We appreciate your interest in our office. Dr. Galliano has over 15 years of experience working with people struggling with mental health and substance abuse issues. We want to give you some details about our practice so you can decide if this is the best option for you. We specialize in high functioning individuals with acute or chronic mental health issues or substance abuse disorders.
The services that we offer are exclusively provided with the purpose of treatment. We want to offer you the best service possible and evaluate if what we offer can meet your individual needs. We encourage an initial evaluation with the purpose of identifying your personalized needs and treatment options.
We treat people with depression, anxiety, bipolar disorder, OCD, attention problems, alcoholism, drug addiction, and many other problems.
Exclusion Criteria & Things to consider
The following will give you some important information that will help you decide if our office can assist with your needs:
For legal matters, you should consider finding a Forensic Psychiatrist. Dr. Galliano does not provide provide this service at this time. Also, This is not covered by most insurances.
If you are in process of getting a disability claim. The only commitment that we can make is to send your lawyer or agency copies of your medical records with a signed release of information from the patient. All disability and FMLA paperwork will be evaluated and may take up to 1- 2weeks to complete.
Dr. Galliano may decline filling out disability paperwork at her discretion and will only fill out forms for patients who have been regularly seen for a minimum of 6 months.
If you have 3 or more systematic illnesses or are above the age of 65 I will advise you to consider an evaluation with a psychiatrist that specializes in psychosomatic medicine or a geriatric psychiatrist.
If your insurance requires continuous and complicated processes of authorizations for visits and medications, you will need to obtain all proper documents and bring them with you to your first visit.
If you take several controlled substances (such as Xanax or Klonopin), and you are convinced that they are the only medication that will work for you, or if you are not open to consider other options, you should consider finding another doctor.
For patients that are on Suboxone or candidates for Suboxone that are planning on taking tranquilizers such as Xanax, Klonopin, or Ambien amongst others, please consider finding a more accommodating office. Dr. Galliano does not support such combinations.
For patients that want to take Suboxone primarily for pain or that have several medical comorbidities, please find a provider who can accommodate your needs.
We believe that controlled medications are useful tools to treat many conditions but my practice minimizes their use and follows the guidelines of the American Psychiatric Association and the American Society of Addiction Medicine as a core base of knowledge to make decisions about your treatment and medications.
If you are an adult that is only concerned about a possibility of ADHD or ADD and have never had a clinical psychological evaluation conducted, please contact a psychologist to get an evaluation before coming in for a psychiatric evaluation and consider medications. Dr. Galliano will not prescribe ADHD/ADD medications if you are not currently on them or have not done an evaluation previously. Please take note that Dr. Galliano does not prescribe Adderall.
We do our best effort to minimize your waiting time in office, but human behavior can be to a certain extent, unpredictable and sometimes there will be delays. We ask that you respond with patience and understanding. It is our goal to start all appointments on time, but be aware there may be a wait, as each individual is different and has different needs.
Duration and nature of treatment
Psychiatric and/or substance abuse treatment typically involves regularly scheduled bi-weekly or monthly appointments. Medication management treatment, when stable, is typically one to three months apart, but may be more frequent when medication changes are being made. The total duration of treatment depends upon your diagnosis, your compliance with treatment, your response to treatment, and other individual variables.
As a part of psychiatric evaluation and treatment you need to have a minimum of one annual physical examination and blood work at least twice a year. You are responsible to coordinate those appointments. Please sign a Release of Information allowing your PCP to send us the results.
Medical problems can cause psychiatric symptoms and medications could potentially cause a negative impact on your health. Careful monitoring is extremely important.
You MUST come to your appointments to receive proper care. We cannot treat you or manage your medication by phone. You are responsible for making and keeping your appointments.All patients should make a follow up appointment prior to leaving the office. If a follow up appointment is not made there is no guarantee an appointment will be available at a later date.
If you miss a scheduled appointment and are otherwise in good standing in this practice, we will reschedule you on a space-available basis AFTER the No Show fee is paid. However, if you have a pattern of missing appointments, or if you do not schedule a follow-up appointment within 120 days, you are considered to have discontinued treatment. We will consider you discharged from this practice. In some cases, you will need to start as a new patient.
Always remember: if you have a potentially life-threatening emergency and need help IMMEDIATELY, CALL 911 or GO TO AN EMERGENCY ROOM. You can contact us once the situation is stabilized.
For general questions or concerns you can call during our office during hours and speak to a staff member. Be prepared to give a detailed message to the staff member. They will consult with your physician and will call you back. If you chose to leave a detailed voicemail, please be aware that calls are returned within 24 business hours.
If you call after office hours, please leave a message and we will call you back on the next business day or you can also send us an e-mail to email@example.com and expect an answer within 24-hours.
We will try our best to get back to you as soon as we can, but remember that urgent matters are handled first. If you have an urgent matter that can’t wait until the next business day, please email firstname.lastname@example.org get a call back.
Your attendance at appointments, face-to-face with your physician is essential to successful treatment. We cannot treat you without seeing you. Therefore, we handle your medications, medication changes and refills at your regular office appointment during normal business hours. We do not accept refills requested by pharmacies and we do not refill any controlled medications without being seen at the office.
We do not replace lost/stolen controlled prescriptions - NO EXCEPTIONS. In general, Dr. Galliano does not refill medications without a visit. Depending on the situation, refill of medication or new prescription can be called in by phone, but you may be charged $25 for the service. This fee must be paid prior to prescription being called in or written for fax delivery.
Please be aware that Dr. Galliano has the ability to monitor if you have received any controlled medications prescribed by other providers. Obtaining controlled medications from more than one provider can be considered “doctor shopping” and may result in dismissal from the practice or denial of entry into the practice. Always inform every doctor you are seeing of ALL of the medications you are taking.
Your appointment time is scheduled only for you; there is no double booking at our office. All appointments need to be confirmed within twenty-four (24) business hours of the time scheduled. If your appointment is not confirmed, it is subject to being cancelled and you will be charged the No Show or the Late Cancelation fee. It is your responsibility to come to your appointments on the correct date and time.
If you need to cancel an appointment, you will need to do it with at least twenty-four (24) business hours’ notice by calling or emailing our office or you will be charged the Late Cancelation fee. If we are unable to answer your call, PLEASE LEAVE A VOICEMAIL stating you are cancelling and why.
Late cancellation fees/ No show fees are as follows:
$100 for Follow up appointments
$200 for New Patient appointments.
We strongly believe that all patients deserve the best behavioral health care that we can provide. Further, your understanding of our Financial Policy is important for our professional relationship and we feel that everyone benefits when clear financial policies are outlined and agreed upon.
Our professional services are rendered to you, not the insurance company. Therefore, payment for services is your responsibility.
You are directly and fully responsible for charges not covered by your insurance company, such as co-payments, deductibles and any balance for non-covered services.If your insurance company fails to pay your balance in full, or there is no payment made within 45 days, it is your responsibility to pay for services rendered.
If you fail to make timely payments on your account, your account will be frozen, and you will be unable to schedule any future appointments. You will be responsible for any and all reasonable costs of collection, including filing fees as well as attorney’s fees.
Medical records may be requested and sent, if approved, to the office/ agency requesting them ONLY.
Dr. Gallino WILL NOT release records to patients or family members directly. Please see HIPPA regulations for MENTAL HEALTH RECORDS, which differ from other medical records.
Our fees are compliant with the Florida Statues and are $1 per page up to 25 pages, and $0.25 cents per page thereafter. Patient is responsible for fees not paid by requesting party within 60 days. Our office will fax Medical Records (1) time for free. All other requests will be subject to the fees listed above.
Payment and Insurance
Payments for services are due at the time of your appointment, and your account must be settled by the end of each visit in order to schedule a follow up appointment. If you have an outstanding balance with this office, you will not be allowed to schedule your follow up until your balance had been paid in full. You may pay with cash or credit card. We DO NOTaccept checks for initial evaluations.
Payment for the INITIAL Psychiatric Evaluation is due prior to seeing the doctor.
For self-pay patients, the Psychiatric Evaluation has a cost of $250 and Follow Ups $150, both with payment due at the time and date of service.
If you are not using insurance, or if you are using insurance but haven’t met the deductible, your payment will be the entire cost of the session. If the doctor is in network with your insurance company, you will pay a fixed cost as determined by your insurance company. If the doctor is out of network, you will have to pay the doctor rate for the session and you will be provided the documentation necessary for you to submit the claim to your insurance for reimbursement. We do NOT submit out of network claims for you.
If your insurance company refuses to authorize your care for any reason, you will be responsible for all charges and payments for services rendered.
If you change your insurance policy or company, please notify our office PRIORto your next appointment. Your benefits and eligibility must be verified PRIOR to services being rendered. If you decide not to inform us of changes ahead of time, you will be responsible for any charges not covered by the insurance company we have on file. Once your new benefits are verified, you will be responsible for covering the difference at your next appointment or your office account will be credited with the difference and applied to your next visit.
If your visits require preauthorization, you are responsible for notifying our staff in order to call the insurance provider before the visit. If preauthorization is not completed prior to the visit, you will be responsible for payment of ALL charges.
Fee disclosure for non-covered costs
Many services that our patients need are not covered by insurance. Letters and other paperwork, and consultations with other professionals are just some of these services. This type of work requires a substantial amount of time outside of scheduled appointments. Since we are a small practice and the doctor does all paperwork herself, we ask that you give us 3 business days for all requests made through the office. Depending on your request, the following charges will apply:
- Letters to employers, schools, lawyers*, etc. Based on provider hourly rate $250/hour
- Comprehensive chart reviews Based on provider hourly rate $250/hour
- Consultation with schools, insurances, etc. Based on provider hourly rate $250/hour
- Insurance-required prior authorizations for medications $10-$25 per chart pulled/reviewed (called, faxed)
- Late cancelled appointments less than 24 hour notice $100
- Late arrival to appointment $25-$75
- Missed initial appointment: Psychiatric Evaluation $200
- Missed appointments Follow-up $100
Notice of Privacy Practice
You may request a copy of the Privacy Practice Form as required by HIPAA at any time during your treatment, from our front desk.
Dr. Galliano does NOT talk to lawyers regarding her patients and does NOT do forensic psychiatry.
Dr. Galliano does NOT provide evaluations or treatment for disability claims, short term or long term.
**You have the right to request your psychiatric records for that purpose but Dr. Galliano does not commit to completing forms for disability purposes. Records will only be released to the requesting entity and not directly to the patient.Forms to be completed by the physician will be finished within 5 business days, and the provider hourly rate will apply.
Terminating of Treatment
Dr. Alina Galliano-Pardo will deem treatment ineffective and advise a patient to seek treatment elsewhere when a patient’s actions indicate that he or she has disengaged from treatment. Following are some examples of situations warranting termination of treatment:
- The patient misses multiple appointments
- The patient ceases paying for treatment
- The patient is noncompliant with treatment recommendations
- The patient misuses or abuses prescribed medications
- The patient behaves in an abusive, threatening or inappropriate manner toward staff, or other patients
- The patient fails multiple drug screenings (Suboxone or controlled medication patients)