POLICIES & FEES
FREQUENTLY ASKED QUESTIONS
INSURANCE & PAYMENT QUESTIONS
Do you take insurance?
Out-of-network: We do not contract with or accept insurance. This means that Dr. Stein’s practice is fee-for-service and is considered out-of-network. Health insurance carriers often place limitations on the duration, frequency and type of care provided by contracted physicians.
Important Note Regarding Insurance Listings: As UCLA clinical faculty, Dr. Stein volunteers her time 1/2 day per week to train resident psychiatrists at UCLA. Because UCLA sometimes bills insurance and MediCare for Dr. Stein’s service, insurances will sometimes erroneously list Dr. Stein as being in-network, when it is more accurately UCLA that is in-network for Dr. Stein’s voluntary service. Dr. Stein has not signed any contracts with insurances to be in-network and does not receive any financial compensation for her work at UCLA.
Why do you not contract with insurance?
More time, access, and quality. When Dr. Stein first opened her practice over 18 years ago, she made a conscious decision to provide psychiatric care based on the needs of patients, rather than on restrictions placed by insurance companies. Being out-of-network allows Dr. Stein to be more accessible, to provide high-quality, holistic care, and to spend more time with patients. Patients can still submit superbill receipts for out-of-network PPO insurance reimbursement. Call the number on the back of your insurance card to better understand their coverage of your psychiatric out-of-network outpatient services.
What if my PPO insurance denies coverage of prescription medications, or Dr. Stein’s out-of-network services?
We do not contract with insurance and are not responsible for denial of coverage or for appealing denials. If you want Dr. Stein to take the time to pursue an appeal, let Dr. Stein know and please be aware of the associated time-based fees, as listed on the fee schedule below.
What if my insurance denies coverage of my prescription medication?
Dr. Stein will discuss prescription alternatives with you. If you wish Dr. Stein to take the time to pursue an appeal or a prior authorization, please be aware of the associated time-based fees as listed on the fee schedule below.
Do you work with MediCare?
Dr. Stein is not contracted with MediCare. If you are a Medicare patient and wish to work with Dr. Stein, MediCare requires that you sign a MediCare private contract and agree not to submit superbills to MediCare for reimbursement.
What if I need Dr. Stein to complete health, life, workers compensation, or disability etc insurance paperwork or talk to insurance reviewers?
Please bring your paperwork to your appointment so Dr. Stein can address them at the time of your visit. If there is not enough time and/or insurance work needs to be done between appointments, patients are responsible for compensating Dr. Stein per her hourly fees.
What if I need Dr. Stein to testify at a legal case?
Sometimes patients get involved in legal matters (e.g., actions against their employers or others, divorces, personal injury cases, etc.) that ultimately require a clinician’s records, opinion, or testimony. Whether a patient is the plaintiff or the defendant, patients accept responsibility for payment forensic fees for any and all time Dr. Stein spends dealing with the legal case. This includes time spent addressing subpoenas (eg, including working with the patient’s attorney to legally prevent the release of records if the patient so chooses), reviewing, preparing and/or discussing your case, charts or files, traveling to/from and testifying at appearances.
What if I miss an appointment?
Each patient is assigned an appointment time reserved only for them, so a missed visit with insufficient notice represents a missed opportunity for others to come in. The office has found that it takes at least 48 business hours to connect with patients who are waitlisted to schedule an appointment. This is why the policy is to automatically charge patients the full visit fee if they do not provide at least 48 business hours advance notice by voicemail prior to cancelling.
How do I handle prescription refills & Other Pharmacy Issues?
When to arrange refills:
Medications and refills should be prescribed during our scheduled appointments, not in-between. During our visits, Dr. Stein tries to arrange enough medication and refills to last until the next recommended visit.
Between-Visit Refill Requests:
On the rare occasion when refills are needed in-between appointments, this usually means you are overdue for follow-up. In such cases, please call your pharmacy to be sure you are out of refills; if this is confirmed, then you (not the pharmacy) should schedule a follow-up as soon as possible and message with my office to request a refill. Because pharmacies frequently send out refill requests whether patients are due or not, we only respond to patient refill requests, preferably during appointments. 48 business hours is required to process between-visit refill requests and the card on file will be charged $20 for non-controlled prescription and $40 for controlled prescription refills to cover clinician time to carefully review the chart, consider the refill request, and contact the pharmacy, and if necessary, check other databases, etc.
Disable Pharmacy Auto-Refill Requests
Instruct your pharmacies to disable auto-refill requests for my prescriptions. Please note that since refills are provided to last until the next recommended scheduled appointment, there is no need for pharmacies to send autio-refill Fax or message requests to Dr. Stein. Nowadays, Pharmacies tend to send refill requests even when patients are not out or due for refills, significantly burdening the medical system. As a result, ALL Pharmacy refills requests via Fax or messaging will be ignored and deleted by this practice. It is the patient’s responsibility to make timely refill requests, if truly needed (see above policy).
Pharmacy Clarifications and Prior Authorizations:
If a pharmacy needs a prior authorization in order for insurance to cover a prescription, please have them send a form to me via the “CoverMyMeds.com” or the office Fax at 310-740-9061 Time spent reviewing patient charts and preparing for prior authorizations are charged per the fee schedule (see below).
If your pharmacy has a question, please have them call my office and leave a voicemail at 310-529-6051.
What are your fees?
The Current Fee Schedule is as follows (Rates Subject to Change):
- 90 min initial consultation: $675
- 45 min appointment: $450
- 60 min hourly rate: $540 for:
- Tele-visit and Telephone consultations
- Prior Authorizations and other Insurance-Related Documentation (prorated)
- Reports and Letters (prorated)
- Disability Evaluation Services (prorated)
- Insurance Evaluation Services (prorated)
- Evaluation of Records (prorated)
- Sessions that are 60 min or more
- In-Office Lab Collection & Administration: $65
- Document Production (electronic): $0.35/page
- Document Production (paper): $0.45/page + postage
- Forensic Fee Schedule: Check with the office.
- Between-Visit Refills and Prescriptions (requires 48 business hours’ notice):
- $20 for non-controlled prescriptions
- $40 for controlled prescriptions
To avoid between-visit prescriptions fees, patients should address medication refill needs during scheduled appointments.
How often do I need to come in for follow-up visits?
At each appointment, Dr. Stein will recommend when you should set up your next follow-up. This typically means weekly to monthly 45 minute appointments initially, depending on your psychiatric history and symptoms. As symptoms improve, we may increase time between visits, potentially limiting them to every 3 months.
How do I schedule follow-up visits?
Usually Dr. Stein will schedule follow-ups at the completion of each visit. The fastest and easiest way to cancel or request a follow-up visit in-between appointments is by using the patient portal online scheduler, which can be accessed HERE; otherwise you can message or call the office.
How do I reach you between visits for non-urgent questions or requests?
If you have a non-urgent clinical or administrative question, you can instant message me or leave a voice message. You can also use email for administrative, non-clinical issues. Cancelations and reschedules should not be left via email.
See above section on How do I handle prescription refills?
Does Dr. Stein offer televisit appointments, or telemedicine?
Yes, Dr. Stein offers secure telemedicine visits. There are no “walk-in” telepsychiatry visits and they need to be scheduled in advance through the patient portal. Initial evaluations can be via live televideo visits after an initial 10 minute pre-consult interview, please see the section on “Initial Visits” to learn more and schedule Patients attending a televisit must concurrently be located in the State of California, must have confidence in the security and speed of their internet and WIFI, and their physical privacy.
What should I do in case of a clinical emergency?
If you are experiencing a life-threatening situation or an emergency, please call 911 and/or go to your nearest emergency department; then have them call the office and leave an urgent message for Dr. Stein or the covering doctor at 310-529-6051.
What should I do in urgent clinical situations that are not life threatening but cannot wait for the Office to check messages?
Only for already-established patients: Call the office at 310-529-6051 and select the Urgent option and leave a slow and clear message that will be transcribed and messaged to Dr. Stein or follow instructions on how to reach the covering doctor. If you do not receive a callback within 2 hours, please assume technical error and call again.