# Psychiatrist billed my insurance $495 for consultation. Is that anywhere near reasonable? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [April 2, 2014, 4:20pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176 "2014-04-02T16:20:52Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [April 2, 2014, 5:43pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/21 "2014-04-02T17:43:51Z")
My take is that with the current medical expenses that are common in the US there is a unstability. That being the pool of who can pay is getting ever smaller as prices increase, and those who can’t afford medical care getting every larger (directly related to price increase). Much like the stock market crash in the great depression this is going to lead to people getting medical care without paying and the few who can afford to pay for everyone’s medical, eventually this system has to collapse. Medical cost increase can not be expected to substantially exceed the rate of growth, and while a short term gain it must fail in the long term IMHO. ---
**Author:** ![Hello\_Again](https://avatars.discourse-cdn.com/v4/letter/h/85e7bf/32.png) [@Hello\_Again](https://boards.straightdope.com/u/Hello_Again)\ **Post date:** [April 2, 2014, 5:45pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/22 "2014-04-02T17:45:01Z")
I think it’s surprising that a person who can get along without medication sees a _psychiatrist_ since basically their only function is to dispense psychoactive medications. Usually they don’t treat on the behavioral level. ---
**Author:** ![CatherineZeta](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@CatherineZeta](https://boards.straightdope.com/u/CatherineZeta)\ **Post date:** [April 2, 2014, 5:57pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/23 "2014-04-02T17:57:18Z")
My primary care doctor recommended me to him to start with and the psychiatrist was going to refer me to counseling. I’m not sure why psychiatrist is in quotes- he has an MD. I apologize if I’ve offended anyone for seeking help. I suppose it’s those sorts of attitudes that prevent anyone from speaking up in the first place. ---
**Author:** ![Hello\_Again](https://avatars.discourse-cdn.com/v4/letter/h/85e7bf/32.png) [@Hello\_Again](https://boards.straightdope.com/u/Hello_Again)\ **Post date:** [April 2, 2014, 6:00pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/24 "2014-04-02T18:00:48Z")
Psychiatrist isn’t in quotes, stars are like italics. It not surprising you would see a doctor, it’s a little surprising to see a psychiatrist other than to receive a prescription. Because that what they do. They give out prescriptions. I’m sorry your having troubles, I certainly didn’t mean any insult. Again, stars are not air quotes. ---
**Author:** ![CatherineZeta](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@CatherineZeta](https://boards.straightdope.com/u/CatherineZeta)\ **Post date:** [April 2, 2014, 6:04pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/25 "2014-04-02T18:04:57Z")
My apologies- I’m on my iPhone and did not see that correctly. I know what quotation marks and asterisks are. Thanks. ---
**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\ **Post date:** [April 2, 2014, 6:09pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/26 "2014-04-02T18:09:41Z")
Yes, his initial consultation charge sounds about right. I called a psychiatrist a few months ago and she told me her charge for initial consultation is $475. I just got my EOB (now that I have insurance, yay!!) from the psychiatrist I saw recently and his charge was $465. ---
**Author:** ![Q.N.Jones](https://avatars.discourse-cdn.com/v4/letter/q/3da27b/32.png) [@Q.N.Jones](https://boards.straightdope.com/u/Q.N.Jones)\ **Post date:** [April 2, 2014, 6:22pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/27 "2014-04-02T18:22:01Z")
> [@CatherineZeta](#): > > Because I function better with Zoloft, but I’m not going to kill myself without it. As a mental health activist do you think that those with diagnosed depression but who can get by without medication shouldn’t see a doctor? No. With people who come to our organization, we generally try to convince them that it is important to pursue the interventions that will get them to optimal functioning as aggressively as possible. Then we get the pertinent details and direct them to the resources that they qualify for. If you’re interested in dropping the combative attitude, I would be happy to help you do that. PM me if you are. ---
**Author:** ![CatherineZeta](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@CatherineZeta](https://boards.straightdope.com/u/CatherineZeta)\ **Post date:** [April 2, 2014, 6:41pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/28 "2014-04-02T18:41:34Z")
Thanks for the added information. I was asking that as a serious question- not challenging you. ---
**Author:** ![RivkahChaya](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rivkahchaya/32/8919_2.png) [@RivkahChaya](https://boards.straightdope.com/u/RivkahChaya)\ **Post date:** [April 2, 2014, 7:02pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/29 "2014-04-02T19:02:19Z")
> [@Q.N.Jones](#): > > Also, I’m not sure why you wouldn’t fill the prescription just because you didn’t like what the doctor charged. Zoloft is not something people tend to abuse, and it’s cheap, so people don’t tend to resell it, either. Look at the prescription, and see if it is a 90-day prescription, or has refills on it. You may be able to fill it very cheaply, and with a good buffer of three months or more to find another prescriber. I’m kinda surprised your GP wouldn’t prescribe it, since it sounds like you’ve been on it before. It wasn’t like you needed monitoring or several follow-ups until you found the right drug. I’m more suspicious of this practice wringing money from people, or their insurance companies, by sending them to specialists within the practice, and getting the “new patient” fee when it isn’t necessary. It might simply be a policy within the practice, though, that only psychiatrists prescribe psychoactive drugs, only endocrinologists prescribe insulin, only pediatricians see patients under 12, and the doctors in the practice have signed some agreement to this effect, and soforth, even when it means that one person must see several different doctors in the practice. You might check on that. ---
**Author:** ![CatherineZeta](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@CatherineZeta](https://boards.straightdope.com/u/CatherineZeta)\ **Post date:** [April 2, 2014, 7:21pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/30 "2014-04-02T19:21:00Z")
It may be their policy to do that. My regular doctor told me he felt uncomfortable prescribing it in case it wasn’t right for me, but you’re correct, I have taken it before for three years when I was in high school (which I told him). I’ll see if I can get it cheaper anywhere else. It’ll be around $40 for the two month prescription that he wrote for me at the pharmacy closest to me. ---
**Author:** ![Blackberry](https://avatars.discourse-cdn.com/v4/letter/b/ecd19e/32.png) [@Blackberry](https://boards.straightdope.com/u/Blackberry)\ **Post date:** [April 2, 2014, 7:39pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/31 "2014-04-02T19:39:12Z")
> [@CatherineZeta](#): > > It may be their policy to do that. My regular doctor told me he felt uncomfortable prescribing it in case it wasn’t right for me, but you’re correct, I have taken it before for three years when I was in high school (which I told him). I’ve never been to a PCP who wouldn’t prescribe SSRIs that a patient had already taken successfully. I would hate that. Especially if I had to pay for it out-of-pocket! The cheapest option might be for you to find a new PCP, although maybe you don’t want to switch. ---
**Author:** ![Carol\_the\_Impaler](https://avatars.discourse-cdn.com/v4/letter/c/6a8cbe/32.png) [@Carol\_the\_Impaler](https://boards.straightdope.com/u/Carol_the_Impaler)\ **Post date:** [April 2, 2014, 8:04pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/32 "2014-04-02T20:04:24Z")
> [@CatherineZeta](#): > > It may be their policy to do that. My regular doctor told me he felt uncomfortable prescribing it in case it wasn’t right for me, but you’re correct, I have taken it before for three years when I was in high school (which I told him). > > I’ll see if I can get it cheaper anywhere else. It’ll be around $40 for the two month prescription that he wrote for me at the pharmacy closest to me. Call Kmart and Costco. I’ve spent a ton of time calling pharmacies to find the cheapest meds, and Kmart is always the cheapest (with a $10 annual rewards fee). Costco is equally cheap and will let you use their pharmacy without a membership. ---
**Author:** ![Inna\_Minnit](https://avatars.discourse-cdn.com/v4/letter/i/5f8ce5/32.png) [@Inna\_Minnit](https://boards.straightdope.com/u/Inna_Minnit)\ **Post date:** [April 2, 2014, 8:07pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/33 "2014-04-02T20:07:29Z")
> [@CatherineZeta](#): > > It may be their policy to do that. My regular doctor told me he felt uncomfortable prescribing it in case it wasn’t right for me, but you’re correct, I have taken it before for three years when I was in high school (which I told him). > > I’ll see if I can get it cheaper anywhere else. It’ll be around $40 for the two month prescription that he wrote for me at the pharmacy closest to me. Does your insurance have a mail order option? If you can fill for 90 days it’s often less expensive. ---
**Author:** ![Inna\_Minnit](https://avatars.discourse-cdn.com/v4/letter/i/5f8ce5/32.png) [@Inna\_Minnit](https://boards.straightdope.com/u/Inna_Minnit)\ **Post date:** [April 2, 2014, 8:11pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/34 "2014-04-02T20:11:38Z")
Another thought occurs to me. Zoloft should have a generic option. It’s possible (I don’t know) that it might be one of the walmart $4 meds. I would think you could see a list on their website? ---
**Author:** ![CatherineZeta](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@CatherineZeta](https://boards.straightdope.com/u/CatherineZeta)\ **Post date:** [April 2, 2014, 8:24pm UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/35 "2014-04-02T20:24:29Z")
Wal Mart or Costco are good options. Costco would work best for me since there’s no Wal Mart in the NYC area. The generic of Zoloft is Sertraline which is what he prescribed. K Mart is also very convenient for me. I will definitely consider switching to a PCP who is comfortable prescribing SSRIs- that will probably save me a lot in the long run. ---
**Author:** ![harmonicamoon](https://avatars.discourse-cdn.com/v4/letter/h/65b543/32.png) [@harmonicamoon](https://boards.straightdope.com/u/harmonicamoon)\ **Post date:** [April 3, 2014, 3:21am UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/36 "2014-04-03T03:21:26Z")
A lot of discussion about the price of the office visit, prescription, etc. But did the shrink help you? To me that would be the important question. Are you better off now? Do you go to them for a path to wellness or drugs? Sorry, I am just not getting it. ---
**Author:** ![Q.N.Jones](https://avatars.discourse-cdn.com/v4/letter/q/3da27b/32.png) [@Q.N.Jones](https://boards.straightdope.com/u/Q.N.Jones)\ **Post date:** [April 3, 2014, 4:22am UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/37 "2014-04-03T04:22:39Z")
You might consider filling the prescription for sertraline, and talking to your PCP about whether s/he is willing to do the refills in the future. Your PCP may be happy to do the refills now that a psychiatrist has evaluated you. ---
**Author:** ![CatherineZeta](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@CatherineZeta](https://boards.straightdope.com/u/CatherineZeta)\ **Post date:** [April 3, 2014, 4:33am UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/38 "2014-04-03T04:33:14Z")
Both **harmonicamoon** \*\*\*\*. For some people a combination of drugs AND therapy is what works best. As I explained above, my PCP referred me to a psychiatrist and the psychiatrist was supposed to refer me to counseling after getting me set on the Zoloft, but I haven’t followed up re: counseling yet and will likely go through other avenues than him. I hope that makes sense. My PCP started me on Zoloft because I have taken that before and I guess he and the psychiatrist thought it was fine to be on it while sorting out the counseling situation. I’ll inquire about that **Q.N.** \*\*\*\*- that’s a good idea considering they’re in the same practice. Presumably the PCP will trust the psychiatrist that I’m ok on the Zoloft. Sorry, I missed part of your question **harmonica** \*\*\*\*. Yes, he helped in the sense that Zoloft helps, but finding a good therapist (for talk therapy) will help a lot as well. ---
**Author:** ![Space\_Vegetable](https://avatars.discourse-cdn.com/v4/letter/s/6de8d8/32.png) [@Space\_Vegetable](https://boards.straightdope.com/u/Space_Vegetable)\ **Post date:** [April 3, 2014, 5:24am UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/39 "2014-04-03T05:24:25Z")
> [@CatherineZeta](#): > > **kayaker** - The receptionist at the practice told me that starting January 2014 (I saw this guy in February) mental health appointments were going to be billed as standard appointments, but she was obviously wrong. My fault for not asking a second person. If you relied on incorrect information provided by the psychiatrist’s office staff in deciding whether to go there, I don’t see how it’s your fault at all. It sounds like it’s their fault, and they need to honor the pricing info they gave you. I’d write to them, explain what you were told, and ask them to correct their billing error, cc’ing your insurance company. ---
**Author:** ![Blackberry](https://avatars.discourse-cdn.com/v4/letter/b/ecd19e/32.png) [@Blackberry](https://boards.straightdope.com/u/Blackberry)\ **Post date:** [April 3, 2014, 6:09am UTC](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176/40 "2014-04-03T06:09:49Z")
> [@Space\_Vegetable](#): > > If you relied on incorrect information provided by the psychiatrist’s office staff in deciding whether to go there, I don’t see how it’s your fault at all. It sounds like it’s their fault, and they need to honor the pricing info they gave you. I’d write to them, explain what you were told, and ask them to correct their billing error, cc’ing your insurance company. Agreed. For your own peace of mind it might be a good idea not to rely on the word of one staff member, but you \*should \*be able to. It’s definitely worth telling them. And if it turns out that the PCP won’t even refill a prescription for an SSRI that was prescribed by another doctor in their practice, knowing how much money the patient will have to pay out of pocket to talk to the psychiatrist for a few minutes every few months…well, I’d say it’s definitely time to find a new clinic, because this one sounds like bullshit. [Previous page](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176.md?page=1) [Next page](https://boards.straightdope.com/t/psychiatrist-billed-my-insurance-495-for-consultation-is-that-anywhere-near-reasonable/685176.md?page=3)