My fee is $180. I am out of network, as are all private specialists competent to treat OCD and other anxiety disorders. Regardless of whether you see me or someone else, don't waste time and money 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 they won't get rid of your 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.
The good news is:
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 70%) and usually for more or unlimited sessions. So whether or not the therapist is in-network doesn't make as big a difference as it used to. In fact, even with HMOs, I can negotiate with them to cover me as if I were in-network. See below for more information on negotiating with HMO's. Book an appointment online instantly and insurance will likely authorize it retroactively, or call 212-726-2390 or email Dr. Brodsky for a free consult.
LOW COST TREATMENT: IF YOU HAVE NO INSURANCE
If you are uninsured or have an HMO or EPO, there are excellent alternatives. In the NY Metropolitan area, the following are more affordable alternatives for OCD, Panic, and PTSD treatment which either might take insurance or have a sliding scale (affordable) fee:
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., 212-543-546, 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
I WILL NEGOTIATE WITH INSURANCE OR MEDICAID TO COVER ME AS IF I WERE IN-NETWORK
I negotiate with HMOs, EPOs, and Managed Medicaid (Americhoice, HealthPlus, etc.) to cover me as if I'm in-network. If successful, that means your insurance will pay you back everything (their entire usual and customary fee) except your standard copay. In other words, you'll get back between a third to 70% of what you paid. 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 often successful. For info call Dr. Brodsky at 212-726-2390, or email Dr. Brodsky or make an appointment instantly online, and they'll approve coverage retroactively. To start the authorization process you have to make the first call to your insurance, and then I'll take over to advocate for you. Please follow the instructions below exactly as they are written.
1. 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 who will just take down basic facts. Get the names of all people you talked to. Tell them the following:
a. “I am seeking a ‘single case agreement’ to cover services of a 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 add 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 the details of your faith.
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 won't argue with you) and say someone else will review your request and speak to Dr. Brodsky. Before you hang up, get 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, and 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. That will greatly speed up your authorization.
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 yourcase. Next, the care manager will call either you and/or Dr. Brodsky to get further details to justify “medical necessity.”
4. If they give you a hard time, which is very rare:
a. You can prove the necessity of ERP by showing them documents from the OCD Foundation and the Expert Consensus Protocol, which appear on my full web site when you click on the link titled "Insurance."
b. Hang up, call again, and get someone else. If that doesn't work ask to speak to a supervisor if the person you are speaking with can’t help you.
c. 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 the details of your faith and who is willing to consult with your clergy.
5. Bottom line, don’t take no for an answer. If they ever give you a hard time, politely remind them: “You are legally required to cover appropriate treatment of my condition (even if they're an HMO), and must make alternate arrangements if your providers can't treat me, or if your insurance doesn't cover enough (if you have out-of-network coverage)." For more details visit my full web site and click on "Insurance & Fees."
If you have further questions, you an email Dr. Brodsky for a free consultation, call 212-726-2390 or, if you're ready, make an appointment online yourself, and usually insurance will authorize it retroactively.