Contact Us

Kayla Supley, Office Manager

Shannon Stott-Rigsbee, Office Assistant

3 Cumberland Avenue
Plattsburgh, NY 12901

T: 518-566-6000
F: 518-561-0674

Hours

Daniela V. Gitlin, M.D.

Monday - Wednesday:  Noon - 5 p.m.

Kevin N. Gitlin, M.D.

Monday - Friday:  8:00 a.m. - 5:00 p.m.

Office Information

Appointments

Phone Calls

Emergencies

Prescriptions

Cancellations & Misssed Appointments

Payment

Using Health Insurance

Paying Out of Pocket

Paying with Insurance

Appointments

We strive to run on schedule but unavoidable delays occur. If your session does not begin on time because we are running late, you will receive the full time of your scheduled session. However, should you arrive late, the session will unfortunately have to end at the scheduled time. If there is room in the schedule to run over, we will try to accommodate you, but we cannot promise to do so.

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Phone Calls

If you call during working hours, you will speak with one of our office staff. Should you get the voice mail system, that means they are answering other calls, or unable to get to the phone. Please go ahead and leave a message. If our staff can help you, they will call you back that day or as soon as possible the next working day. The doctors will do their best to return your call within two working days. 

If you call after hours, please leave a voice mail message. Your message will be picked up the next day by one of our staff, and relayed to us. Calls left during the weekend are returned early the following week.

It's not unusual for us to receive sixty or more calls a day. Please help us call you back quickly by stating your name AND your phone number in any message that you leave. Please speak slowly and clearly.

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Emergencies

We carry beepers when not in the office. We accept pages only from established patients of the practice and only for extremely serious medical problems that cannot wait until the office re-opens. Examples of legitimate reasons to page include:

  • a suicide attempt, or serious risk of suicide attempt
  • disabling medication side effects
  • unexpected worsening of the condition you are in treatment for
  • new, frightening symptoms
  • you are in the emergency room because of the condition you are in treatment for and need us to speak with the emergency room physician

You will be charged for pages that are not emergencies as if the call were an office visit.

For matters that can be addressed within a day or two, such as calling in prescriptions, please leave a message with office staff during working hours or leave a voice mail after hours.

For scheduling, canceling, or rescheduling an appointment, please call during working hours and speak with one of our staff. Please do not page the doctors after hours regarding scheduling matters. Scheduling is done with computer software during office hours only.

Please do not page us during office hours as we are in session with other patients. Call and speak to our staff, explain you have an emergency, and we will call you back as soon as we come out of session.

Should your situation be so urgent that you cannot wait for a call back after paging or contacting us at the office, please go directly to the Emergency Room at your nearest hospital.

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Prescriptions

As of March 2016, we were mandated by New York state to electronically prescribe. If your medications are not due on the day of an appointment, please call in to the office at least 72 business hours (or 3 business days) before you run out. We will send the prescription to your pharmacy eletronically as soon as we can. Less notice may result in a $25 charge.

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Cancellations & Missed Appointments

In order for treatment to be effective, regular appointments are a necessity. As a courtesy, our staff will call to remind you of your appointment. However, it is your responsibility to know when your appointment is and to keep it, or cancel it with appropriate notice. When you make an appointment, you are reserving our services for that time period.

You will be charged for appointments not kept and/or canceled with less than 48 (business) hours notice. (The voice-mail system logs the time). Insurance companies do not reimburse for missed or canceled appointments so you will have to pay out-of-pocket. Monday appointments must be cancelled by Thursday at 5 p.m. This will enable us to use Friday to offer another person the Monday session you are canceling.

Office hours are limited. If you are unable to keep your appointment, other patients in the practice could use that time. 48 hours notice is generally enough time for a person to make arrangements to come in on short notice.

The initial (first) appointment is an hour and a half session. Should you cancel with less than 48 hours notice or not keep the appointment, we will not be able to offer you another appointment unless you pay for the missed session in full. Your insurance will not cover this charge, so you will have to pay out-of-pocket. Once we have received your payment, we will be glad to reschedule.

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Payment

We are psychiatrists because we want to be of service to people. This is also the way we make our living. We've found that the relationship between our patients and ourselves works best when there is a shared understanding about financial issues.

Dealing with insurance companies to pay for treatment has become very complicated. Over the past twenty years, there have been significant changes in health insurance policies, in benefits, and in the paperwork required to use those benefits. Using insurance benefits to pay for treatment highlights some long-standing problems and may lead to new ones.

Please review the following sections "Using Health Insurance" and "Paying for Treatment Out-Of-Pocket" and consider both sides before making a decision. If you decide to pay out-of-pocket, simply let us know.

If you wish to use your insurance, proceed to the section titled "Paying with Insurance." Each insurance policy has its own rules and requirements for using benefits and getting reimbursed.

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Using Health Insurance

The primary benefit is clear. You paid premiums for health insurance, either directly or indirectly through your employer. It is an investment. One return on the investment is reimbursement for part of your treatment bill. This helps your budget.

Problems come in three areas: loss of privacy, loss of control of treatment, and the consequences of having a psychiatric diagnosis.

  1. Increasing Loss of Confidentiality:

     

    In the past, psychiatrists only needed to provide insurance companies with a diagnostic code, identifying information and dates of service. Now, "reviewers" and "case managers" working for the insurance company demand a detailed description of your problems, history, symptoms, family life, work life, and anything else they deem necessary. You have signed a form giving them permission to do this. In order to provide them this information, you must also sign a release with us. The information is then used to determine "medical necessity" and then, reimbursement.

  2. Loss of Control of Treatment:

     

    Managed care companies use the information we must provide to decide if treatment meets their criteria for "medical necessity" initially, and later on as well, if treatment continues. Managed care companies are for-profit businesses. They make money by limiting treatment. They do this by making the criteria for reimbursable treatment very restrictive.

    The two people who can best make treatment decisions are you, the patient, and one of us, the psychiatrist, in partnership. It used to work that way. Today, if you depend upon health insurance benefits, it may not.

    Control over treatment is also lost because some kinds of services and problems are not covered. For example, marital counseling and family therapy are not usually covered even though their effectiveness is well documented. Therapy for the destructive consequences of emotional/physical/sexual abuse and personality/relationship/work problems that often result are almost never covered by managed care.

    Managed care companies usually reimburse treatment that focuses only on symptoms. They usually refuse to cover treatment aimed at underlying problems that cause symptoms. Managed care is a system that works best in dealing with crises. However, if people don't address the underlying causes/issues, new crises are likely to occur.

  3. The Effects of Psychiatric Diagnosis:

     

    Health insurance benefits can only be used for the treatment of "illness." This means you must have a diagnosis to make your benefits available.

    We are increasingly seeing diagnoses come back to haunt people. Many people have found that using health insurance benefits for treatment has actually cost them money: their premiums went up after submitting a claim. This is unfortunate. There is strong scientific evidence that psychiatric treatment improves not just brain health but general health, which in turn reduces total medical bills. 

     Life and disability insurance applications have been affected. Military applications and security clearances have been held up. The insurance company sometimes notifies employers about all medical care visits, including psychiatric visits.

    Because we are psychiatrists, there is a strong possibility that at the beginning of treatment you will indeed have a diagnosis, and require medication. However, though medication will address the symptoms, it will not address underlying problems that are based on how you deal with stress, intense emotions, people, and your past, among other things, which set you up for further symptoms flares. The healing, curative part of the treatment occurs in the therapy process, is separate from the symptom relief that medication brings, and can usually only be done when you are symptom free. Most insurance companies resist paying us to do therapy.

    In order for you to trust us and trust in the treatment process, it is extremely important that we not engage in any fraudulent activity that would undermine our credibility with you. Padding or fudging a diagnosis with made-up symptoms, or giving you a diagnosis for the purposes of insurance reimbursement when you have no symptoms are examples of fraud.

    A more subtle and insidious consequence of giving you a diagnosis when you don't need one is this: the act of labeling you plants the idea in your mind that we really do think you are ill. This is true even if you are the one requesting the diagnosis to access your insurance benefits. Treatment contaminated by deceit is ineffective.

Choosing not to use health insurance benefits bypasses most of these troubling issues.

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Paying Out-of-Pocket

By paying for treatment yourself, you control all aspects of your treatment. You are free to choose your psychiatrist. No one needs to know you are in treatment unless you give your written permission. You and your psychiatrist decide what kind of treatment would be appropriate, including the frequency and for how long you will be in treatment. Confidentiality is assured.

What costs can you expect?
It is impossible to know, at the beginning, how many sessions or what kind of sessions, will be the most helpful. After a careful assessment of your situation and your goals, we can make an educated estimate.

Usually, 90% of outpatient treatments take less than 25 visits. If you are consulting with us for medication management only, the number of times you may need to see us in one year could be far less. We'll be in a better position to judge that after a few sessions and your needs become clearer.

It may be useful to think of treatment as an investment rather than a cost. Research studies show that people often experience a variety of gains from a successful outpatient course of treatment.

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Paying with Insurance

We are unable to call your insurance company to obtain the specifics of your policy. We require you check your insurance coverage in preparation for the first session. Once you are in treatment, your insurance may change. It is very important that you notify us of all changes in your coverage. If you don't, and we continue billing your old insurance, it may not be possible after a certain time to rebill to the new insurance to receive payment. If that happens, you will have to pay for those sessions out of pocket.

It is your responsibility to call your insurance company to find out what the rules are for using your benefits. If your new insurance requires pre-certification for a visit, and this is not done, you may have to pay for your session out of pocket.

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