Olney Geriatric Psychiatry
Specializing in the Assessment and Treatment of the Behavioral and Psychological Symptoms of Alzheimer's/Dementia in the Home Setting
Insurance Information
A few words about insurance and why I do not participate with insurance companies:

I hold myself to very high standards of patient care.  Many physicians today are put under pressure to see more and more patients for less and less reimbursement.  In psychiatry, patients are often limited in the number and types of visits they are 'allowed' by their insurance companies.  More and more physicians are finding it difficult to provide high quality health care in the face of rising costs, declining reimbursements, and enforced time limitations.  Many psychiatrists are forced to see patients only for medication management; an initial consultation may be 45 minutes or less and follow-up appointments only 10 minutes long.  I cannot fathom how one can establish a trusting relationship with a patient or even begin to understand the complex individual who that person is in such a small amount of time.

I offer 2 services: an initial consultation which is 4 to 6 hours in total, and follow-up visits.  These are usually conducted where the patient resides such as in a Assisted Living facility or in their own home as it is often difficult/inconvenient for my patients and their families to leave their home for a medical visit.  Patients can be seen at my office if it is more convenient for them.  The fee for the initial comprehensive evaluation is $1,500. Follow-up visits are $325.  I do not charge for brief communication in-between visits, calling in prescriptions, etc.  For extensive discussions and document preparation I do charge the pro-rated hourly fee. Fees for legal services are billed at $450 per hour and are obtained as per a retainer agreement through the representing attorney.

Should you wish to seek reimbursement through your insurance company I will be glad to assist you with this and include you in each step of the process, often times filling out forms and writing letters together so that you can determine exactly what information is given to them.  Before out first session I highly recommend that you contact your insurance company to inquire about reimbursement with an 'out-of-network' provider.  You will need the codes for the various services called 'CPT codes'.  Although my services are limited to those described above, the reimbursement varies depending upon which code is used.  For the initial consultation, I use 99345 + 99354 (extended service) and 99350 for follow-up visits.  When calling your insurance company to ask about reimbursement they will usually quote you a percentage of the "usual and customary fee" (which is an arbitrary amount established by the insurance companies that in no way reflects the actual fees of physicians).   Your out-of-pocket expense can be calculated by subtracting the percentage of the quoted usual and customary fee from the actual fee.  Also, when calling the insurance company be sure and ask them if "pre-authorization" is required, otherwise they can refuse to pay any of your bill because you didn't ask them permission first.

Medicare Patients
I have "opted-out" of Medicare; this means that if you have Medicare as your primary insurance, you will not be able to submit bills to Medicare for reimbursement.  If you have secondary insurance, you may submit bills to them, however, reimbursement depends entirely upon the 'out-of-network' benefits that your individual policy has.  I strongly recommend contacting your insurance company prior to an appointment to find out how much you will be reimbursed.

Should you have any questions regarding this policy, please do not hesitate to contact me.  
Website Builder