Depending on the complexity of the issues to be addressed, Dr. Nathan’s initial evaluation generally consists of one to three fifty minute appointments. After this evaluation, Dr. Nathan and the patient will jointly decide on a treatment plan, which may include more appointments. If Dr. Nathan will provide psychotherapy, these sessions would generally take place every one to two weeks for fifty minutes. General psychiatric care, including routine follow-up of stable patients, is provided in twenty-five or fifty minute appointments depending on the patient’s needs. Patients schedule these appointments on a flexible basis as needed to monitor progress—usually between once a week and every three months.
To arrange for an initial evaluation, please contact Dr. Nathan directly.
Privacy & Discretion
In Dr. Nathan’s practice, patient privacy is of paramount importance. Patients often require that no one knows they are seeking help, so Dr. Nathan practices with a level of discretion that is beyond what is required by law. Dr. Nathan’s medical records are stored securely and carry the legal protection of the doctor-patient privilege. With a few specific exceptions (discussed below), the only way that third parties will ever know that someone is seeing Dr. Nathan is if the information comes from the patient himself or herself.
Dr. Nathan will not release patient information to third parties, nor even confirm or deny that an individual is seeing him, unless at least one of the following conditions is met:
- The patient has given permission to release information to an individual or organization.
- The patient has submitted a claim to an insurance company and the company needs information to supplement the claim.
- The patient needs Dr. Nathan to communicate with other treaters about him or her.
- The patient has failed to pay for services, in which case Dr. Nathan may engage an outside agency to collect the payment.
- The patient is a danger to self or others.
- Dr. Nathan suspects that a child, an elderly person, or a disabled person is being abused.
- A court order is issued requiring Dr. Nathan to turn over records.
Except for the first three instances, which involve the patient’s implied or explicit consent, these situations rarely, if ever, arise in Dr. Nathan’s practice.
Unless other arrangements are made, payment is due for each appointment at the time it is held. Dr. Nathan can accept payment via check, Visa and MasterCard.
If patients have other specific needs beyond face-to-face meetings (examples include extensive record review, report writing or frequent contact by phone or email with a patient or family), they need to let Dr. Nathan know in advance so that he can be clear about any appropriate charges.
Finally, because Dr. Nathan needs at least one day to fill an open appointment slot, patients are expected to pay for all scheduled appointments unless they are canceled more than twenty-four hours in advance. Note that insurers do not reimburse patients for missed appointments or late cancellations.
Insurance and Treatment Decisions
While there are continuous developments in the field of psychiatry, Dr. Nathan regards the doctor-patient relationship as the sacred foundation for high quality treatment and good outcomes. For this reason he has chosen to be a solo practitioner, and his practice is not administered in any way by a hospital, group practice, PPO or HMO.
He makes no contractual arrangements with and is not an “in-network” provider for any insurance company.
He has chosen this approach to maximize time spent in patient care and minimize the sharing of clinical information with insurance company employees who could dictate choices about treatment.
If patients plan to use insurance benefits to cover the cost of treatment, they should first be sure they have met any prior authorization or referral requirements of their insurance plans. Recently there has been a trend for insurance companies to require that doctors—even out of network doctors—complete a “prior authorization” process for appointments or certain (i.e. more expensive) prescription medications. Contrary to what insurance companies want patients to believe, they will often waive the prior authorization requirement if patients firmly and repeatedly insist that the chosen physician does not have the staffing needed to deal with them and refuses to do so. Prior authorizations are frustrating and tedious, taking much time away from patient care, so please be aware that if patients want/need Dr. Nathan to defend their insurance coverage, he needs to charge for his time (usually 10-20 minutes for each prior authorization).
Medicare patients should know that Dr. Nathan is no longer a Medicare provider, and neither Medicare nor Medigap insurance programs will reimburse patients for the cost of their visits. Medicare patients are required by law to sign a private contract with Dr. Nathan to document their understanding that Dr. Nathan has “opted out” of Medicare.