I do not accept or participate in ANY insurance companies. No medicare. No medicaid.
I do generate receipts that allow for easy submission to these companies (but never for medicare/medicaid) for reimbursement.
Patients who see me who have medicare are required, by law, to review and sign what is known as an “opt out agreement” that stipulates that they do understand that I do not participate and that there is no way that they will be reimbursed by medicare for their expenses in seeing me. Supplemental insurance may still pay.
I spend 2 hours with most adults on their first visit.
I spend 90 minutes with adolescents on 1st visit and 60 minutes with children. These visits are prorated accordingly.
Follow up visits are very important. They generally run 30 – 60 minutes (children almost always 30 and some adults also, but many adults are 60 because of the nature of the problem and the need to discuss interdisciplinary and integrated approaches to their particular situation. Counseling on lifestyle issues, diet, nutrition, stress reduction, meditation, yoga, etc., etc. is an ongoing process and requires revisiting.)
Medicine cost is usually factored into each visit. Sometimes the medicine that I require is in my office. At other times I might write a prescription for it, and sometimes I will mail it from Rhinebeck. If I do bill for medicines (this might be the case if it is the result of a telephone call) then the fees are always reasonable for a supply that usually lasts several months or more.