Please note the following policies and procedures regarding care at Neighborhood Psychiatry. Feel free to reach out with any questions.

Patient Financial Responsibility

We value you as a prospective patient and appreciate that you are considering Neighborhood Psychiatry as your care provider. Please note that there are charges for each of the services that we provide. We are pleased to assist you by billing through our health insurance contracts. Please make sure you update us with any changes to your insurance so we can best meet your needs. Payment is due at the time of your visit.

You are responsible for the payment of co-pays, co-insurance, deductibles and all other procedures or treatment not covered by their insurance plan. The amount you owe will depend on your individual plan deductible, co-pay and other terms, coverage, type of service and provider seen, and other coverage related factors. Please ask is if you would like help understanding your plan, and contact your carrier if you have any questions we cannot address. We only charge fees according to your plan’s parameters and any additional fees about which you are notified in writing (e.g. cancellation/late rescheduling of appointments, below). There are times when your insurance company may inform us that you owe us additional payments for non-covered services after you have received care. We will notify you of any such charges but please note that you are responsible for such charges because of your health insurance coverage, and not Neighborhood Psychiatry. We are also happy to explain any charges in person. If there is a payment-related error on our side, we will correct it. We reserve the right to utilize third-party agencies, such as collection agencies, in the event of uncollected debt.

Since you are responsible for payment for provided services, it is our policy to obtain and securely store your credit card information. This information is kept as part of your medical record and as such is subject to federal regulations pertaining to the security of medical records. In providing credit card information and signing below, you authorize us to collect payment for any amounts due in the event that you have not paid at the time of service. We are compliant with privacy regulations as outlined in the HIPAA Acknowledgement form.

Please note we require two business day notice to reschedule your appointment. The fee for appointments cancelled or rescheduled with less than 2 business days is $100. The fee for such 1 hour appointments is $150.00. We must charge these fees as we are unable to make use of scheduled clinician time under the circumstances noted. We reserve the right to charge for missed or cancelled appointments with less than the required notice, appointments to which patients arrive too late to be seen (generally later than 15 minutes for ½ hour visits and 20 minutes for initial assessments). Fees may be waived for true personal medical or family medical emergencies, or in the event of a death of a close friend or family member. If you are sick, please notify us in advance to avoid a cancellation fee. We charge for appointments missed or cancelled late due to transportation issues, work-related scheduling changes, weather, etc.except in the event of a major storm with governmentally initiated city-wide restrictions on transportation.

There is a $30.00 administrative fee for returned checks. Please note that insurance will not cover this fee or cancellation and rescheduling fees.


Treatment Agreement

Our goal is to provide a high level of care in order to obtain the best results for our patients. The following policies and procedures are intended both to ensure the best care we can by being clear about treatment agreements, as well as to ensure that the practice runs smoothly.

Clear and timely communication is essential for proper clinical care. Please notify us without delay by telephone with any questions or problems with your treatment. Please contact us prior to making any treatment changes (e.g. change in medication dose, stopping medications, adding additional psychotropic medications, if you are concerned about adverse effects) or with any urgent matters. Please let us know immediately if your insurance or financial circumstances change.

Please follow-up promptly with evaluations necessary for your care, e.g. laboratory testing, psychological testing, medical evaluations, specialist referrals, and so on.

At any time, please contact us via the patient portal or call the main office telephone 929.777.0173 or for any routine matters, such as scheduling, billing, prescription refills, or other administrative functions.

Please provide at least 3 business days to respond to routine matters. If you are unsure whether you are experiencing an emergency, and cannot reach your a clinician, please seek immediate medical attention.

Emergencies: Call 911 or go to your nearest emergency room for medical emergencies. The nearest emergency room from the 39 West 14th Street is Mount Sinai Beth Israel, located at 1st Ave and 16th Street, New York, NY 10003.

Please indicate your communication preferences with us for text and email via our Communication Consent and Preferences form.

We require 2 business days notice to reschedule your appointment. We charge for missed appointments or appointments too late to use for adequate clinical care. The fee for follow-up appointments cancelled with less than 2 business days notice is $100.00 for 30 minute appointments and $150.00 for one hour appointments. We reserve the right to charge for missed or cancelled appointments with less than the required notice, barring true personal or family medical emergencies, death in the family, or similar events. We charge for appointments missed or cancelled late due to transportation issues, work-related scheduling changes, weather, etc. except in the event of a major storm with governmentally-initiated city-wide restrictions on transportation. If you are sick, please call us in advance to reschedule as we do charge for cancellations without sufficient notice. Insurance will not cover these fees.

Payment is due at the time of your visit, and may be in the form of check, cash and credit or debit cards. If you are using a debit card, either a regular card or an HSA (Health Savings Account) card, please make sure you know your PIN so we can process it as a debit card. Please let us know if you have any difficulty with payment, and we will make every effort to accommodate.

There is a $30.00 administrative fee for returned checks. Please note that insurance will not cover this fee.

If you cancel or miss your appointment without rescheduling we will attempt to reach out to you via your preferred communication methods and ground mail at least 2 times. If you do not respond within a clinically-appropriate time frame as determined by your clinician, we will send a termination letter with recommendations and referral possibilities. The treatment relationship is determined to have ended either when you notify us you have stopped treatment, or we otherwise learn or conclude you have stopped treatment (e.g. no response to outreach efforts, another provider informs us she or he has taken over care, etc.).

If you discontinue treatment, the clinician will provide coverage for 30 days from the date of termination in order for you to transition your care, including prescriptions to cover 30 days from the date of termination, and assistance with referrals. Please notify us if you plan to stop treatment or seek treatment elsewhere. If you stop treatment and have passed the coverage period, we will not be able to provide clinical care, including prescriptions without re-consultation. We are not obligated to resume treating patients who have stopped care against medical advice.

Please arrive on time for your appointment. If you are running late, please call our office to notify us if you can. We usually are unable to extend late appointments beyond the scheduled time. If you arrive more than 15 minutes late, we may not be able to see you and will ask you to reschedule. You will be responsible for the missed appointment fee if you are too late to have a sufficiently long visit to address appropriate clinical concerns.

In order to assure adequate continuity of care, your clinician will meet with you regularly, e.g. to provide closer monitoring, to check medication responses and make adjustments, to follow up on behavioral treatments and responses. Please let us know if you have any questions about this. We cannot provide care to patients are are unable or unwilling to meet at a clinically-appropriate frequency in the clinician’s best clinical judgment for standard and customary care.

Prescriptions are provided electronically during appointments. Please keep track of whether you require refills so this can be done during scheduled appointments. If you find you are running low on medication, a refill may be requested with a minimum of 3 business days notice. We use Capsule Pharmacy unless you choose to opt-out. Capsule delivers in all 5 boroughs and responds quickly to requests. They provide discounts as available and assist clinicians with medication prior authorization paperwork. To opt-out of Capsule, please provide the name, telephone number and address of your preferred pharmacy.

Patients are expected to behave appropriate for a professional setting in the office, and when communicating with all staff. We reserve the right to discharge patients who are disruptive to the care environment, inappropriate or threatening to staff or other patients, or who otherwise create an unsafe or unprofessional environment. We will make every effort to address clinical issues which may be contributing to such behaviors, as appropriate, prior to considering discharge of disruptive patients.

If you are consistently unable to work within the agreed framework described herein, we reserve the right to refer to a higher or more intensive level of care (e.g. a hospital-based practice or specialty clinic, etc.) and end the treatment relationship due to non-adherence or inability to provide indicated treatment. We will make every effort to work with you within our treatment framework before recommending transfer of care. If your care is transferred, we will provide treatment during the transfer period up to 30 days and coordinate with your new clinician(s) and/or treatment setting.

Any dispute between the parties, shall at the option of any party, be determined by binding and final arbitration before a single independent arbitrator administered by Arbitration Services Inc., its successors and assigns, under its arbitration rules at www.arbitrationservicesinc.com, except that no punitive or consequential damages may be awarded These disputes may include, but are not limited to, malpractice claims, claims for money owed for services rendered and issues of arbitrability. The arbitrator shall be bound by the terms of this provision and is authorized to conduct proceedings by telephone, video or by submission of papers. By agreeing to this arbitration provision you are waiving your right to a jury trial, waiving your right to appeal the arbitration award and waiving your right to participate in a class action. Service of process or papers in any legal proceeding or arbitration between the parties may be made by First-Class Mail delivered by the U.S. Postal Service addressed to the party’s address in these forms or another address provided by the party in writing to the party making service. The parties submit to the jurisdiction and laws of New York and agree that any litigation or arbitration between the parties may be commenced and maintained in Nassau County, New York. You acknowledge that this provision to arbitrate disputes and any subsequent arbitration between the parties is binding and final and that you are waiving your right to trial in a court of law as well as other rights.