2604-B El Camino Real; Carlsbad, CA
- Only telehealth services are provided at this tim
PHONE: (760) 295-3988
- Please call for a free phone consultation.
- I will do my best to return your call within two business days.
- Please do NOT send text messages to this number. Text messages will NOT be received on my phone. This phone number is a landline and thus is NOT equipped to receive SMS (normal mobile phone text messages).
- You can message me regarding quick administrative issues such as changing appointment times via the Signal Private Messenger app at (760) 295-3988. Signal is a free, open source, and secure alternative to standard texting that works on a smartphone.
- Internet is not a secure or confidential medium. Therefore, do not send by email any information which you consider confidential. Email communication should be
restricted to matters related to scheduling, and all other communication regarding clinical matters should be done over the telephone or in person.
- If you have a medical or psychiatric emergency, please call the San Diego Crisis Line at (888)
724-7240, your local hospital emergency room such as the Tri-City Emergency Room at (760) 940-3505,
- As a rule, I do not keep emergency hours and my concern is that messages regarding urgent matters may end up reaching me later than would be desired
or, in rare cases, not at all. I understand some clients may need more availability than I offer, so please consider this limitation when searching for a therapist that best meets your
OFFICE POLICIES AND INFORMATION
APPOINTMENT HOURS: Monday, Wednesday, Friday
FEES: $180 per 60-minute session of individual psychotherapy.
- If you are in need of financial assistance, please inquire about my sliding scale fees.
- My fees include the many handouts, worksheets, and readings that I prepare for you to continue the therapy process at home. The fees also include the time I spend
between sessions to prepare materials and content to facilitate treatment.
- My approach tends to be short-term and time-limited. Much of the information about anxiety and treatment strategies are provided in the first 8 sessions and many
people experience improvements during this time. I find though that many of my clients tend to continue therapy for 10-20 sessions which is the recommended amount for
the cognitive behavioral treatment of most anxiety disorders. The number of sessions can vary depending on severity of anxiety, years with anxiety disorder, life
situation, trauma history, and how well cognitive behavioral therapy matches your goals and learning style.
- When comparing costs of treatment, keep in mind that some talk therapies can go on weekly for months, if not years, with limited information and materials, which may
not be ideal for those suffering from an anxiety disorder.
- Lectures and speaking engagements are charged at $40 for each 15-minute increment, similar to the fee for therapy. However, I do offer many lectures free of cost.
Contact me for more details.
- Appointments are made to reserve a specific time slot for you, and therefore, a minimum of 24 hours notice is required for rescheduling or
canceling an appointment. A cancellation fee of $50 will be charged for sessions missed or rescheduled without sufficient notification. Most insurance companies will not reimburse for missed
Confidentiality is the cornerstone of mental health treatment and is protected by the law. I can only release information about our work to others with your written
permission. Some basic information about diagnosis and treatment may be required as a condition of your insurance coverage. In addition, I may occasionally find it helpful to consult with other
professionals. In these circumstances, I will make every effort to avoid revealing the identity of my client. The consultant is also legally bound to keep the information confidential.
Exceptions to confidentiality where disclosure is required by law:
- if there is threat of serious bodily harm others, I am required to take protective actions, which may include notifying the potential victim, notifying the police,
or seeking appropriate hospitalization.
- If there is threat to harm yourself, I am required to seek hospitalization for you, or to contact family members or others who can help provide
- If there is an indication of abuse to a child, an elderly person, or a disabled person, even if it is about a party other than yourself, I must file a report with
the appropriate state agency.
- If you are involved in judicial proceedings, you have the right to prevent me from providing any information about your treatment. However, in some circumstances in
which your emotional condition is an important element, a judge may require my testimony.
- If due to mental illness, you are unable to meet your basic needs, such as clothing, food, and shelter, I may have to disclose information in order to access
services to provide for your basic needs.
These situations have rarely arisen in my clinical practice, but should such a situation occur, I will make every effort to fully discuss it with you before taking any
I do not serve on the panels of managed care companies
which means that you will be responsible for paying all fees in full at the end of each session. With self-pay, you can be assured that you are getting the best available treatment without
restrictions and based on your needs and desires.
If you prefer to use your
insurance benefits, I will provide you with documentation that can be submitted to your insurance company as you may be able to receive some reimbursement with me as an out-of-network provider. Your
insurance company will determine whether to reimburse you or not and will likely request personal information about our therapy sessions to determine your reimbursement. If this occurs, I will
maintain as much discretion and confidentiality as is possible.
If you are going to use your health insurance, call them (there may be a separate phone number for mental health or behavioral health) and ask:
- Do they pay for mental health services? Do they pay for the services of a clinical psychologist?
- Do they cover out-of-network providers? And if so, what is the reimbursement rate (amount insurance pays per visit) for an out-of-network provider (vs in-network)?
What is the co-pay?
- Is the coverage for parity and non-parity diagnoses the same? If not, how do they differ (OCD, Panic, and Major Depression are considered parity diagnoses and are
covered similarly to medical illnesses whereas other anxiety disorders may not be covered in the same way)?
- What is the deductible and of the out-of-pocket maximum? How much has already been met?
- What is the maximum number of visits per calendar year? Maximum amount paid per calendar year?
- Is authorization required? Are there any other limitations or exclusions for my coverage?
Negotiating payment and insurance can be a confusing process, especially for someone in the middle of a crisis, so if at any time this information becomes too
overwhelming, just give me a call as I have helped many previous clients through this process.
Reasons to not be on a managed care panel:
|Limitations on length of treatment and type of treatment
||Treatment is only authorized by insurance companies if a reviewer determines that the treatment conforms to the policies set by the company. This reviewer assesses
the severity of your problem, your motivation for treatment, and whether treatment is necessary, and then determines whether you will be reimbursed. This reviewer need not have any mental
health experience despite being responsible for making these very important decisions about your treatment. In addition, managed care companies encourage very brief treatment and favor the use
of medication over psychotherapy.
Choosing your own therapist
||Self-pay and out-of-network benefits allow you to choose a therapist that has the qualities and qualifications you are looking for.
To justify treatment and determine reimbursement, insurance companies will require disclosure of information about a client's most dysfunctional behaviors.
Treatment plans, progress notes, and a diagnosis may be required. Oftentimes, this information is put into a data bank and it is not always clear who has access to the information (some
employers have been able to access information from their employees' insurance companies), how this information is protected, and how this may affect the client's future abilities to acquire
insurance coverage in the future (health insurance, life insurance, disability).
|Managed care is a business
Managed care companies will often make treatment decisions based on cost rather than the needs of the clients. Being a business, managed care companies also use profits
for advertisements, executive salaries, political lobbying, and shareholders.
Managed care companies often require treatment to be "medically necessary" for it to be covered. This means that a psychiatric diagnosis is required regardless of your
reason for seeking therapy. Many clients come to therapy for issues such as self-growth, stress-management, or habit change, which are issues that may not warrant a psychiatric
All health insurance providers will be different but with in-network providers, insurance companies typically cover 80% of the fee set by the managed care company, which
usually mean a cost of about $10-20 for the client. Thus, an in-network provider is the most cost efficient choice. I am not on any insurance panels, and thus, am not an in-network provider for any
insurance. If a client sees a therapist who is an out-of-network provider (as I would be), the insurance company usually covers the same 80% of the fee set by the managed care company, but because
the therapist may charge more than that set fee, the client is left having to pay the difference. Thus, with an out-of-network provider, an insurance company may pay 80% of $100 (or whatever amount
they set) but because my fee is $180, this means the cost to the client is still about $100. The savings of $80 can be significant for some, while others feel it is not worth using insurance for this