1. Do you take insurance?

I am currently not taking any insurances plans. Insurance companies heavily incentivize doctors to see patients every 15 minutes or less, which I don’t believe is an adequate amount of time to address all of patients’ concerns during an appointment. Furthermore, accepting insurance adds a lot of complications and administrative duties, which takes away time from helping patients. Almost all medium-to-large clinics have a full-time person whose entire job is just to negotiate fair reimbursement rates with insurance companies and to get them to pay the doctors for their work. As a solo practice, I don’t have the resources to do hire someone or do it myself.

2. Why are your fees so high?

My goal has always been to focus on providing the highest quality care possible. In prior clinics, once I started seeing more than 40 patients per week, the ability to be attentive and respond quickly to clients’ needs between appointments started to decline. Furthermore, keeping a smaller caseload will allow more flexibility in scheduling. If you ever need an appointment outside of my normal hours, we can probably make it work. My rate of $450/hour is around the average for “cash-only” psychiatrists in the LA/OC area. This rate will allow me to balance my responsibilities in and out of appointments, while still being able to cover my overhead and take care of my family. I appreciate your understanding and welcome honest feedback if you ever feel like I’ve deviated from this commitment.

3. What happens if I miss an Appointment?

You are responsible for the full cost of the missed appointment. I do make exceptions for emergencies (car accident, family member in hospital, etc.). If you’re scheduled for an in-person appointment, and traffic is worse than you expected, then pull over to a safe place and we can change the appointment to telehealth. This is preferable to showing up 15 minutes late.

If you are, for example, 30 minutes late to a 90 minute appointment, then you will still be charged for the full 90 minutes, but in most cases, I will only be able to see you for the remaining 60 minutes.

Additionally, if you miss an appointment, but need a refill, I can provide a refill of the last dose you were on, but cannot make changes without an appointment. If you miss multiple appointments back-to-back, then I cannot safely manage your medications and will refer you to urgent care or your primary care doctor until you make it to your next appointment with me.

4. What happens if you (Dr. Bello) are late?

In our field, appointments can be unpredictable at times. While I do my best to keep on schedule, sometimes the patient in front of me is in crisis, and I need a couple extra minutes to ensure their safety. If I am ever running behind, I will always make up the time on the tail end of your appointment. If your schedule doesn’t allow for that, I will either credit you for the time I owe you or reschedule the appointment at no charge, depending on your preference.

5. Do you prescribe controlled medication?

I do prescribe stimulants (Ritalin, Adderall, etc.) when indicated. However, I almost never prescribe benzodiazepines (Xanax, Ativan, Klonopin, Valium). The exception is a few pills once or twice a year for specific situations (ex: flying or infrequent panic attacks). The reason is that, while often effective in the short-term, this class of medications is inherently addictive, and research shows they worsen people’s longterm outcomes when taken regularly. If you come to me already taking them routinely at a reasonable dose, then during our first appointment, we will discuss the plan to taper them off over the next few months. If you are currently taking them at higher than indicated doses, even if that’s how your last doctor wrote them, then I won’t be able to fill your prescription and will have to refer you to the ER or your prior doctor.

Lastly, I do not prescribe opioids (methadone, Suboxone), but am happy to prescribe Vivitrol (long-acting naltrexone) to help you maintain sobriety.

6. Will you fill out my disability paperwork?

I don’t fill out disability forms at the first appointment and generally prefer to see someone at least 3 times before I will complete them.

7. What about Emotional support animal letters?

I love pets, but I’m not trained to evaluate them for safety. If I write the letter and your pet attacks someone, that person can sue me. Because of this liability, I don’t write ESA letters without proof that your pet has been evaluated by a certified trainer/handler and deemed to be safe around strangers. Example: The American Kennel Club’s Canine Good Citizen evaluation.