FAQ

Edward Timinski PMHNP-BC, AGACNP-BC accepts Aetna, Cigna/Evernorth, Blue Cross/Blue Shield, and  UHC/Optum (their commercial network consists of Harvard Pilgrim, Choice Plus, UMR, Allsavers, SUREST, Mass General Brigham Health Plan, and Health Plans Inc.), Tufts, Carelon Behavioral Health/Masshealth (Fallon, Tufts, HNE, Steward Health Choice, Mass General Brigham, and Wellsense), Medicare, Unicare,  and Health New England commercial.  Private pay is always accepted.

For the time being, once psychotherapy is available at MHPNE, therapists may not file or bill insurance companies directly.  Each therapist determines if they take insurance or not.  Ketamine infusion services will not be accepting insurance.  We only accept direct payments from people in the form of cash, check, credit card, flexible spending account (FSA), or health savings account (HSA). MHPNE provides invoices to people with provider information and other details most insurance companies request when processing reimbursements. We happily work with you to answer any requests for additional information from your insurance company. However, it is the person’s responsibility to understand any coverage restrictions and allowances of your insurance company prior to beginning services if your intention is to seek reimbursement.  

There are many reasons why therapists may not take insurance at this time, and the needs of the people we support are at the top of the list. Reasons we have declined to accept insurance include:

• Improved Services for the people we support: Most insurance companies have policies regarding diagnosis requirements, treatment limits, and approved modalities of plans of care. Through private pay, we are able to make recommendations based on your needs and set appropriate goals, length of appointments and plan of care.

• Savings for the people we support: We are able to charge less for our services because we don’t spend valuable hours on insurance paperwork nor do we have staff hired solely for the purpose of managing insurance payments, billings and forms.

Again, we are happy to work with you to seek reimbursement through your insurance company but will not bill them or accept payments from your insurance company for services provided, and we make no guarantee that your insurance will reimburse you as there is much variation in cases and we are not insurance experts.

Telehealth — sometimes called telemedicine — lets your doctor provide care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.

• Limited physical contact reduces everyone’s exposure toCOVID-19
• Virtual visits ensure you get health care wherever you are located – at home, at work or even in your car
• Virtual visits cut down on travel, time off from work, and the need for child care
• Virtual health care tools can shorten the wait for an appointment
• Increased access to specialists who are located far away from your hometown

We are currently evaluating the demand for this service but there is a great likelihood that this will open in the near future. Please
contact ketamineinquires@mhpne.com to inquire about this service.

Ketamine is a well-established medication most commonly used for surgery and pain relief. It’s safe and remains one of the most
common medications used by physicians for pain treatment and anesthesia. Recently, ketamine has been approved as an
effective infusion therapy option for psychological disorders.

Ketamine focuses on changing neural passageways and developing healthy neurons. Ketamine infusion therapy can often change
the way the brain responds to medications, increasing the effectiveness of already prescribed drugs. Many people who haven’t
found sufficient improvement through traditional medications are now able to experience life-changing relief.

Ketamine infusion therapy can help support many different disorders. It can help with depression, suicidality, anxiety, bipolar, PTSD, OCD, BPD, and sleep disorders,.

There is no evidence that ketamine infusion therapy causes addiction, although there aren’t many studies regarding ketamine.
Ketamine infusions use a lower dose than when taken recreationally, and the clinical setting greatly reduces the possibility of
addiction.

There is no evidence that ketamine infusion therapy causes addiction, although there aren’t many studies regarding ketamine. Ketamine infusions use a lower dose than when taken recreationally, and the clinical setting greatly reduces the possibility of addiction.

Unlike many other medications, ketamine has few side effects. During the infusions, ketamine can cause nausea, temporary
hallucinations, and a lack of appetite. These are often very short-lived and mild. Patients commonly feel tired and groggy after an
infusion, but this goes away in 24 hrs.

We require that you consult with one of our psychiatrist providers to see if ketamine infusion therapy is right for you.  If you are
currently seeing a psychiatrist that is providing you medication management, we can collaborate to determine if Ketamine
infusions would be a viable option for you.

Benzodiazepines (such as Xanax, Klonopin, Librium, or Valium) interfere with ketamine if they are at a high dose or are used
daily. If you are currently on benzodiazepines, our suggestion is to avoid the medication 4-6 hours before the infusion as it makes
it less effective. Our clinical evaluation will review your medical history and current medications to ensure that ketamine infusions
are safe for you.

You can eat and drink before your infusion, but a light meal is recomended.

There’s an optional free 15-minute consultation to see if the process is something you might want to look into, followed by an
appointment with a psychiatrist. After determining that ketamine infusion is right for you, you can schedule an appointment.
Sometimes we can get you in immediately. During the infusion, you will be in a comfortable chair and given eyeshades and
earbuds. The IV drip increases very slowly, but we can stop it if you ever feel uncomfortable. Experienced IV nurses stay to check
on you and take your vitals every ten minutes. We suggest going into the experience with your goals for you individuals plan of
care in mind. This makes the dissociative phase as beneficial as possible, as your brain works to repair itself.

Many patients feel relief within a few hours or days. Usually, those who struggle with thoughts of self-harm and suicide notice
those thoughts and feelings go away first, bringing immense relief. Many times people notice a gradual improvement from their
disorder as they go through the course of their infusions.

Patients usually have a few infusions over a short period of time. Occasionally patients require infrequent infusions for
maintenance. The recommended course depends on several factors and differs from person to person. We will work with you to
create a unique plan of care that is optimal for you.

Ketamine is administered intravenously very slowly over 40 minutes. The first 20 minutes of your infusion will have no noticeable
effects. At around 20 minutes, you may notice blurred or double vision, a feeling of “lightness” or “floating,” and sometimes
numbness in the toes or area around your mouth. During the final 20 minutes of the infusion, these feelings tend to build; the
medicine is at the peak of its intensity at the very end of your infusion. Other common feelings include euphoria, talkativeness, a
feeling of being in a dream-like state, heightened senses, and a feeling that people often describe as “weird, odd, different, or
interesting.” Less commonly, people may experience anxiety, headache, nausea, or sweating.  These feelings will subside 10-15
minutes post-infusion.

It is important that you arrange transportation for after your infusions, as it is highly recommended that you do not drive or operate
any dangerous machinery until the next day.  We will not discharge you from our ketamine clinic without a driver.

Prior to your first infusion, we will ask you to rank various aspects of your depression. We will then ask you to rank those same
aspects 24-hours after your infusion. This will help us determine how effective the infusion was. It is possible to notice positive
effects as soon as 40 minutes after your infusion, or up to 24 hours later. Most effects, however, typically start 2-4 hours post-
infusion. You won’t wake up suddenly feeling perfectly overjoyed but rather more hopeful and less sad, with decreased thoughts
of suicide, increased calmness, and more willingness to engage with people. Further improvements are often seen over the
course of subsequent infusions.

Each ketamine infusion costs $600 for the initial infusion, subsequent infusions are $500 or $3000 for the first six IV sessions. Health insurance does not cover this fee.