I never close for bad weather. If you cannot get in because of the weather, we can still do something at your appointment time. Please note that my 48 hour cancellation policy applies no matter what the weather. As long as I have a working cell phone or a working internet connection, I will keep my appointments with patients. I believe that it is better to have an appointment, even if in may be somewhat harder to do by phone, or a bit harder to do telepsychiatry than to skip it altogether.
I am able to get to my office in any kind of weather, so I can be there if you want to come in. If you want, we can do things over the phone (or even better, by telepsychiatry, and save both of us time. The quality of telepsychiatry video is very good, and I strongly suggest that you consider getting set up for it. Telepsychiatry is good not just for seeing me without having to come in, but given the price (free), it's a fabulous way to stay in contact with people all over the world.
Because I am often doing sessions with people over the phone during bad weather, the chances are high that my office phone will be busy at the time if you call or videoconference me. If you are calling or videoconferencing in for your appointment rather than coming in, please call 443 470 9101 or text a couple of minutes after your appointment is scheduled to begin as I may be finishing up with another person.
- If you miss your appointment, you will be charged.
- If you cancel your appointment with less than 48 hours notice, you will also be charged, unless I am able to fill your scheduled time with someone else.
The first of these policies is standard procedure for most mental health professionals. The second of these policies relates to how I run my practice. My schedule is either filled or close to filled most of the time. If I am seeing someone else, I am not able to call someone else to reschedule your appointment when I am seeing a patient, and the time I previously scheduled for you goes to waste. Please be considerate of my time and that of others.
The only time I make an exception to these polices is for life-threatening emergencies or the death of immediate family members.
If you are not able to be at my office but are able to talk, we can do your appointment by telephone and you should call 443 470 9101 a couple of minutes after your scheduled appointment time.
My calendar program usually sends you a reminder 72 hours before your appointment. Because of the vagaries of email, I cannot be responsible if this email fails to reach you.
- I do not respond to requests for prescription refills from pharmacies because I always want to talk to the patient first. Asking pharmacy staff to fax or call in refill requests only wastes your time and theirs.
- When patients call in for refills out of session I see it as a red flag that something has gone wrong. I believe that anytime people call for refills out of session that a medication error has occurred, and I want to be proactive about preventing medication errors, which can lead to serious harm. I feel that whatever problem which led to the medication error needs to be addressed and fixed, not ignored or swept under the rug.
- Like most physicians, I DO NOT REPLACE ANY LOST, STOLEN OR PREMATURELY FINISHED PRESCRIPTIONS FOR SCHEDULE II DRUGS SUCH AS STIMULANTS OR PAIN MEDICATIONS.
I want to do all prescriptions refills during your session. There are six good reasons for this policy:
Prescription refills outside your session are due to:
- errors on my part or the pharmacy's part,
- some error in the way you take your prescriptions,
- the timing of your appointments,
- a failure on your part to keep up with your refills, or
- a discrepancy between what I think you are taking and what you are really taking.
The error rate on prescriptions that are called or faxed in is significantly higher than those which are handled during your session. Within the field of medicine, there is a big push to avoid medical errors. All errors due to telephone or fax mis-communications are reduced by not doing refills by telephone or fax. Also, if there is an error in the communication between me and your pharmacist, there is no way to find out which one of us has made a mistake.
- If your medication dose needs adjustment, it makes much more sense to talk about this during your session than to make a rushed decision over the phone with incomplete information.
- Calling for prescriptions outside your session wastes your time,
- Calling for prescriptions outside your session wastes my time,
- I am not set up to provide paperwork services on the days that I am not in my practice office, so many times a refill out of session is not feasible. I regret that I am not able to provide 24/7 paperwork services, but I do not plan on raising my overhead (and my fees) so that could happen. I would rather charge people who require this kind of service a fee rather than raising my rates for everyone.
If you need me to fill prescriptions outside your session, I consider this service to be emergency paperwork and my minimum fee for this service is the charge for 15 minutes of my time.
If you are out of a prescription because of changes I made between one of your sessions and the next, I will refill medications outside your session without charge. However, if you have run out of medication because you missed or rescheduled your appointment, you will need to pay the emergency paperwork fees.
Paperwork outside your session
In general, I prefer do all my work for you during your session. I do not charge any additional fees for any paperwork that we do during your session. When we are together, it is much easier to get things done quickly and efficiently. If you need any paperwork from me, such as insurance forms, prescriptions, letters to work, etc., please let me know at the beginning of your session so that we can attend to them during your session. If you wait until the end of your session, we may not have time to complete them, and you will will probably need to wait until the next time we meet. I believe it is unfair to my next patient for me to delay his or her session because of paperwork that could have been done during your session.
As a rule, I do not attend to non-clinical matters outside your session. Anything that is not an emergency will need to wait until your next session. If I absolutely must attend to a non-clinical matter at any time other than during your session, I charge for this time in 15-minute increments. You must pay in advance for at least 15-minutes (or more if I know that it is going to take longer than 15 minutes). I will charge you from the moment I start something until I complete it and you must pay the balance of any additional charges at your next session.
You should know that insurance companies and pharmacy management companies often keep people on hold for 20 minutes or more, so these calls can get expensive quickly.
Most health insurance companies contract with another company, called a "pharmacy benefits manager" or PBM, to restrict your access to your medications.
If you go to the pharmacy and are told "we need prior authorization from your doctor," you should know that this statement is terribly misleading. What is going on is that your PBM is restricting your access to your medications, not your physician, and not your pharmacy.
To save money for your health insurance company, the PBM intentionally introduces considerable delay in the process of getting your medications. They do this through a variety of methods such as:
- asking for long forms to be filled out, many of which are not available online,
- insisting on personal conversations with me, often with 15+ minutes waits on hold,
- turning off fax machines Friday afternoon and not turning them back on until Monday morning, and
- taking two or three additional days to make a decision after all the information has been provided to them.
The good news is that most prescriptions will approved by your PBM. The bad news is that the more they can delay you getting your prescriptions, the more money they make.
It is probably as important these days to know your pharmacy benefits manager it is to know your health insurance company.
If you have complaints about delays in getting your prescription filled, I would suggest you call your insurance company and complain about their pharmacy benefits manager to them. The problem relates to a contract between your insurance company and another company where each benefits by blaming the other for any problems.
Please note that prior authorizations involving telephone calls outside your session fall under the category of "emergency paperwork," and involve additional fees as these are issues that due to your insurance company, not to your clinical condition.
Although I am familiar with most of the major PBMs, if I am not familiar with yours, you will need to get the necessary forms from your PBM.
If you have an emergency and cannot reach me, please go to the nearest emergency room and ask to see a psychiatrist. I try to answer phone calls as promptly as I can, but I also have a policy of not taking phone calls from one patient while I am with another patient, so that sometimes limits my opportunities to get back to you.
The bottom line is that if you don't think that you can wait for about 24 hours, you should probably go to the nearest emergency room.
I do not charge for most brief phone calls or emails directly related to your clinical condition. By clinical, I mean dealing directly with
- your family members,
- a pharmacist who needs to clarify a prescription,
- another physician, or
- another mental health professional regarding your treatment.
Dealings with anyone else are non-clinical, for example:
- insurance companies,
- pharmacy benefit management services, and
- attorneys because I am not working for them and they do not reimburse me for the use of my time.
Furthermore, I consider it a non-clinical matter to:
- fill out forms,
- reprint receipts,
- replace lost or stolen prescriptions (some lost or stolen prescriptions cannot be replaced),
- refill expired prescriptions, or
- write letters for you because these matters can easily be taken care of during your session.
If you need me to do things outside your session you will need to pay additional fees for paperwork
Please note that I do not respond to phone calls from insurance companies until I have received a signed release of information from you.
I do my best to respond to emails or voicemails within 24 hours, but if you cannot wait that long, you should go to the nearest ER or call 911.
My email address is: firstname.lastname@example.org
I try to check my email once a day. For privacy reasons, I advise that you to be thoughtful when using email to contact me. Email is much less private than most people think, and many people such as systems administrators, bosses, and curious family members can often read any email that you send. Email communication is good for a brief note saying something like "you asked me to check in with you to let you know everything is fine, and it is." or "I can't make next week's appointment," but bad for anything complicated or anything that you would not want to have widely known. I do not believe that it is possible to practice medicine by email, so please don't be offended if my response to your email is something like "Call me at the office."
Depending on whether I need to triage my email, it may take up to 24 hours to return your email, and sometimes longer, particularly if I am travelling. In an emergency, go to the closest ER or call 911.
Please see communication for policies on clinical communications.
Please note that your internet service provider may put email the email from me (or anyone else) to you in your spam folder, and that email service, like the U.S. postal service is not completely reliable. I cannot be held responsible if your internet service provider is putting my email to you in the spam folder--this is not something I can control.
I offer telepsychiatry services via doxy.me and sometimes other videoconference methods such as Skype and Zoom. The advantange of doxy.me is that using it does not require that you install any software on your computer or phone, but you do have to allow access to your microphone and camera.
You must be a Maryland state resident.
- You must fill out a telepsychiatry consent form
- I reserve the right to terminate telepsychiatry services to any patient at any time if I do not feel that it is safe or meets professional standards of care.
If you have never used doxy.me before, click on the link below to test your system before your appointment.
You may wish to read the Getting started for patients document for some additional information about checking in to my virtual office on doxy.me.
My doxy.me website is at:
you may wish to bookmark this site for your next visit.
My Skype name is: patbarta
I would usually prefer to do video calls rather than audio calls for your sessions.
- I do not charge for sending medical records for clinical reasons if I have seen you within a year.
- I do charge for sending medical records for any non-clinical reason, or if I haven't seen you within a year. My current fees for this service are:
- $22.18 for preparation,
- $0.73 per page, and
- the cost of any postage and handling.
Charges for medical records must be paid before they are sent. I do not accept payments from anyone other than you. It is up to you to get reimbursed by insurance companies, the state of Maryland, etc.
There is a $25 charge for any check returned by the bank.