More providers, doctors, dentists, etc. are asking for a credit card up front and will charge it in the event that you fail to show.

It is difficult to find a psychiatrist who is accepting new patients. The exorbinant fee may be charged because the doctor has a waiting list and he could have accomodated someone else if he had known that you would be late or fail to show. The Pdoc can charge whatever he wants since no shows are not covered by insurance. The contract with your insurance company does not come in to play so he does not have to consider the contracted price.

I think that it is reasonable for your Pdoc to ask for a note from the doctor stating that you were there with your boyfriend. There is no reason not to get it if you are already there.

I have been in this spot and called immediately to say what happened and let them know that I was going to be a few minutes late and could they still accomodate me without an extra charge. I haven't been denied yet.

It is a business and they have to have a policy in place because there are people who take advantage. Even though that isn't the situation with you, your Pdoc has to have a formal policy in place.