PRACTICE POLICIES

New patients will be asked to sign and return a copy of the practice policies prior to entering treatment. The policies can be found in the IntakeQ portal and signed electronically. Some of the most commonly referenced policies are also noted below.

PAYMENT FOR SERVICES RENDERED

A credit card must be kept on file (stored safely in the electronic health record system) during treatment at Evergreen Psychiatry. Evergreen Psychiatry does not participate with any insurance plans nor file claims on behalf of patients. Payment for services is due at the time of service. Payment will be billed to the credit card held on file unless other arrangements are made at the time of service.

APPOINTMENT CANCELLATION

The keeping of regular appointments is crucial to successful treatment. We will work with you to the best of our ability to find a convenient time for your appointments. The scheduling of an appointment constitutes an agreement to pay for the professional time reserved exclusively for you/your child.

Appointments cancelled with 48 hours notice or more will not incur a charge. Fees for late cancellations and missed appointments will be charged to the credit card on file.

CONTROLLED SUBSTANCES

All prescriptions for controlled substances (stimulants, benzodiazepines) will require a signed controlled substance agreement, and (by law) Dr. Harmon will check the appropriate state drug monitoring program database prior to prescribing any controlled substances.

Providers may not prescribe controlled substances without an in-person examination prior to starting the medication, and regularly thereafter (at least every two years). In keeping with the requirements of the Ryan Haight Act, Dr. Harmon cannot prescribe stimulants or benzodiazepines via telemedicine, unless a relationship has already been established from an in-person visit.

If you anticipate the need for a controlled substance prescription, please indicate this during the appointment scheduling process.

FEES & BILLING

Evergreen Psychiatry is considered an out-of-network provider. Most insurance companies will provide partial reimbursement for services rendered by a psychiatrist. If you have out-of-network benefits we will provide an itemized bill that you can submit to your insurance company for your entitled reimbursement.

Child (under 11) Initial Evaluation (150 minutes, 2-3 visits) $910

Adolescent/Young Adult (11-18, still in high school or with extensive parent support) Initial Evaluation (180 minutes, 2-3 visits) $1050

Extended Adult Initial Evaluation (18+, 90 minutes, 2 visits) $560

Standard Adult Initial Evaluation (60 minutes, 1 visit) $350

Extended Follow-Up Visit (50 minutes face-to-face) $350

Brief Follow-Up Visit (25 minutes face-to-face) $210

FORMS