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 we do not participate with insurance companies:

We hold ourselves 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.  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.  We 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.

We offer two services: an initial consultation which is four to six 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 our 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 with Dr. Schor and $275 with Andrea Kohn. *Please note, rates will increase $25/per visit in 2020* We 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 $500 per hour and are obtained as per a retainer agreement through the representing attorney.

Should you wish to seek reimbursement through your insurance company we will be glad to assist you with this and will 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 our first session we 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 our services are limited to those described above, the reimbursement varies depending upon which code is used.  For the initial consultation, we use 99345 + 99354 (extended service) and 99214 + 90836 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. You must explain to the insurance company that we have "opted out of Medicare" for them to understand how they would reimburse.

Medicare Patients
We 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.  We 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 us.  
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