These policies are to offer you the highest care according to the law and professional guidelines. They clarify our roles and responsibilities. By coming to see me, you are agreeing to abide by these policies. I operate strictly within these policies to maximize safety. You should see another provider if your needs cannot be accommodated within these policies and you want more flexibility.

You can always call 911 or visit your local emergency room for emergencies like if you ever feel like you want to hurt yourself, hurt others, or cannot get out of bed/eat/do your normal activities of daily living.

GENERAL INFORMATION
  • Appointments must be made in advance. There are no drop-ins except in emergency cases for established patients.
  • Practice hours are generally Mondays 1030am-130pm, Wednesdays 1030am-830pm, and Fridays 9am-130pm. 
  • The practice is closed on Tuesdays, Thursdays, weeknights, and weekends.
  • In general, I can only send prescriptions to pharmacies in New York. I am not able to send routine prescription orders to pharmacies out of state.
  • Animals are not permitted in the office due to allergies of others in our workspace.

THE FIRST VISIT
  • I will do a psychiatric assessment and present you with treatment options.
  • We will discuss whether you wish to initiate care with me or see someone else. I will also let you know if your needs fall within - or exceed - the scope of my practice. I may suggest a referral accordingly.
  • If you wish to continue seeing me, I will ask for any past treatment records.
  • Please note that I do not accept bookings for adults made on behalf of a family member or other third parties since mental health information is confidential. The sole exception is when parents make bookings for minors for the specific purpose of a DOE evaluation.
​
PAYMENT
  • All payment is due at the time of the appointment either in cash or check. Fees can be found here: http://www.neilkaggarwal.com/contact.html​. 
  • I will write you a receipt for all appointments if you would like. The responsibility for reimbursement from your insurance company lies with you, and I will provide any supporting documentation as long as we agree that it does not break your confidentiality.
  • If your check cannot be processed, I will ask you to bring payment for the last and next appointments in cash so that there is no problem with deposits.

APPOINTMENTS
  • The expectation of booking appointments is that you will come on time during my business hours. You can book on ZocDoc directly or call/email me for availability and I will try to fit you in. I do not hold appointments outside of my business hours and do not have drop-in visits unless there is a true emergency (you want to hurt yourself or feel unstable).
  • You will be charged full fee for a 30 or 50 minute appointment if you arrive late or leave early.
  • You will be charged full fee if you cancel an appointment without providing a minimum of notice 24 hours beforehand. The only exception is if you book for an open slot earlier or later on the same day. I will waive the fee of your first missed appointment in good faith since mistakes happen.
  • I will waive the fee only for personal or family medical crises. Being too busy at work and canceling the appointment without 24 hours of notice is not a valid exception.​
​
PRESCRIPTIONS
  • I only prescribe one month of medications for controlled substances and two months for non-controlled substances at a given time. If you are stable on medication dosages and live outside of a 50-mile radius from the practice, I will prescribe a maximum of one month for controlled substances and three months for non-controlled substances.
  • Every time I prescribe a controlled substance, I am required by law to check New York's Prescription Drug Monitoring Program to see if you are receiving controlled substances from other prescribers. This is for your safety since we are in a prescription drug epidemic. 
  • I will not prescribe controlled substances if: (1) you receive a prescription for a controlled substance without informing me, (2) you give away or sell your medication, (3) you use your medication in a way that is not how it was prescribed, (4) you repeatedly lose your medication.
  • I will not replace lost or stolen prescriptions. Please treat them like cash and store them in a safe space. This is especially true for controlled substances where I cannot write another prescription for the same 30-day period. Please file a report with your pharmacy and the police if your prescriptions are lost or stolen as many medications have high street value when sold illicitly. 
  • I do not refill medications without an in-person appointment. I adhere strictly to professional guidelines on checking each prescription's therapeutic and side effects. We will use this time to also discuss whether your medication is on formulary for your insurance company (if relevant) and what alternatives could be covered, if not. If you are worried about not finding an appointment when your prescription is up, please book in advance. My preference is to book your next visit during the current session. This will help avoid any possibly dangerous side effects of withdrawal.​ Prescribing by phone or email may seem convenient, but it is not standard of care.
  • Your pharmacy may reach out to me for a refill. I will then contact you to see when you can come in, as seeking medication refills are your responsibility. Neither the pharmacy or I know how much stock you have. I will prescribe a maximum of 7 days for a controlled substance and 10 days for an uncontrolled substance to bridge you until a next visit. If you cannot come in for a prescription within that time period, then I won't prescribe any longer.​

COMMUNICATION BETWEEN VISITS
  • I am available at 917-725-0723 at all times. I check voice mail regularly and will call you within one business day for non-urgent matters.
  • I use email only for administrative matters such as scheduling and forwarding receipts. The email is HIPAA complaint. Emails become a part of your medical record. 
  • I do not text with patients as it is not confidential.
  • Please do not use email or text for clinical matters such as crises, persistent symptoms, or side effects. Please call me. I will return your message as soon as possible if I'm in session.  
  • I will leave information about how to access services and who is covering my practice if I am out of town. Please note that covering physicians may have their own fees for psychotherapy and medication management such as filling prescriptions. They may choose to fill your prescriptions for a shorter period of time than I do and they may ask you for documentation - you can take a picture of your prescription directions and send it to them for proof.

WHEN TREATMENT COMES TO A CLOSE
  • In most cases, we will end treatment once your treatment goals are met.
  • In rare cases, you and I may have different expectations of each other. I may initiate a discussion on termination if: (1) your needs require a higher or different level of care than what I can provide in my scope of practice, (2) you miss two consecutive payments, (3) you miss two consecutive appointments, (4) you do not return my emails or phone calls, or (5) you knowingly violate my practice policies. I will then initiate a conversation about transitioning your care. Ending a relationship can be uncomfortable, but need not be conflictual.
  • I will provide you with (1) a list of referral resources (you can always search ZocDoc and PsychologyToday, or call your insurance provider for referrals), (2) availability for any urgent matters for as long as your prescription lasts, but will also refer you to your local emergency room or call 911 as well, (3) 30 days worth of prescriptions unless you have already received prescriptions beforehand and not come in for a follow-up appointment - then I will prescribe only 21 days of prescriptions, (4) a copy of your medical record which I will email to you if you want it to transition care elsewhere (link below in the next section). I will officially no longer be your physician after this 21 or 30 day period.
  • I will assume that you have implicitly decided to end our patient-physician relationship if you do not make an appointment to follow up within four months of our last appointment. We can then discuss whether to reestablish a patient-physician relationship if you wish to make a new appointment after this four-month period.

MEDICAL CONFIDENTIALITY
  • ​My relationship is only with you. It is not with your spouse, significant other, family members, close friends, other medical providers, attorneys, or insurance companies. Your safety and confidentiality are my priorities.
  • I will always protect your medical confidentiality unless you are at imminent risk of harming yourself, harming someone else, or unable to care for yourself. I will then call your emergency contact person provided during the first visit.
  • On my end, only I have access to your medical chart and invoices.
  • I will release your medical records to a third party only after you email me this form: https://www.health.ny.gov/forms/doh-5032.pdf.
  • I will not complete any documentation for a third-party such as an insurance company or disability administration outside of appointments. This is to avoid disclosing any medical information inadvertently. I will compete this information only during session when you will review the completed documents to protect your confidentiality.
  • Similarly, I can complete standardized prior authorization forms sent to me through my prescription software without an appointment. However, I will only speak to the insurance company by phone for prior authorization during an appointment to protect confidentiality.

COURT POLICY
  • I do not participate in person, by phone, or in writing in any court related matter that any of my patients may be a party to or become a party to in any way. 
  • At no time will I offer an opinion or recommendation in any court matter, especially as it relates to custody, disability, worker's compensation. I am not a forensic psychiatrist.
  • Should I be requested to write a treatment summary, I will not be stipulating in writing or in person as to an opinion. I will only provide clinical observations and feedback. At no time will I make a recommendation in regards to any other court related matter.
  • If a court order is served and is requesting that I be present in person and/or there is a request for records, patient consent will be requested before turning over confidential information. When obtaining this consent, the patient will be told exactly what has been requested by court and there is no guarantee that the information will be kept confidential. This includes a patient's mental health history; current status and inclusive records and may not be in the best interests of the patient. The patient-physician relationship does not render me an advocate. I will withhold any opportunity to engage in a dual treatment-forensic relationship with patients.
  • Should I be ordered to appear in court, the fee stipulation is as follows: (1) $2,500 per day plus $200 per hour for travel to and from the court AND (2) $300 per hour for preparation.
  • I will NOT be ON-CALL at anytime. Should a case be trailed, I will be paid in full for each day as well as an additional $1,000 per day as it hinders my ability to be available to other patients. 
  • All court fees must be received by cashier’s check 14 days prior to the court date. Should the court calendar the hearing for another date, I must be re-issued a court order with the new court hearing date.
  • Should I be on vacation, the party initiating the court order must take reasonable steps to avoid imposing undue burden or expense on a person subject to the subpoena. 
​
SERVICES I DO NOT PROVIDE (WHERE YOU SHOULD SEE A SPECIALIST, NOT ME)
  • Prescriptions for medical marijuana
  • Prescription for suboxone
  • Prescriptions for pain medications
  • Documentation for emotional support animals