Insurance & Billing
See us regardless of your plan.
Our physicians hold subspecialty fellowship training that is exceptionally rare. Fewer than 250 fellowship-trained neuropsychiatrists exist nationwide, and 70% of U.S. counties lack sufficient psychiatric resources for perinatal mental health. Because most insurance networks cannot provide a fellowship-trained neuropsychiatrist or a perinatal psychiatrist, the majority of our patients are able to see us regardless of their insurance plan.
In-Network Coverage
We are currently in-network with the following payers. Network participation varies by physician. Contact our office to confirm that your plan and preferred physician are covered before scheduling.
We are not contracted with Medicare at this time. Network participation varies by physician and payer.
Fees
We believe in transparent pricing. The following are our standard rates for self-pay and out-of-network patients. Patients seen through in-network insurance plans pay the copay, coinsurance, or deductible specified by their plan. We accept HSA and FSA cards.
Fellowship-trained in forensic psychiatry and Behavioral Neurology & Neuropsychiatry (Stanford). Former Harvard Medical School faculty.
Dr. Patel completed his Behavioral Neurology & Neuropsychiatry fellowship at Stanford. Dr. Staley is board certified in psychiatry and consultation-liaison psychiatry, with a focus on perinatal, reproductive, and perimenopausal psychiatry.
Network Gap Exceptions
If your insurance plan is not listed above, or if your preferred physician is not in-network with your payer, you may be entitled to see us at in-network rates through a Network Gap Exception. This is a process in which your insurer authorizes coverage for an out-of-network physician at in-network cost-sharing levels because their network cannot provide a specialist with equivalent qualifications.
Because fellowship-trained neuropsychiatrists and perinatal psychiatrists are exceptionally scarce, most insurance networks in California cannot meet the timely access and geographic proximity standards required by state law. This applies across our practice's subspecialties: Behavioral Neurology & Neuropsychiatry (Dr. Lodhi and Dr. Patel, both Stanford fellowship-trained), consultation-liaison and perinatal psychiatry (Dr. Staley), and forensic psychiatry (Dr. Lodhi). If your insurer does not have a physician with equivalent subspecialty qualifications available to you within a reasonable time frame and distance, they may be required to cover your visits with us as though we were in-network.
How to Request a Network Gap Exception
You can request a Network Gap Exception directly from your insurance company. The process typically involves a single phone call or letter. Below is everything you will need.
"I need to request a Network Gap Exception because I need care from a physician with subspecialty training in [neuropsychiatry / perinatal psychiatry / consultation-liaison psychiatry], and there are no in-network physicians with this training available to me within a reasonable time frame or distance."
If you have an HMO plan, you may need a referral from your primary care physician before submitting the request. Ask your PCP for a referral specifying neuropsychiatric care.
Practice Information for Your Insurer
Your insurer will ask for the following details. You may also find these on the template letter linked below.
| Practice name | Bay Area Neuropsychiatry (Lodhi Medical Group, Inc.) |
| Address | 870 Market Street, Suite 341, San Francisco, CA 94102 |
| Phone | (650) 248-2467 |
| Group NPI | 1689439911 |
| Dr. Lodhi NPI | 1922539337 |
| Dr. Patel NPI | 1851929731 |
| Dr. Staley NPI | 1275038275 |
| Specialties | Psychiatry, Behavioral Neurology & Neuropsychiatry, Consultation-Liaison Psychiatry, Perinatal & Reproductive Psychiatry, Forensic Psychiatry |
| CPT codes | 90792, 99205, 99215, 99214, 90833, 90836, 90837 |
If Your Request Is Denied
Ask for a written explanation of the denial. You have the right to appeal. California law requires commercial health plans to cover mental health care at parity with medical and surgical care (SB 855), and to provide non-urgent mental health appointments within 10 business days (SB 221). If your insurer cannot meet these standards for neuropsychiatric care, the denial may not be legally supportable.
If your appeal is unsuccessful, you may file a complaint with the California Department of Managed Health Care at 1-888-466-2219 or HealthHelp.ca.gov. You may also contact your state assembly member's office for constituent services assistance.
Out-of-Network Reimbursement
If you prefer not to pursue a Network Gap Exception, or if you would like to begin treatment while your request is being processed, you are welcome to schedule as a self-pay patient. We provide a superbill after each visit that you can submit to your insurance company for out-of-network reimbursement.
Reimbursement rates vary by plan but typically range from 40% to 80% of the allowable amount after your out-of-network deductible is met. Contact your insurer to understand your specific benefits before your first visit.
Common Questions
Can I see you even if you are not in my insurance network?
In most cases, yes. Our physicians hold subspecialty fellowship training in neuropsychiatry, perinatal psychiatry, and consultation-liaison psychiatry, which are rare enough that most insurance networks cannot provide equivalent specialists. The Network Gap Exception process described above allows many patients to receive in-network coverage for our services. Patients may also choose to see us on a self-pay basis with superbill reimbursement.
How long does a Network Gap Exception take?
Most insurers respond within two to four weeks. Some approve on the first request; others may require an appeal.
Which physicians are available through my plan?
Network participation varies by physician and payer. Contact our office to confirm availability for your specific insurance plan.
Do you accept Medicare?
We are not contracted with Medicare at this time.