Practice Policies

Welcome to my practice.
Please review the following so you are aware of the policies of my practice and contact me with any questions. Once you have signed this agreement, I will assume you have read and understood it. Thank you and I look forward to working with you.

Initial Consultation: Our first visit will be a consultation for the purpose of evaluation. After evaluation, I will offer some first impressions of what our work might include, a treatment plan, and considerations regarding psychotherapy, medications, and holistic approaches. You may use this information—along with your own comfort in working with me—to make your decision as to whether you would like to pursue treatment. If you do not feel comfortable working with me, or if I do not feel able to help you for any reason, I will try to assist you with referral to others who may be able to meet your needs.

Confidentiality: Our sessions are confidential and what we discuss may not be revealed to anyone without your permission except where disclosure is required by law. Disclosure may be required where there is a reasonable concern of: 1) abuse or neglect of a child, 2) danger of harm to yourself or others, 3) grave disability, or 4) in the case of a legal proceeding, I may find it helpful to consult other professionals about your case; however, neither your name nor any identifying information about you will be revealed. In the case that another person (such as a family member or friend) is paying for your treatment, that person will not receive any confidential information about your care without your explicit written consent.

Follow Up Appointments: Regular follow up appointments are required in order to ensure good care. Follow up appointments are scheduled for either 50 minutes or 25 minutes depending on the complexity of the issue and whether we are setting aside time for psychotherapy. The appointment time is reserved for you, so it is important that you are on time. If you are late, your appointment will still conclude at the end of your scheduled appointment, or your appointment may have to be forfeited. If you miss or have to cancel an appointment, please reschedule within 30 days. If I do not hear from you within 90 days of a cancelled or missed appointment I will assume you are receiving your care elsewhere and administratively discharge you from my practice. Please be aware that once discharged, I may not be able to accept you back into my practice should you follow up with me in the future.

Medication Refills: Medication refills will be sent electronically to your pharmacy. I typically submit refills during scheduled appointments, but as long as you are coming for regularly scheduled appointments at the minimum of every three months I can provide medication refills between appointments. Please allow three business days for me to respond to refill requests. Do not leave these requests to the last minute. If you have not been seen in over three months, you will need to schedule an appointment to obtain a refill.

Please be aware than when prescribing medications for my patients I will routinely check medication prescription history via available platforms, including PMPs, centralized databases that show patients' medication prescriptions from different providers, in order to ensure good care.

Controlled Substances: In some cases I may prescribe controlled substances (such as benzodiazepines or stimulants) as part of your care. It is important to take these medications as prescribed, and not to increase or change your dose without specifically discussing any change with me. In the case that you change your medication dose on your own and run out early, I will not provide an early refill and you may experience withdrawal symptoms.

Prior Authorizations: Most medications I prescribe are covered by insurance, but insurance companies sometimes require prior authorization for certain expensive or brand name medications. I can not guarantee a medication I prescribe will be covered by your insurance, but I will do what I can to make it as likely as possible by submitting medical justification to your insurance company. Because of the time involved with this process, I bill for it at the rates indicated below. I generally waive fees for prior authorizations for a single medication.

Contact & Follow Up: I am available by phone or email during business hours. I will return messages in a timely fashion, typically within 48 hours. If you need assistance more urgently, please go to your local urgent care. In case of an emergency, please call 911 or go to your nearest emergency room. I am not available during evenings or the weekends.

Cancellations and Missed Appointments: Should you need to cancel, please do so at least 24 business hours in advance. Business days are considered weekdays, and exclude holidays. Cancellations made with less than 24 business hours notice, or missed appointments, are charged the full appointment fee. For example: an appointment scheduled for 12pm on Monday must be cancelled by 12pm on Friday to avoid incurring a fee.

Email Communication: I am available to communicate with patients via email because of the convenience it allows. However email is not a completely secure means of communication because messages can be addressed to the wrong person or accessed improperly while in storage or during transmission. I do not receive emails after hours, on the weekends, or on vacation. In the case that I am on vacation, I will have a colleague providing coverage for me. Complex clinical questions should only be discussed during appointments as opposed to over email.

Billing and Payment Policies: Payment is expected at the time the service is provided and will automatically be billed to the credit card on file after your appointment.

Fees Structure:
Billing for appointments: The following indicate rates for scheduled appointments.

For your initial consultation, you will be scheduled based on your requested treatment preferences.

Initial consultation
Essential Psychiatric Assessment: 60 minutes $495
In-depth Psychiatric Assessment, multiple issues, increased complexity: 90 minutes $595
Integrative/Functional Psychiatric Assessment: 120 minutes $695

Follow up appointments:
Focused Follow-Up Sessions: 25 minutes: If the time since last appointment is over 3 months: $275
If the last appointment was over 6 months previous, a 50 minute appointment is required) $250
Full Follow-Up Session: 50 minutes If the time since last appointment is over 3 months: $400 $375

Late cancellations and missed appointments are billed at the rate of the scheduled appointment Fees are subject to increase on an annual basis. You will be notified in advance of any fee increases.

Fees for services between appointments:
Clinically-related services provided between scheduled appointments are billed at the rates listed below, although for brief or limited services (less than 15 minutes), I generally waive these fees. Note: Non-clinical phone, email, or text contact (such as scheduled or billing questions are not subject to fees.

Fees for services between appointments:
Paperwork such as letters, forms, or prior authorization paperwork
Time spent preparing medical records to transfer between providers. (Please be aware that you have a right to request a copy of your medical records at any time; there is no additional administrative fee to release records to you, although I require we set up a follow up appointment to review and discuss your records prior to releasing them to you). $50 per letter or form OR $50 per 10 minute increment for more time-involved forms
Phone calls with family members or other providers such as therapists or primary care doctors Clinical questions answered over email (billed based on the time it takes me to respond to the question) $50 per 10 minute increment

Specific lab testing is discussed during our sessions and ordered as clinically indicated based on your symptoms and goals.

Basic lab work: Cost of lab testing — billed to insurance (copay may apply), Lab Review Fee — $75
Genomic Testing: Cost of lab test — billed to insurance (copay may apply), Lab Review Fee — $150
Functional Lab Testing: (includes both cost of lab test (billed by lab directly) + Review Fee) (Integrative/Functional Treatment Track only)
  • Functional Nutritional Testing: $650
  • GI gut testing: $650
  • Comprehensive Allergy & Immunology Testing (includes testing for sensitivities to foods and mold): $650
  • Salivary Adrenocortex Profile (cortisol testing): $260
  • Salivary Melatonin Profile: $190

Insurance Coverage: I am not in-network for any insurance panels, including Medicare, and am considered an “out of network provider” for PPO plans. While I do not contract with insurance companies, I do assist my patients by providing the paperwork necessary to submit into their insurance carriers for reimbursement (a “superbill”). I am not able to negotiate or submit claims with insurance companies. Please be aware that your insurance provider may not reimburse you for any, or may only reimburse you for a part of, the charges for my services. Insurance companies generally do not reimburse for administrative services or missed appointments. Limits of Service: I do not provide disability evaluations, worker's compensation evaluations, forensic evaluations, emotional support animal evaluations, or provide legal services or testimony. Should you require legal testimony at some point during our treatment together, you will need to retain an independent forensic psychiatrist.

Get in touch
Tamarack Psychiatry 802.404.5140