EFFECTIVE JULY 1ST 2021
*PATIENTS ON CONTROLLED SUBSTANCES CAN NOW GO TWO MONTHS BETWEEN VISITS IF APPROVED BY DR GRACE
*PATIENTS NOT ON CONTROLLED CAN NOW GO THREE MONTHS BETWEEN VISITS IF APPROVED BY DR GRACE
THE COST OF VISITS IS NOW $120.00
1) PATIENTS MUST CHECK IN MONTHLY BY SUBMITTING THE FOLLOWING CHECK IN FORM
2) SELF PAY PATIENTS MUST PREPAY EITHER 1/2 OR 1/3 OF THEIR UPCOMING VISIT COST WITH FORM
3) ALL PATIENTS MUST PAY $20.00 PER MONTH TOWARDS ANY BALANCE OWED
In other words,
If you're on a controlled-substance you basically have to pay $60.00/month ($80.00 if you have a balance).
If you're not on a controlled you would have to pay $40.00 / a month. ($60 if you have a balance).
Additional visits would be additional cost but we would try to do everything we could by phone which is only about $25.00 a call if possible.
BELOW IS OUR CURRENT FEE SCHEDULE
NEW OR RE-ESTABLISH VISIT (CODE 90792)- $505.00 ($275.00)
If you go longer than six months without being seen by this office or are treated for mental health issues by another provider. You will need to reestablish as a new patient.
New patients are automatically given a follow up at 1 week and 3 weeks to monitor the progress of their initial care and instructions. These visits must be prepaid prior to the first visit.
ESTABLISHED PATIENTS OFFICE OR TELE VISITS
These visits are based on medical complexity. They may also be based on time if considerable time is spent counseling as well.
SIMPLE OFFICE OR TELE-VISIT (99213) - $120
MODERATE OFFICE OR TELE-VISIT (99214) - $120
COMPLEX OFFICE OF TELE VISIT (99215) - $200
These are based only on time. Only visits with physicians or physician assistants are billed. Nursing is not. Calls shorter than five minutes are not charged.
BRIEF PHONE VISIT WITH PROVIDER 5-10 MINUTES (99441) - $25
PHONE VISIT WITH PROVIDER 10-20 MINUTES (99442) - $50
PHONE VISIT WITH PROVIDER 20-30 MINUTES (99443) - $100
PLEASE UPDATE & REVIEW INFORMATION BELOW
COMPLETE MEDICATION LIST - to include all presciptions from other doctors offices and over the counter medications or supplements
CONTACT INFO AND RELEASE OF INFORMATION
AFTER COMPLETEING THIS ONLINE CHECK IN FORM, YOU WILL STILL NEED TO LOGIN TO THE VIRTUAL WAITING ROOM ON DOXY.ME AT YOUR APPOINTMENT TIME, THANK YOU