Getting Started
You can start by contacting me at drjlavender@gmail.com or 212-866-0461.
In a brief phone conversation, I will gather basic information about your situation. Any practical concerns you have can be addressed at this time. All information will be confidential and in accordance with state and federal regulations governing mental health care.
While I have treated a wide range of problems, I may recommend that you need specialized help for certain types of difficulties such as more serious drug/alcohol, legal issues, immediate high risk or violent behavior.
Please note that I am an Out of Network Provider or Out of Pocket provider ONLY. I am glad to provide you with an itemized bill suitable to present to your insurance provider, but I will ask you to pay me directly. For your own sake I suggest contacting your insurance company and other financial resources before you start psychotherapy.
Re Medicare, I am an OptOut status in Medicare. This means that you and I agree to paying me a private fee without ever submitting my invoices to Medicare. This is an ethical and legal process approved by Medicare. It affects ONLY your treatment for psychotherapy; all other Medicare treatments are paid as usual.
Always consult your insurance company before starting your psychotherapy!
Insurance companies have complicated procedures that change without notice so you should document every contact you have with your insurance providers. This will help you to protect your ongoing treatment. It is federal law (Parity Law) that your insurance company cannot charge you a different copayment for behavioral health treatment, nor limit the number of sessions, if they meet the criteria for medical necessity.
1. Call your insurance company customer phone number on the back of your insurance card. Tell them you need to know the details of your mental health coverage.
2. There are two categories of mental health coverage: In Network and Out of Network providers. Ask for the Out of Network benefits. These are the ones you will need in order to start treatment with me.
3. Does your insurance provide Out of Network (OON) benefits?
4. If yes, ask what is the Deductible?
5. What is the Percent of Coverage? Is it 50/50, 70/30, or some other ratio? Make sure you know exactly which side of the percent ratio
you will be receiving.
6. You will hear the terms R & C (Reasonable and Customary). R&C is the fee or price that your insurance company has decided to
pay for your sessions with me. Different insurance companies have different prices for the same treatment. I am a clinical psychologist
(not psychiatrist). There will be a specific R&C listed for services provided by a clinical psychologist with a zip code of 10024.
7. My total fee will most likely be different than the R&C listed. For example, if I charge $200 per 50-minute session, the R&C
might be a lower figure. You will be paying the difference between what I actually charge and what the insurance company is setting up as a fee
on which to base their % of reimbursement to you.
8. Precertification (Preauthorization). Some insurance companies require that you call them before you start treatment to precertify
the treatment. If you do not do this, you could lose any chance of getting reimbursed for sessions with me.
9. Ask about the maximum numbers of visits you are given for the year.
10. If your insurance company asks for the CPT Code, this refers to the length of the session with me. Individual sessions that are
45-50 minutes are coded CPT 90834.
