New Patient Information

FEES

Telephone Consultation....No Fee (10-15 minutes)

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Hourly Rate: $400/hr

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New Patient Evaluation:

1st session...$400-600 (60-90 minutes)

2nd session...$400 (60 minutes)

3rd session...$400 (60 minutes)

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The initial intake evaluation will consist of 2-3 sessions (interview with child, adolescent, or adult alone; interview with parent(s)/guardian(s) alone; session with parent(s)/guardian(s) and child or adolescent, or adult alone to discuss impressions and provide recommendations for treatment), and is required for initiation of care.

If the decision is made to continue treatment, follow up appointments for therapy and/or medication management will be approximately 50 minutes, and medication management alone will be approximately 25 minutes. Services include, review of records, communication with physicians, teachers, therapists, medical work up as needed, as well as writing of prescriptions, letters, forms, and reports (additional fees may apply - based on hourly rate).

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Follow Up Appointments:

Medication Management with Therapy, Therapy alone, or Extended medication management alone....$400 (50 minutes)

Medication Management alone....$225 (25 minutes)

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Patients under the care of Dr. Martin are typically scheduled for follow-up appointments monthly. Appointment frequency may be adjusted as clinically appropriate based on Dr. Martin’s professional judgment, taking into consideration each patient’s individual needs, treatment complexity, and symptom severity.

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To ensure safe and effective medication management, patients receiving prescription medications from Dr. Martin are required to maintain regular follow-up appointments. Dr. Martin is unable to continue prescribing medications if a patient has not been seen for a clinical follow-up visit within the required three-month timeframe, unless an alternative plan has been specifically established based on clinical circumstances.

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OFFICE POLICIES

Appointments

If you are interested in scheduling an appointment, please call me at (719) 357-7617 and leave a message on my confidential voicemail or fill out the Prospective Patients Form. I will call you back as soon as possible.

Prior to scheduling an intake appointment, I will send you a link to sign up for my patient portal through Valant.  You will be prompted to fill out my practices intake forms and office policies. Once completed, you will be scheduled for an appointment.

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Payment

Payment is due at time of the appointment: I accept cash, check, zelle, or credit cards.

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At this time, I am not taking insurance, but will provide a super bill for those who have insurance that covers out-of-network benefits. Your insurance company will then provide you with financial reimbursement for services. The amount of reimbursement you receive will depend on the policies of your particular health plan.

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance, or who are not using insurance, an estimate of the expected charges for medical services, including psychotherapy and medication management services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy and medication management services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

PLEASE CONTACT YOUR INSURANCE COMPANY PRIOR TO YOUR FIRST
APPOINTMENT TO YOUR VERIFY BENEFITS

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LATE CANCELLATIONS AND MISSED APPOINTMENTS
If you will be unable to keep an appointment you have scheduled, you must provide 24 hour
notice. Failure to do so will result in a full session fee. Please note that health plans do not
pay for missed appointments and these charges will be your responsibility. If for any reason, I
 must cancel an appointment, you will be advised at the earliest possible time.


 

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