Frequently Asked Questions (FAQ)
General FAQ
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Yes, I am currently taking new patients in Washington state.
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I treat a wide range of psychiatric conditions, with a particular focus on individuals dealing with depression, anxiety, trauma related disorders, ADHD and the intersection of addiction, chronic pain and chronic medical illnesses. I am also extensively trained in treating sleep disorders, psychotic disorders (such as schizophrenia/schizoaffective disorder), stress management, burnout, life transitions, and identity issues spanning cultural, ethnic, sexuality, gender, and college age issues.
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I see adults ages 18 to 63 years old.
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That is 100% ok! I will manage the medical aspects of your care, and you can continue to meet regularly with your therapist. We will work closely to coordinate your care effectively.
Integrative Psychiatry Questions
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Practicing integrative psychiatry means that I blend medication management with evidence-based complementary therapies to address psychiatric symptoms and enhance overall well-being. Integrative psychiatry embraces both Western and Eastern medicines, providing a wider range of healing possibilities. It is important to note that I am not against medications; rather, we will explore its benefits alongside other strategies such as supplements, psychotherapy, lifestyle management, mindfulness, yoga and other modalities to tailor a personalized, comprehensive treatment plan.
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Integrative clinicians leverage the strengths of Western medicine alongside evidence-based alternative therapies for a balanced approach to healing. Unlike alternative healers who steer clear of Western medicine entirely, integrative practitioners integrate the most effective elements from both practices.
Medication Questions
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I have an office in the Fremont area and aim to meet all patients in person once to comply with DEA regulations for writing controlled substance prescriptions.
I cautiously prescribe controlled substances, including stimulants for ADHD, sleep aids for insomnia, and benzodiazepines for anxiety/insomnia.
While I don't prescribe esketamine/Spravato due to FDA requirements given the set up of my clinic, I can offer referrals to clinics that do. Additionally, I prescribe lower doses of ketamine for therapy if you and I feel like it would be beneficial for our therapy sessions.
While I do prescribe suboxone for opiate use disorder, I do not prescribe other opiate medications such as oxycodone, hydrocodone, etc. These medications would need to be written by your primary care provider or other pain specialist provider.
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Medication refills will be sent electronically via the electronic medical record IntakeQ to your pharmacy. I typically submit refills during scheduled appointments and provide enough refills until our next appointment. As long as you are coming for regularly scheduled appointments at the minimum of every three months, you typically will not need me to refill between appointments; however if that does arise, I can provide medication refills between appointments if deemed appropriate.
It is best to send me a secure message in the patient portal so you can explain why you need the refill early. I then can put in the refill electronically and will let you know when it is complete. Please allow for a minimum of 3 business days for me to respond to refill requests. Do not leave these requests to the last minute as you might run out of the medication. If you have not been seen over the previous three months, you will need to schedule an appointment to obtain a refill. If you have been discharged from the practice, I will not be writing you medication prescriptions unless it is agreed upon.
In some cases I may prescribe controlled substances as part of your care. This list includes but is not limited to stimulants for ADHD such as Ritalin and Adderall, sedatives/hypnotics for insomnia such as Ambien, Sonata, and Lunesta, and benzodiazepines/anxiolytics such as Ativan, Xanax, and Klonopin. It is important to take these medications as prescribed, and not to increase or change your dose without specifically discussing with me. In the case that you change your medication dose on your own and run out early, I will not provide an early refill and you may experience withdrawal symptoms. It is your responsibility to keep them safe. I recommend keeping them in a safe, secured location. Toxicology screens will be required on an annual basis for safety. Please note that i do not write for opioids such as oxycodone, oxycontin, or hydrocodone.
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I don't currently accept insurance and operate as an 'out-of-network' provider with all insurance companies. However, I offer itemized receipts, known as ‘superbills’ which may facilitate partial or even full reimbursement from your insurance provider if you have out-of-network benefits. Additionally, you can utilize your Health Savings Account (HSA) for payment. Insurance plans typically cover prescription medications, laboratory tests, and some specific genetic panels. More details about my billing practices and fees are available here. If prioritizing insurance coverage is important to you, I suggest exploring an in-network provider.
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In many insurance-driven psychiatry practices, sessions are often limited to 15 minutes, primarily focused on medication refills, with minimal, if any, time for psychotherapy. The psychiatrist has little time to discuss alternatives to medications given the time constraints. Additionally, finding a practitioner well-versed in integrative psychiatric approaches can be challenging.
On the contrary, I am dedicated to delivering evidence-based integrative psychiatry services. Freed from the constraints of the insurance industry, I prioritize spending more time with you during sessions, fostering a collaborative and personalized treatment plan. With manageable patient numbers, you can conveniently schedule appointments and enjoy direct access to me between visits.
While the upfront cost may be higher, the long-term benefits far surpass these differences. Studies have also shown that people free of mental health symptoms earn 50% more income than those suffering with severe symptoms. Effective treatment makes financial sense. Investing in your mental health is an investment in YOU!
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While my services are fee-for-service, you can still use your insurance for other related expenses like prescription medications that I might prescribe, lab tests that I might order, and disease screenings, as typically covered by insurance plans.
In addition, if your policy supports out-of-network coverage, you can seek partial or full reimbursement for our visits. I recommend calling your insurance carrier and asking the following questions to get a better idea for how much you will should be reimbursed by them:
What is my eligibility for out of network mental health outpatient telepsychiatry care?
How much will be covered for out-of-network office visits with CPT code 90792 (Initial intake code), 99214 + 90833 (25 min follow up appointment), and 99214 + 90836 (50 min follow up appointment)?
Am I responsible for a certain amount of payment each year (deductible) before my insurance starts to cover payments?
How many sessions are covered by my plan per calendar year?
If I am asked by you, I'll provide you with a detailed ‘superbill’ (essentially a receipt with diagnostic codes for our visit) following our visit for you to submit to your insurance for partial to full reimbursement. Additionally, my partnership with Reimbursify.com simplifies this process, helping you much more easily collect out-of-network benefits from your insurance company.
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My fees are listed on my Services page.
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Payment in full is required at the start of each session, and you can conveniently use credit or debit cards, as well as HSA/FSA cards. Unfortunately, I do not accept cash or personal checks. Following each session upon request, l will promptly email you a receipt/invoice and can provide a ‘superbill’.
Finance Questions
Scheduling and Appointments
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New client appointments and follow-up visits are usually available within 14 calendar days.
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If you reside in Washington state, have reviewed my services and fees page, and sense that we could be a good fit, please schedule a complimentary 15 minute introductory phone call. This call will provide an opportunity for us to discuss your goals and how I can help you start feeling better. At the end of this call, we will schedule our first initial consultation intake.
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The frequency of our meetings depends on your current challenges and the tailored treatment plan we devise together. In the initial stabilization phase, we may meet every 1-4 weeks, transitioning to once every 1-3 months once stability is achieved, based on your preferences. For straightforward cases, follow-up visits are usually 25 minutes, but if you prefer extended sessions, we can allocate 50 minutes. Complex cases or sessions requiring more discussion merit 50-minute follow-ups. Therapy sessions occur more frequently—typically 50 minutes every 1-2 weeks.
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All appointments are via telemedicine using a secure video platform through my electronic medical record system IntakeQ. I do like to meet once in person (ideally our second appointment) at my office in the Fremont neighborhood in Seattle so that if in the future I need to write a controlled substance, I have the ability to do so.
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Following our initial 15 minute phone consultation (which you do not need to do anything prior), you will receive an email with a link and a code to complete intake paperwork in an online portal for our initial 90 minute or 120 minute consultation visit. It is very important that you complete this intake paperwork at least 2 days prior to the 90 or 120 minute consultation so that I have time to review it prior to our initial consultation. It is quite extensive so please allow for ample amount of time when completing it. You do not have to complete it all in one sitting. You can save your answers and come back to it. Should you not complete the paperwork, I will have to go over many of these questions with you during the initial consultation which will take time. We may not fully complete the intake and it will need to be completed at our second appointment, delaying some of our treatment planning.
Emergency
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If you or someone you know are having an emergency (suicidal, homicidal, putting oneself or others in danger), please call 911 or go to the nearest emergency room. You may also contact the King County Crisis Line which is available 24 hours a day, 7 days a week at 206-461-3222 or 866-4-CRISIS (866-427-4747). You can also visit their website at www.CrisisConnections.org. You may also contact 988 which is the National Suicide and Crisis Lifeline.
As the only physician in my practice, I do not have weekend or evening coverage. Also there are some days that I might only check my messages once during the day so it is always best to seek the aforementioned services if having an emergency. I, of course, would like to be notified if you are having an emergency, but please do not wait to hear back from me before taking steps to safely address the emergency.
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The following resources are up to date as of Feb 1, 2024
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
National Hopeline Network: 1-800-SUICIDE (800-784-2433) ; thehopeline.com
Crisis Text Line: text "START" to 741-741
Self-Harm Hotline: 1-800-DONT CUT (1-800-366-8288)
The Steve Fund: Young People of Color can text "STEVE" to 741-741 to connect with a trained crisis counselor 24/7
Veterans Crisis Line: veteranscrisisline.net
National Domestic Violence Hotline: 1- 800-799-7233
Planned Parenthood Hotline: 1-800-230-PLAN (7526)
Substance Abuse and Mental Health Services Administration (SAMSHA) National Hotline: 1-800-662-5357
American Association of Poison Control Centers: 1-800-222-1222
National Association of Anorexia Nervosa and Associated Disorders (ANAD) 1-888-375-7767, open Monday to Friday 7 am - 7 pm PST
LGBTQ+ National Hotline: 1-888-843-4564
LGBTQ+ National Hotline: 1-888-843-4564
LGBT National Coming out Support Hotline: 1-800-688-5428
LGBT National Senior Hotline 1-888-234-7243
TREVOR Crisis Hotline (for LGBTQ+ youth): 1-866-488-7386
Trans Lifeline: 877-565-8860; translifeline.org
AIDS Crisis Line: 1-800-221-7044