Case Management Policy

Following is an addition to the Outpatient Services Contract effective immediately:

I run my practice in as independent and private a manner as possible by choosing not to be contracted with insurance companies that are likely to impose excessive bureaucratic requirements. Even on an out-of-network basis, some insurance companies may request additional information about your treatment in the form of utilization reviews or requests for additional information about you.

My default response is to refuse such requests for the dual purpose of protecting your privacy and maintaining the autonomy of my practice. I will notify you if I have received any such requests from your insurance company, and you and I may discuss on a case-by-case basis whether or not to comply with such requests. Time spent on case management will be billed to your account on a prorated basis.

If you are insured by Aetna, your case may be selected by Aetna for a utilization review meeting by telephone. If your case is selected for utilization review, I will discuss this with you before participating in the review, and you and I may decide together whether or not to comply with the request. Time spent on utilization reviews with Aetna will not be charged.

If in addition to individual psychotherapy you are also being treated by a psychiatrist or another mental health professional (for example, group therapist, couples therapist), with your written authorization I may periodically discuss your treatment with that professional to ensure continuity of care. There is no charge for routine coordination of care with other mental health or medical professionals. However, in the event you are hospitalized, your account will be billed for time spent on coordination of care with treatment providers at the hospital.

If you have authorized me to discuss your case with any other individuals who are not mental health professionals (for example, a family member or employer), time spent on these activities will be billed to your account on a prorated basis.

text edited 09-19-2012