Eval $ question

[Deborah]

Wanted to get your opinion on this - saw a woman for a bariatric psych Eval. She said she would mail me a check - usually I have patients pay me at the time of visit, but she didn't have any $ on her. $$ is not an issue for this patient (organization may be, but definitely not money). Anyhow I sent her an email letting her know that I was holding onto her completed Eval, and was happy to send it as soon as I received payment.

Is this ethical?
Thanks
Deborah Vineberg

Sent from my iPhone

[Warren Huberman]

I've been burned on this at least 25+ times over the years. I've had patients knowingly give me checks from closed bank accounts. This is fraud and a federal crime but good luck pressing charges.

I was advised by two attorneys to include a statement in my practice policies statement saying that "information will be forwarded to the consented parties (the surgeon) upon clearance of payment." In this way, the patient has agreed to the policy before the evaluation was conducted. This is no different than having patients sign a form consenting that they understand they will be charged for missed appointments or when less than 24 hours notice is given. Many doctors have and enforce this policy.

What may not be ethical is to hold the report indefinitely. When push comes to shove, you may have to release it. There is no rule that says you have to write and forward the report immediately. Perhaps you can make it a policy to wait a few days after depositing checks before forwarding reports to the surgeon.

Interestingly, a colleague of mine indicated that when he does not receive payment, he informs the surgeon and the practice as he believes this "non compliance" is clinically relevant information. Debatable, but interesting.

Warren Huberman

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[David Mahony]

In these situations I don't write the report until I get paid. 

If the report is written, the patient can legally demand a copy of it but if it's not written then you have some leverage.

I had a situation once where the pt did not pay, demanded the report, and told the surgeon's office that I would not release it. The surgeon was not too happy about that so we decided in those cases to not write the report until I received payment. Also, it sounds a lot better if you say you haven't written the report due to lack of payment then if you say you are not releasing the report.

D

David Mahony, Ph.D., ABPP

Clinical Psychologist

(718) 668-1919

[Corrales, Arturo]

Good point David…. Gonna keep that one in mind!

 

On a similar note, regarding “sliding scale,” how have others gone about setting their private fees? I know this type of discussion is discourage on certain list-serves, but I’m not sure how other’s feel about this discussion here?

 

Arturo Corrales, Psy.D.

Licensed Clinical Psychologist

Department of Bariatric Surgery

 

Jacobi Medical Center

1400 Pelham Parkway South

Building 8, Room 2B-111

Bronx, NY 10461

 

(P) 718-918-8140

(B) 917-205-0544

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[Warren Huberman]

To All-

Again, it's always best to state these things in a "policies" document that you give patients, no different than the HIPAA policy statement psychologists are obligated to provide. By doing so, a patient cannot say they were not informed that this was the policy. Legally, you cannot hold a report ransom if they demand it. It would be like a physician refusing to give you the results of your lab work because you had yet to pay your bill. This is what I was told by two separate attorneys. 

Warren

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[Michael Grove]

Good question Deborah. I dont like it when a patient has no money on them.I then want to use square to take their credit card payment .Many people have a card with them.I have to let square take 2.75 percent but some clients will pay that charge on top of the fee.

Also I know some clinicians that request the patient bring the fee to the meeting before they meet for the first time.

On Mon, Mar 9, 2015 at 11:35 AM, Deborah <dvin...@gmail.com> wrote:

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[Alexis Conason]

I believe that the reason that some listservs discourage discussion of fees is that it could lead to price-fixing, which I think is illegal. Does anyone know more about this? I have no problem discussing fees but obviously don't want to open us up to something that could be problematic. 

I can say generally that I set my fees in large part based on how much I think my time is worth (within reason of market value). I ask myself: is X amount of money worthwhile for me to spend X amount of time performing this service (rather than doing something else with my time). When I first started my practice, my time was less valuable because I had more of it so I was happy to see a patient for a lower fee (it was just nice to have company in my empty office, lol!). As my practice has filled, my time is worth more since I have less of it. 

Alexis Conason, Psy.D.

Licensed Psychologist

115 East 57th street

New York, NY, 10022

(646) 841-3652

www.drconason.com

On Mar 9, 2015, at 1:22 PM, "Corrales, Arturo" <Arturo....@NBHN.NET> wrote: