Call our office to make an appointment OR book a tentative appointment online.
Our staff will talk to you by phone to:
TELL YOU MORE ABOUT THE PRACTICE
1) We will answer all of your questions about the practice and fees;
2) We will get some info about you and your situation to determine whether our practice may right fit for you, at least for an initial evaluation. We do not turn anyone away based on financial need, provided that we deem that the patient is an appropriate fit in terms of obtaining sufficient benefit from our services. To be able to sustain this model, we reserve financial assistance only to individuals or families who lack the resources to otherwise obtain high quality care. In these cases, fees are set by our office manager who will work with you to find a fee that is not negligible to you, but manageable, such that we work together in a collaborative spirit where we feel both parties (you and the practice) are investing significantly into your treatment.
3) We will guide you on which questions to ask your insurance company (upon your request). Most of our patients with good out-of-network benefits receive 60-100% reimbursement of our fees.
4) We will determine if you, or your referring doctor, would like to speak to the clinician with whom you are scheduled. If yes, please let our staff know so we can set up a time for that communication.
SET UP YOUR FIRST APPOINTMENT
1) We will help you decide which clinician to schedule your initial evaluation with. At our practice, we have one Psychiatrist, three Psychiatric Mental Health Nurse Practitioners, and two Psychiatric Registered Nurses, all of whom see patients regularly.
2) We will schedule your initial evaluation based off the clinician that you choose. You can schedule a 90-minute initial evaluation with a Psychiatric Mental Health Nurse Practitioner or a Psychiatric Registered Nurse. Our Nurse Practitioners can work independently without our Psychiatrist and can write prescriptions, and our Psychiatric Nurses are always paired with a clinician who supervises them. If you would like to initially meet with our Psychiatrist, you can schedule a 45-minute consultation; after the consultation, you will be paired with a Nurse Practitioner or Psychiatric Nurse for a 60-minute consultation follow-up, and if it is the right fit, you would be seeing this clinician for any future follow-ups. Because our practice likes to work together as a team, even when seeing a clinician aside from the Psychiatrist, the Psychiatrist could still be involved in your treatment.
- For most adults, the above typical intake format is sufficient.
- If the appointment is for a young child, we will typically split up the 90 minutes into two 45-minute sessions, one with just parent(s) and one with just child, while other party waits in reception area. It may make sense to schedule these two 45-minute sessions on different days; regardless, a 45-minute follow-up session with parent(s) will be scheduled after the initial 90 minutes to discuss assessment and treatment recommendations in depth.
- If the appointment is for a teenager,we will typically split up the 90 minutes into two 45-minute sessions, one with just parent(s) and one with just teen, while other party waits in reception area. Initial assessment and treatment strategies may be briefly mentioned in this 90-minute session. It may make sense to schedule these two 45-minute sessions on different days; regardless, a 45-minute follow-up session with parent(s), with or without teen, will be scheduled after the initial 90 minutes to discuss assessment and treatment recommendations in depth.
First Appointment Procedure
What should I complete before my first appointment?
Complete the two forms that were sent to you via the confirmation email and fax any other clinical information you want your clinician to review before the appointment. If indicated, we can call other involved clinicians before this appointment. If not, we will call them after intake to either pass on recommendations or to collaborate going forward.
What happens during the first appointment?
We tend to treat appointments as extended conversations or discussions. We want to get to know you as a person as well as the health reasons that have brought you in. Often, we will let you begin wherever you would like, but we will keep in mind what needs to be covered during the session, and so will redirect you if needed and will ask any other specific questions we have. Towards the end of the session, we reserve some time for a discussion. We will present to you which treatment options exist, let you know the benefits and risks of each option, and then will talk with you to find an option that best fits your needs and concerns. If medications are warranted, in most cases, medicines are not prescribed on the first visit and a follow-up is required where medication is discussed in depth before prescribed.
What happens after my first appointment?
SCHEDULE A FOLLOW-UP
You and your clinician will schedule a follow-up appointment to complete your consultation and recommend the best course of treatment for you. If you will not be continuing in our practice, we may still meet an additional time to discuss treatment options in depth. We will also speak to your ongoing doctor (if you have one) to pass on our assessment and recommendations. In cases where you would like to continue with your current MD, but would like to see us for expert consultation on an infrequent basis, we are happy to collaborate with your MD and pass on our ongoing recommendations. This is most common in cases where patients are travelling quite a distance to get to our office, or when patients have an ongoing relationship with another doctor and it’s not in the patient’s best interest to transfer care.
RECOMMEND COURSE OF TREATMENT
After the initial evaluation, your clinician will make a recommendation for the best course of treatment for you. This means we can work together in at least four possible ways.
- Psychotherapy: Typically, appointments are once weekly (but could be twice weekly) as less than this tends to be insufficient. If your goals are met, but you would like to continue for maintenance sessions, you may speak to your clinician to request adjusting the frequency.
- Psychotherapy and Medication Management: All of our clinicians are trained to work with you in psychotherapy, while also managing medications simultaneously during treatment. Appointment frequency is same as that of psychotherapy sessions.
- Medication Management: If you choose to include medication as one of your treatment strategies (lifestyle/behavioral/preventative health is always a part of any treatment), we would typically see you at least monthly in the beginning, but with time could transition to every 3 months if all is stable. If medication doses are being adjusted, it may be necessary to meet every other week, and in rare cases, weekly. When medicine has been started, we would like you to update us on how you are doing within a few days of starting, even if things are going well. Often, we will schedule a follow-up appointment, but if you have a concern or question, or we can make a slight adjustment before your appointment that would save time or help you feel better sooner, we are happy to touch base briefly by phone between appointments. Phone calls are charged only when they run over 10 minutes.
- Medication Management and outside Psychotherapy: If you are in psychotherapy with someone outside our practice, we are happy to collaborate and communicate with that person. The frequency of medication sessions tends to be the same as if you were only in mediation management, however, at times, you may need to come in to see us less often because we know that a professional is working with you who could alert us to any changes in your health.
Fees and Billing
The fees for each type of clinician are as follows:
Nurse Practitioner: 90-minute initial evaluation = $350, 30-45-minute follow-ups = $250
Psychiatric Nurse: 90-minute initial evaluation = $200, 30-45-minute follow-ups = $150
Psychiatrist: 45-minute consultation = $500
Credit card is required to be kept on file for appointments. Fees are charged prior to time of your appointment. If you are not able to pay by credit card, please call and speak with graymatters staff.
What is billed to your card?
- Missed sessions/late cancellations (less than 48 hours in advance) are charged the full typical appointment fee.
- Phone calls with a clinician in between appointments that are longer than 10 minutes are billed at a rate proportional to appointment fees.
- Paperwork completed outside of session time that requires longer than 10 minutes are billed at a rate proportional to appointment fees.
- Requested communication with outside parties (school, work, etc.) that takes longer than 20 minutes are billed at a rate proportional to appointment fees. We reserve this fee only for lengthy conversations as we do not want fees to interfere with our ability to collaborate with others in your care.
Out-of-Network with Insurance Companies
We are not in-network with any insurance company. If you have a PPO plan that has out-of-network coverage, you may choose to submit our statements to your insurance company, and depending on your plan, you may receive reimbursement. Please call your insurance company to inquire about possible benefits; we are also happy to call your insurance company to find out that information for you.
Please note that our billing and fees are not contingent on any insurance reimbursement you may or may not receive. You will be charged the fee for your session, even if you do not receive reimbursement. Please note that missed sessions tend not to be reimbursed by insurance companies. Also, if you arrive late to your session, you may receive less reimbursement from your insurance company as the billing codes on our statements are specific for face-to-face time spent with patient, and insurance companies tend to reimburse varying amounts based on billing codes used.
Statements are emailed to you the day after each session, or upon your request for specific dates. We find that the majority of our patients request emailed statements, but if you would like to receive statements in another form, rather than email, please let us know.
The statements you receive include all the info necessary to send to your insurance company. You will send two forms to your insurance company- the statement and a form that your insurance company will provide you. See link for sample form from an insurance company. Fill in the top part (patient portion) and then write “see attached” on our portion, and also send in our statement. Please call the office if you have any questions about how to submit claims to your insurance company.