Overview

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About my practice

I am a psychiatrist (a medical doctor who specializes in illnesses with mental symptoms) with a solo private practice in Towson, MD. My training was at Johns Hopkins, and I am certified by the American Board of Psychiatry and Neurology. I take care of adults (ages 18+) with illnesses such as:

I do not usually take care of people with:

In rare cases, I take care of patients between 16 and 18 years old who have illnesses which are similar to those found in adults (such as depression, schizophrenia, or bipolar disorder).

Almost all of my patients have insurance, usually a preferred provider organization (PPO). I don't usually see patients who are in a health maintenance organization (HMO) or those with Medicaid or Medicare. I work on a fee-for-service model, meaning that I ask to be paid at the time of service and I will provide you receipts for you to submit to your insurance company. In general, insurance companies cover the majority of my charges, but you will typically have to pay something, depending on the details of your plan. I do see patients on Medicare, but this is a special situation (see below).

There are two primary business models for how psychiatrists see patients: solo versus being a member of a group practice associated with an organization such as a hospital. I am a solo practioner. This has certain advantages such as:

It also has certain disadvantages, such as:

I realize that my practice is not for everyone, and I am not interested in trying to have any more than a limited number of patients. I am not trying to compete with bigger, less personal organizations.

Schedule

In general, I work Wednesday and Thursday. I sometimes see established patients outside these times (such as a Saturday) in an emergency situation, or if holidays interfere with my usual schedule.

New appointments

I prefer to talk with you on the phone before your first appointment, primarily to make sure that I feel that I may be able to help you.

If you would like, you may leave a message on my answering machine, or send me an email with your contact information.

In general, I try to avoid having someone other than the patient be involved in setting the first appointment time, unless the patient is a minor.

If you do come for a consultation, I would appreciate it if you would look over the first visit link before you come. If you can do the things on that page before you come, it will free up at least 20 additional minutes during your consultation during which we can discuss why you came and what to do rather than spending the time doing paperwork.

Payment

I accept personal checks, Visa and Mastercard. For security reasons, my billing system does not retain any of your credit card information. I would prefer that you not pay in cash because I would rather not have currency in my office.

I don't send bills. I ask to be paid by check or credit card at the time of service.

Private insurance

There are basically two different kinds of private health insurance: Health maintenance organizations (HMO's) and Preferred Provider Organizations (PPO's). If you have HMO coverage, you have no mental health benefits other than those offered by your HMO. If you have a PPO, the insurance company will pay some, but not all of my fees.

I do not bill insurance companies for you. Some insurance companies have arrangements with physicians called "preferred providers" or "in-network providers." These physicians agree to see certain patients for less than their usual fee in return for referrals. I have not entered into any of these agreements because I think that insurance companies are not as interested in the quality of your health care as they are in getting a deal which improves their bottom line.

If you need it, I can supply a receipt for you to submit to your insurance company. Almost all of my patients have insurance and get at least some reimbursement from their insurance company. I have a small practice, and I keep my overhead (and my fees) down by not hiring a person to waste their time dunning insurance companies. Your insurance policy is a contract between you and your insurance company, not between me and your insurance company. You are ultimately responsible for paying for your care.

I would urge you to keep copies of any documents that you send to insurance companies to save your time and mine and to avoid additional fees related to paperwork outside your session.

"Usual, reasonable and customary" fees

Since different insurance companies have different ideas of what is "reasonable and customary," it is evident that there is no consensus on what this term means.

Although the government and insurance companies often say they will pay some percentage of "reasonable and customary" fees, all the formulae for calculating these fees are secret. The Health Insurance Association of America (one source that insurance companies quote as a source of their data) has disclaimed, in court, the integrity of any of their data. Although the government and most insurance companies claim that these fees represent some kind of average fee charged by physicians in a region, the fact is that there is no credible evidence that "reasonable and customary" means anything other than "what we feel like paying." I suspect that the term is no more than a marketing ploy to mislead patients into thinking that physicians are overcharging patients rather than that the government or the insurance companies are paying less for services than what people are charging.

Medicare insurance

Medicare's mental health benefits are lower than Medicare's other benefits. Outpatient mental health visits are only covered up to 50% of very low reasonable and customary fees, and that plus the substantial overhead of billing Medicare is why many psychiatrists who provide outpatient mental health treatment choose not to accept patients on Medicare.

There are three possible relationships that physicians can have to Medicare:

For the first two options, the government dictates the fees doctors may charge. I have chosen to opt out. This means I can set my own fees, but Medicare will not pay you anything if you see me. However, some supplemental insurance policies will.

Medicaid insurance

I do not accept Medicaid insurance.

Billing codes

Here are some typical billing codes I use in my practice. These are not the only ones I use, but can help you find out how much your insurance pays.

Procedure code Service
90792 Psychiatric Diagnostic Interview (first vist)
90833+99213 30 min visit, therapy + short exam for purposes of medication management
90836+99214 60 min visit, therapy + longer exam for complicated medication management or problem

Philosophy

I run my practice by myself to keep my overhead down. This choice has certain advantages, most notably that I deal with everyone directly and that it is easy to keep your case confidential. It also has some disadvantages, primarily in that I sometimes have to triage requests for my time and that it isn't feasible for me to spend lots of time on insurance company or legal paperwork. If you want a doctor who

I think that there is a good chance we can work together successfully.

If you

I am probably not the best doctor for you.

Privacy

My privacy practices document goes into detail regarding my privacy practices. In general, I believe that mental health records need to be even more private than most other medical records and I do my best to keep them so. I do take notes on my laptop and all patient information is stored in a locked file cabinet or encrypted computer files so that if my laptop is lost or stolen, none of your private information will be revealed.

Unless you are a minor (in which case your parent or guardian is in charge of privacy issues and records), I will not talk to anyone else (this includes other family members) about your case unless you have given me permission. However, I will speak to your insurance company if needed, but I will not release detailed records without your consent. If someone calls me, such as a relative, I will call you first before discussing your case with them unless you have previously given me permission to speak with them.

You should know though, that there are certain situations where these rules don't apply. If you are in an emergency situation (such as being in an emergency room) I will discuss whatever aspects of your case I think are necessary so that other doctors can take care of you. If I believe (or someone credible, such as a partner, tells me) that you are in clear and imminent danger of harming yourself or someone else, I will take action to make sure that you and they are protected. Finally, state laws in Maryland require that I disclose your information to the proper authorities if I believe that you have abused a child.

Conflict of interest

I do not have any dealings with drug companies. I do not talk with drug company representatives. I do not accept anything from them such as samples or honorariae. None of my research is supported by drug companies.

I do not treat people with whom I have some other relationship such as friends or students of mine. I do not socialize with my patients.

Credentials

Education

Year Experience
1974-1978 BES, Bioengineering, Johns Hopkins University, Baltimore, MD
1978-1985 MD, Johns Hopkins Hospital, Baltimore, MD
1978-1985 Phd, Biomedical Engineering, Johns Hopkins University, Baltimore, MD
1985-1986 Intern, Psychiatry, Francis Scott Key Medical Center, Baltimore, MD
1986-1989 Resident, Psychiatry, Johns Hopkins Hospital, Baltimore, MD

Work Experience

Year Experience
1985-1988 Consultant, Operational and Clinical Systems, Johns Hopkins Hospital, Baltimore, MD
1989-1993 Assistant Professor in Psychiatry, Johns Hopkins Medical School, Baltimore, MD
1994-present Associate Professor in Psychiatry, Johns Hopkins Medical School, Baltimore, MD
2003-present Visiting Professor in Biomedical Engineering, Whiting School of Engineering, Johns Hopkins Medical School, Baltimore, MD

License and Board Information

Year License
1986-present Licensed (D34788) to practice medicine in Maryland
1991 Board certified in Psychiatry by ABNP