Obtaining Clinical Services from Dr. Griffith-- Referrals

To maximize potential clients’ ability to utilize their insurance to obtain clinical care, Dr. Griffith works exclusively by primary care (MD, RPA, NP) or medical specialist (psychiatrist, neurologist) provider referral. Primary care providers and specialists can fax referrals to Dr. Griffith at 315-210-6475. When faxing referrals, as Dr. Griffith has a combined phone/fax line, be sure to wait for the entire greeting to play out and the tone to sound before attempting to send your fax. Or, PCP’s and specialists can send referrals by regular mail (not e-mail) to Dr. Griffith at 1 Bridge Plaza, Suite 205, Ogdensburg, N.Y. 13669.

PCP and Specialist Referrals should include: the patient’s name and, where applicable, parent/guardian name(s); their date(s) of birth; patient phone contact information; the type of client insurance, if any; the client’s most recent office visit note; whether “diagnostic clarification”, “treatment guidance”, or both are needed; the client’s medical history; any relevant laboratory results; and conditions of concern to be treated or assessed. Usually, psychotherapy is considered a “primary benefit” by insurances, and does not require additional insurance approval for treatment beyond the initial psychiatric diagnostic evaluation session. HOWEVER, please note that psychological and neuropsychological testing, based on current Milliman Care Guidelines 21^st Edition for 2017, are not considered to be “primary” insurance benefits. As such, testing must be additionally authorized by insurances as “medically necessary”, and not be merely at the “request of the patient” or the “preference of the physician”. An initial diagnostic appointment must be scheduled prior to any testing being approved by insurances. Based on that initial appointment’s findings, testing must be found, upon insurance company medical review, to be “not more costly than an alternative drug, service, or supply that is at least as likely to produce equivalent therapeutic or diagnostic results, as to the diagnosis or treatment of the (patient’s) mental illness, substance use disorder, or its symptoms.” Please consult Dr. Griffith’s “About Assessments” section of this website for further information about insurance qualifications and restrictions on testing.

Dr. Griffith does not accept Medicaid or Medicare. She is officially “opted out” of Medicare, but offers “senior rates” for those 65 years of age and older, on a sliding scale, starting at $35 per hour. She formally participates with Beacon group commercial insurances (i.e. NYSHIP), Excellus BC/BS, and Fideliscare insurances. She also offers private pay, “fee for service” assessment at $150/ clinical hour, and “fee for service” psychotherapy and consultation at $150/ clinical hour. Some fee adjustments for therapy may be possible for individuals with limited incomes, starting at $50/clinical hour for working adults and their children, and $35/clinical hour for seniors. Dr. Griffith also accepts school voucher payments for services. She will see Canadian clients, if they see her at her office in the United States, and pay her in U.S. dollars (no Canadian checks accepted). Dr. Griffith does not accept credit, health credit, debit, or health flex cards. Insurance is accepted for payment, in all cases, only if it is active and the clinical service performed is authorized by insurance to be covered. Copayments, and co-insurance payments for individuals with deductible plans, are required, by law, to be made at the time clinical services are performed. If insurance does not cover a clinical service performed by Dr. Griffith, the individual him/herself is responsible for service payment. In the case of minor and majority age children, and individuals with legal guardians, the insured parent or applicable legal guardian is responsible for service payment, if insurance does not cover a clinical service performed by Dr. Griffith. Payments to Dr. Griffith must be made by check or in the exact cash amount, as her office does not have change available.