Joseph Bryer, M.D.
Joseph Bryer, M.D.

Practice Policies and Information

 

New Patients:

At this time, my ability to accept new patients is very limited, but would include those seeking ECT consultations or second opinion consultations.

The New Patient Information Form should be printed out and completed prior to the first appointment. Click buttons:

General Patient Information:

I do not participate in any insurance company provider networks with the exceptions of the Dupont (Aetna) program and Medicare. I see Medicare patients and "accept assignment". Since I am not in other provider networks, this means that, except for Medicare and Aetna-Dupont (managed by ComPsych, Inc.) patients, you will be expected to provide payment in full at the time of service. I will provide you with itemized receipts necessary for you to be reimbursed directly by your insurance company. Any co-payments for Dupont-insured patients will also be expected at the time of service.

As a psychiatrist, I am a physician who specializes in the treatment of persons with disturbances of moods, thoughts, and behaviors. My general psychiatric training was completed at The Johns Hopkins University and Hospital in 1990. Later work at Hopkins involved specialized training with the elderly and with persons suffering psychiatric complications of neurological disease. Since coming to practice in Delaware I have been employed at various times by Christiana Care and by MeadowWood Behavioral HealthSystem, in addition to private practice. The following is intended to inform you of some details about the psychiatric services I provide, which I am pleased to offer.

Should you need to cancel an office appointment, I expect that you will do so no less than 24 hours prior to the scheduled appointment. This will allow sufficient time to re-schedule other patients who may have an urgent need to be seen. Charges may be billed to you for missed appointments or for sessions cancelled less than 24 hours prior to the scheduled appointment. Unfortunately, insurance companies generally do not reimburse you for such charges.

Telephone messages may be left for me anytime at (302) 426-9440. My recorded message provides an emergency number (usually 302 540-0177) to contact me (or a psychiatrist who may be covering for me) in an emergency. On weekends and major holidays I do not routinely check the answering machine, so any matters that cannot wait until the next business day should be addressed with use of the emergency number above. You may email information to me (jb@josephbryer.com) if you wish, but email should not be used for any care-related issue (since I do not check email regularly or when on vacation or out of the office). Please use the telephone method for all questions or concerns related in any way to your care, such as requests for prescriptions or appointment changes. Also, keep in mind that email may not be sufficiently secure to maintain the confidentiality of medical information. In most cases there will be no charge for brief telephone consultation with me, but especially frequent or especially extensive consultations may be subject to a charge.

Medication Prior Authorization Fees

Insurance companies are increasingly demanding prior authorization of many medications that I prescribe. Until the past few years, these authorizations were required for only a few classes of medication. Now, however, prior authorization is required for numerous medications, and in some cases even for generic versions of these medications. It is not uncommon that a patient’s insurance requires prior authorization for two or three (or more) medications I am prescribing.

In the simplest cases, all that is required of me is a phone call of a few minutes to provide information justifying the use of each medication. In other cases, the time requirement is greater, and may involve talking to several people via phone, and often includes also the completion of written information for this purpose. All told, it is not uncommon for the entire process to entail much more than five minutes of my time. Occasionally, prior authorization requires thirty or more minutes to complete. Insurance companies usually do not reimburse me for this time. Therefore, it is unfortunate but necessary that I take the step of asking my patients to reimburse me directly for time I spend in obtaining these authorizations. I will do so according to the following scale:

Prior Authorization Time Requirement (per medication) Fee

Five or fewer minutes: $10

Fifteen to thirty minutes: $45

Thirty to forty-five minutes: $60

I hope that you will address with me any questions or concerns you may have about the above.
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Copyright, Joseph Bryer, M.D. 2006-2017