New Patient Guidance

Here is how to start…

Financial concerns:

I care more about my patients than about finances!  I discuss finances first because it is difficult to tell your history and needs to multiple psychiatrists.  If you cannot come, I don’t want that to happen to you.

Scrabble tiles spelling out: Health Insurance
Out of network provider

I am an out of network provider.   This means that I do not accept insurance, but will provide the necessary paperwork for you to submit to your insurance for reimbursement, if you have out of network privileges.  It is wise to call your insurance about reimbursement before starting treatment.

I am opted out of Medicare.  This means that if you have Medicare, you will be paying for my services out of pocket, and will not be reimbursed. You may get reimbursement from secondary insurances, and you should check with them about any such coverage.

Payment is due at the time of service
Payment due at time of service

Your payment is always due at the time of your visit.  It is between you and your insurance how much and when you are reimbursed for that payment. 

Make sure you note on your insurance form that you are to receive your reimbursement checks; they should not come to me.  I cannot sign over to you an insurance check made out to me– such checks will be returned to your insurance by me and must be re-issued by your insurance to you. 

Medicaid and insurances obtained on the insurance exchange do not have out of network privileges, and therefore they will not reimburse.

Credit cards must be uploaded onto your account
Zelle, cash or check preferred

You will need to enter your credit card information onto your portal account into Luminello, (my Electronic Medical Record, EMR, where it is safeguarded).  This keeps your information safest— I do not have access to this information, which protects us both from security breaches, but allows me to withdraw funds from your account according to our agreement, if necessary. Though the credit card is needed on file, payment is preferred by Zelle (for payment linked to 845-367-4800 or, for telemedicine visits and Zelle, cash or check for in-person visits.

My EMR, allows you to print out receipts, schedule and cancel appointments on line, look up when your next appointment is scheduled, read lab results and communicate, as appropriate, through a HIPPA-compliant system for between visit business.  You can also call the office for help with most things.

2022-2023 Fee Schedule
Initial Evaluation (in office or via telepsychiatry)
90-120 minute Initial Consultation $675.00

Established Patients (in office or via telepsychiatry)
1-15 min medication visit (check-in/maintenance) $200.00
16-30 minute medication management visit $275.00
31-45 minute medication visit or medication plus therapy $325.00
46–60 minute medication visit or medication plus therapy $425.00
61-75 minutes medication or medication plus therapy $525.00

Coaching/ Coordinating calls:
Coaching calls are between visit calls/messaging requiring advice, support, skills, or medication questions/ evaluation or trouble-shooting
Coordinating calls include parent communication (advice or updates), calls for coordination of care to/from therapists/ teachers/ agencies). Insurance does not reimburse phone calls text or portal yet, but may reimburse telepsychiatry video calls.
10-15 minutes $150.00
16-30 minutes $275.00
31-45 minutes $325.00

Missed appointments/ Arriving late:
Appointments not canceled 48 business hours in advance– will be charged. Weekends are not counted as business hours, so a Monday or Tuesday visit would need to be cancelled Thursday or Friday morning respectively.
Your appointment is reserved time. If you arrive late, your session time is not extended.

Initial call:

Woman making an appointment
Initial call

Call the office at (845) 367-4800 and leave a detailed message (on my confidential voicemail) and I will get back to you within 24-48 business hours. 

If for some reason you do not get a callback in that time period, please call again.  Something has gone wrong. 

I take callbacks very seriously.  Please check that your voicemail is not full.

Therapist-patient match depicted
Finding a match

We will discuss your situation for 10-15 minutes by phone, to see if I think I can be of help to you, and give you a chance to see if we are a match. During our conversation,  I will ask you some background questions, and you can ask me questions about the practice and therapy styles, if you like.  This is not a consultation, and does not imply that we have formed a doctor-patient relationship yet; it is an opportunity for us decide if we want to proceed to the consultation visit.

I cannot provide therapy or medication or medical advice before our first face-to-face visit. 

Making your first appointment:

If we think we are a match, we will set up an initial consultation.

I will need your name, date of birth, email and cell number to make a chart for you.

Initial appointments are between 90-120 minutes, not including a lot of behind-the-scenes work in preparation for, and after your visit.  For this reason, I ask that at the time you reserve your appointment, you leave a 50% non-refundable deposit.  The other 50% of your initial fee will be charged the day of your visit.

If you want to think about whether you want to make an appointment before securing a spot, that is encouraged.

Shorter follow-up appointments do not require a deposit, but there is a 48-business hour cancellation policy.  That means you would be charged your usual fee for late cancellations or no shows.

Once your portal account is set up, I will send you important initial paperwork (administrative and medical/social history) that must be filled out on-line at least two business days prior to your visit.  This paperwork must be received for you to keep your appointment.

Appointments must be held within NY State

Telemedicine appointments must be made with you inside of New York State or New Jersey. You also must have a private space to have the session.

Your first appointment is a diagnostic consultation where we will discuss your diagnosis, your plan for therapy (if coming to me for therapy) and/or medication and follow-up.  Here we will both determine the next step in your treatment.

Follow-up appointments:

Appointments are made based on your individual needs, but in general, you can come to see me for therapy, medication management or both.

Medication visits:

Woman taking medication in the morning

These are usually visits of 16-30 minutes; longer visits are 31-45 minutes.  Many people prefer longer visits, especially if they are coming infrequently, or have several issues to discuss. If you habitually run over the 30 minutes, you will need to make 31-45-minute visits thereafter.

These visits are usually monthly, until your medications are adjusted and working, and you are feeling better; and then are every three months.  They will be more frequent again, if there are complications, or new problems arise.

You need to come into the office (or have a telemedicine visit) to make medication changes or for clinical advice.  This is not done over the phone or portal. If it is just a quick adjustment, or there is no active issue, there is a 1-15 minute medication visit available.

If you are having between-visit side effects that require a “quick communication,” sometimes that can be accomplished by the portal or with a five minute or less phone call.  Otherwise, you will be asked to make an appointment, or will be charged for a “coaching call.”

Refills are made at the time of your visit.  You are given a prescription to last until your next visit, unless otherwise discussed.  Please do not ask the pharmacy to call me for refills, and do not ask for refills if you are due for a visit; rather time your visits so that you do not run out of medication.

You can make your next appointment at the end of your last visit, schedule recurring visits, or can call when you are closer to your next visit.  If you choose the latter, you are responsible to make that appointment before your medication runs out—so plan ahead so appointments are available.

Therapy visits:

Therapist and patient collaborating

These are usually weekly while you are gaining skills and feeling more distress.  As you improve, they are spread out, until we agree your therapy is complete.  Depending on your therapy type and problem, it may be short or longer-term.  Even when people are “done with therapy” they may maintain their gains with a check-in every six months to one year.

Therapy visits are usually 35-45 minutes.  If you need more time, or habitually run over the 45-minute mark, you will need to make 46–60-minute visits.

Family therapy, couples therapy and individual therapy where more than one person is present are usually 60-minute visits.

At the end of a therapy visit there is usually a task to complete or focus on between visits. Doing work between visits significantly improves outcomes.  It is part of the work of therapy.

Luminello (electronic medical record) logo depicted
You will receive an invitation from Luminello to join the portal.

Please see the Luminello Sheet on Office Policies for any further information.  This will be sent to you when you make your initial appointment.

As a physician, I am committed to ensuring that my patients receive appropriate medical care and
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