Fees for an Initial Evaluation

Unless an existing contract with your employer or some other agency supersedes a private fee agreement, I charge an hourly fee for the interview and flat rate for the report. 90% of cases fall within the range of 10-12 total hours of billing. A typical case has these elements:

  • in-person interview (normally about three hours)
  • reviewing the background medical records, counseling notes, court documents, or other essential items for your case (varies; some cases have a few dozen pages of records while other cases have several thousand pages of revieww documents)
  • producing an FAA-compliant report, generally 25-45 pages (flat rate fee of 6 hours)
  • returning your telephone calls, if you ask for me to call you or my subsequent questions cannot be addressed by email
  • telephoning character references offered on your behalf
  • answering emails about your case

Will my Health Insurance Cover the Costs?

Probably not.

Health insurance plans generally cover medical costs related to the diagnosis and treatment of medical conditions, in the context of a physician-to-patient relationship.

  • In an aviation psychiatric evaluation, the evaluation serves a regulatory purpose. A physician-to-patient relationship is not established.
  • Physician-to-patient relationships require advocacy from the physician in the interest of your well-being.
  • Regulatory evaluations require neutrality, not advocacy, with the opinions applied against a law, regulation, or contract.
  • In a doctor-to-patient relationship, your physician uses what is called a CPT code to define the type of assessment and its complexity. There is no standardized CPT code for a forensic evaluation since you do not receive treatment from your aviation psychiatrist.
  • Medical billing requires an ICD-10 Diagnosis, whereas a regulatory assessment for the FAA does not make an ICD-10 interpretation. FAA evaluations used the Code of Federal Regulations Title 14 CFR 67.107/67.207/67.307 and other regulations instead of ICD-10 guidelines.

Releasing a report to an individual before fees have been paid creates an appearance of bias and allows the psychiatrist’s neutrality to be questioned by the regulator.

How the Retainer is Used and Refunded

  • My payments processor, Square, charges the vendor (me) credit card transaction fees even on refunds/cancellations. Starting on April 11, 2023, cancellation for a self-scheduled appointment is subject to a return fee of (2.9% x retainer) + $0.30. On the same effective date, a cancellation of a directly-invoiced retainer fee is subject to a return fee of (3.3% x retainer) + $ 0.30.
  • If you cancel your appointment, but reschedule the visit within 90 days, half of your cancellation fee will be added back as a credit for a future final balance due.
  • The reservation retainer fee is a four-hour retainer to be applied towards the initial costs in your case.
  • A second four-hour retainer will be due in the office at or before the time of your appointment. The second retainer is considered fully earned at the instant we start your appointment by signing a disclosure agreement.
  • The hourly fee is $360/hour, and charges apply to all time spent in the case; this includes the interview, reading your records, writing the report, and all other time spent on your behalf.
  • After subtracting cancellation fees, the balance is 100% refundable for any reason up to ten exact 24-hour days from your appointment; for example, an appointment for a Wednesday morning @ 9 am, must be canceled by 8:59 am two previous Sundays for a full refund.
  • After subtracting cancellation fees, the balance is 75% refundable, and considered 25% earned, for any reason at less than exactly ten 24-hour days but more than seven exact 24-hour days from your appointment; for example, an appointment for a Wednesday morning @ 9 am, must be canceled by 8:59 am the previous Wednesday for a 75% refund.
  • After subtracting cancellation fees, the balance is 50% refundable, and considered 50% earned, if the appointment is canceled at less than exactly ten 24-hour days, but more than three exact 24-hour days; for example, a Wednesday morning @ 9 am appointment must be canceled by 8:59 am on Sunday of the same week for a 50% refund.
  • Any cancellation at less than 72 hours results in forfeiture of the fee and the retainer has been considered fully earned.
  • For those driving to the Denver clinic, appointments can be changed without any penalty if CDOT has declared a travel advisory affecting travel into or out of metro Denver, but we must discuss and mutually agree on this.
  • For those flying to Denver, if you are traveling with a checked bag please give yourself a minimum of three hours from your flight arrival to be at my office; it can take up to one hour to get to downtown Denver from the airport in traffic.
  • Not showing up for a weather emergency or from a canceled flight without discussing it with Dr. Kirk will result in forfeiture of the fee.
  • An appointment cannot be canceled and refunded for a weather emergency or a canceled flight, it must be rescheduled.
  • Appointments can be canceled by either calling me or emailing me; you cannot text to cancel or change an appointment.
  • The timestamp for the cancellation will be the date and time I have received the email or received your incoming phone call, not the time you sent it.

Can I do a Payment Plan?

You cannot do a payment plan for a forensic assessment. If a client interprets a report as unfavorable, some clients could block or ignore the final balance due. This hypothetical scenario creates a situation where the psychiatrist is more likely, consciously or unconsciously, to act favorably for the client to ensure the agreed-upon compensation. This appearance of bias downgrades the evaluator from neutral to partisan.

Follow Up Evaluations

This discussion applies only if I did your first evaluation. If a different psychiatrist did your first evaluation, the evaluation might be a follow-up visit for you but it would count as the first evaluation for me.

For a pilot flying with a Special Issuance Authorization for a mental health, alcohol, or drug issue, the FAA may require that the pilot have periodic evaluations to maintain certification.

If I did your initial evaluation, followup assessments cost less. For example, I do not have to cover your entire history on the second interview. We can focus on what’s happened since your last assessment.

There is also usually less paperwork to review, whether that is from your doctor, therapist, AME, employer, or the FAA.

Finally, the written report is shorter because I would have already documented a comprehensive history in my first report.

As a rough estimate, a followup evaluation usually takes only about 1/3 as much time as a full initial evaluation.

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