OCD HOTLINE OF NY & NJ ANSWERS WITHIN 24 HOURS

INSURANCE & FEES

SAVING MONEY ON THERAPY

My fee is $180 and I am out of network, as are all private specialists competent to treat OCD and other anxiety disorders.


I only want to be sure you get the right kind of therapy, regardless of whether you choose to see me or someone else.  Every therapist says they treat OCD, but don't waste time and money and suffer longer seeking help from someone on your insurance plan.  There simply are no therapists on any plan that are specialized to treat OCD and anxiety disorders.  They are generalists, who might be good for talking about relationships, a crisis, or self esteem, but not OCD and anxiety.  Why is this?  Therapy is like anything else; you get what you pay for, and a $50 therapist does not offer the same expertise.  To learn more, email a question or request a free consultation within 24 hours.  Of make an appointment online now or call 212-726-2390.

Treatment is more affordable than ever before.

The good news is that treatment for OCD is more affordable than ever before.  Most clients' insurance reimburses them for the vast majority of my fee and offer a generous number of sessions.  Even better news is that due to a new law, called Timothy's law, that requires insurance to cover treatment for OCD and anxiety (which they term a "biological condition") at a higher rate (as much as 80%) and usually for more or unlimited sessions.  So going of network isn't as expensive as it used to be.  In fact, even with if you have an HMO or Medicaid with no out-of-network coverage, I will negotiate with your insurance to cover me as if I were in network.  See below for instructions on negotiating with insurance.

We negotiate with your insurance to cover therapy.  You focus on getting better!

I  WILL  NEGOTIATE  WITH  YOUR  INSURANCE  TO  COVER  ME:

 

I am often successful in negotiating with HMOs, EPOs, and Medicaid (Amerigroup, HealthPlus, Horizon, USHC, etc.) to cover me as if I'm in-network.  If successful, that means you would still pay me my same full fee of $180 at each appointment, but I give you a receipt, and your insurance pays you back everything except your standard copay and/or deductible.  It's not a guarantee, it takes a month to get a decision and involves some hassle on the client's part, but it costs nothing to try and is sometimes successful.  It requires you to start the process.  Please follow the instructions below exactly as they are written.

One call from you is all it takes to get started. We take over from there.


1.    Please call your policy’s customer service department (on your insurance card) and tell them: “I am seeking a ‘single case agreement’ to cover an out-of-network psychologist that I am seeing.” (Sometimes it might be called an "ad hoc agreement" or "exception authorization" or "exception accommodation.")

 


2. They might transfer you to an “intake” person or "care advocate" who will just take down basic facts. Always get the names of all people you talked to. That might be important as insurance companies have a funny habit of "forgetting" what they promised you.


Tell them the following:


a. “I am seeking a ‘single case agreement’ to cover services of an out-of-network psychologist I am seeing. I need a male psychologist in my area who treats OCD with exposure response prevention (ERP), and who can provide therapy outside of his office, and I called all the providers on the list and none fit this description.” (If you wish to tell them that you want “a therapist who is religious,” which I happen to be, it will greatly improve your chances; you don’t have to justify why. If they say you can't choose the religion of your therapist, just say you want someone "initimately familiar" with your religion or values.)

b. Emphasize that “exposure response prevention is the only therapy recommended for OCD” by the Obsessive Compulsive Foundation, which is the national medical organization for the treatment of OCD, and the Expert Consensus Protocol for OCD Treatment.

c. Ask them to call Dr. Brodsky at 212-726-2390 "to negotiate a fee" and cover his services. Usually, they will just take the facts (they will not argue with you). Before you hang up, get their name and a “reference number” for your discussion. This will ensure they approve coverage retroactive to that date. If they won't call me, get a direct number or extension for me to call, or ask if I can fax the request instead of calling. This will speed up the process. If you can't get that, at least get the number for their "Behavioral Health" division.


3.     Usually they tell you they will send your case to a “care manager” or “care advocate” or “utilization manager” who conducts a “clinical review” of your case.  Next, the care manager will talk to Dr. Brodsky to get further details to justify “medical necessity.”

Make sure to have these instructions visible when you call.  Follow them exactly.


4.     If they give you a hard time, which is very rare:


a.     Ask to speak to a supervisor if the person you are speaking with can’t help you.  If that doesn't work, just hang up and call again.  You'll get a different person and probably a different answer.


b.     If they say you can’t specify religion, which is highly unlikely,  you can still tell them you only feel comfortable with someone who is religious in general, or who is knowledgable about your faith.


c.     You can prove the necessity of ERP by showing them supportive professional documents I'll provide.

d.     They might send you several suggested in-network therapists to call first before authorizing Dr. Brodsky.  Just call your insurance back the next day and tell them you called everyone on their list and they either don't do ERP, don't specialize in OCD, hoarding, or panic, aren't male, made you uncomfortable religiously, challenged your beliefs or values, are too far away, aren't taking new clients, or didn't return your call. 

5.     Bottom line, keep calm but don’t take no for an answer.  If they ever give you a hard time, remind them:  “You are legally required to cover appropriate treatment of my condition (even if they are an HMO), and must make alternate arrangements if your providers can’t treat me.”  If you have out-of-network coverage, and they tell you to see me at the out-of-network rate, tell them it's still unaffordable.  

Keep calm.  You have a legal right to coverage.

Note that insurers are obligated to provide adequate care for everything.  When they offer out-of-network coverage, they charge a hefty fee to accomodate a patients' preferences and freedom of choice because patients "like" their old doctor and don't want to change when they get a new plan.  So out-of-network providers are essentially a substitute for an existing in-network provider.  However, insurers are not off the hook if they totally lack any competent in-network provider.  That would mean you're really not insured and would be forced to go out-of-network.  So insurers are still obligated to provide coverage of my services at an in-network rate.

6.      If they finally deny your request in writing, we may appeal their decision twice.  In the interim, if they finally authorize coverage, they usually authorize it retroactively to when you called or often even your first appointment.


For details, email a question or request a free consultation within 24 hours. If we can negotiate insurance coverage for you, insurance companies often authorize coverage retroactively to when you called, if not starting from your first session.  If you don't want to wait and are ready to start, you can make an appointment online now or call 212-726-2390.


IF YOU HAVE NO INSURANCE

If you're uninsured, have extremely minimal resources, or work for a company that is "self-insured" you might be eligible for free or low cost insurance.  You can apply any time of the year.  You don't have to wait for an "open enrollment period" if you're uninsured or losing your insurance (e.g. due to job termination, aging out of parents' insurance, etc.).  A great place to look up plans is www.healthsherpa.com.  It's very user friendly.  You can choose a plan and apply in 10 minutes.  The best part is, if you qualify, they will automatically forward your application to Medicaid, Medicare, or other free program.  Insurance is the best thing you can do for you're mental health; a routine slip, fall, and fracture could wipe out most people financially and medical care is far more expensive than psychotherapy.


In the interim, even without insurance there are excellent alternatives.  In the NY-NJ Metropolitan area, the following are more affordable alternatives for OCD, Panic, and PTSD treatment which either might offer a sliding scale (affordable) fee and use he same techniques as we do:


1. Cornell Medical Center's "Payne Whitney Clinic" on the upper east side of Manhattan 212-746-5868


2. Columbia Presbyterian's "NY Psychiatric Institute" on W.168th and Riverside Drive, call: Jose Hernandez at 212-543-5367 or James Bender Jr., Psy.D., 212-543-5462, or look up http://www.columbia-ocd.org/.


3. Montefiore Medical Center's "Anxiety and Depression Clinic" in the Bronx


4. Cornell Medical Center in White Plains, NY


5. White Plains Hospital


6. Rutgers Anxiety Center, Piscataway, NJ


7. Mt. Sinai OCD Center, Manhattan


8. Hofstra University Graduate Psychology Clinic (Long Island)


9. Yeshiva University Ferkauf Graduate School of Psychology Clinic (Bronx)