free until 2004.  We ought to have things working pretty smoothly by then.