Office Policies, Procedures and Protocols


      Currently we are offering psychiatric  medication management and psycho-therapy via  cyber-psychiatry in Roswell, New Mexico.  Your  visits with Dr. Williams will be hosted in a secure  and private room where you can discuss your  mental health concerns over a HIPAA compliant  video- conferencing platform.

      As a new patient your initial appointment  will be approximately one hour in length.  Please  bring any and all medications that you are  currently taking with you to this appointment,  including over-the-counter medications, herbal  supplements and vitamins.  Also, please bring a list  of all previous psychiatric medication trials, what  worked and what didn’t work in the past, a list of  previous psychiatric hospitalizations and outpatient  therapy trials.  During this initial appointment we  will discuss a variety of topics including your past  medical and psychiatric history, your childhood, work  history and other pertinent information.  This is your  opportunity to tell your story and be heard in a  judgment- free zone.    

      At the culmination of the initial appointment  you will receive a formal diagnosis, have lab-work  ordered and possibly an E.K.G. prior to the  prescribing of any medications.  This is to  promote safe prescribing practices and to ensure  that there are no pre-existing medical conditions  that may be contraindicated with psychiatric  medications that are being considered for your  treatment.

      Your second visit we will be scheduled 1 - 2  weeks after your initial visit and approximately 40  minutes in length.  During this time we will review  lab and EKG results, discuss the holistic components  of mental health and concordantly make medication  selections based on your presenting symptoms,  personal needs, goals, and concerns. 

      Subsequent follow-up appointments will be  approximately 20 minutes in length and may also  include brief, supportive psycho-therapy, coupled with  medication management based upon your  individual needs.  During follow-up appointments we  will discuss the effectiveness of your current  medications, any medication side effects that  you may be experiencing, residual symptoms that  need to be addressed, coping skills and medical  and psychosocial changes that may have occurred  since your last visit, which can impact your recovery.  Subsequent follow-ups are usually scheduled at one  to two month intervals, depending on the needs of  the individual.  Please bring any new or changed  medications that you may have from other  healthcare providers so that we may update your  records at this time.

      When new medications are prescribed it is  important that you are monitored consistently  throughout the course of treatment.  Typically you  will be asked to come back within 2- 4 weeks to  follow-up after new medications are prescribed to  ensure that medications are working as they should  with no severe adverse side effects.  Some  medications require periodic blood-work to ensure  that the dose is safe and effective, you will be  notified of this at the time the medication is  prescribed.

   Scheduling, late arrivals and no-shows:

      Please arrive at your appointments 10  minutes in advance to allow for time to address  any administrative concerns and to have your vital  signs taken prior to your appointment start time.  If you arrive at your appointment more than 5  minutes late you may be asked to re-schedule your  appointment and incur a $50.00 fee.  If you need  to reschedule your appointment please do so 24 hours  in advance or you may incur a $50.00 fee.  Same  day cancellations are considered "no-shows" and will  incur a $50.00 fee.  Three "no-shows" within a 12  month period may result in dismissal from the  practice or restriction to only being seen on a walk-  in basis.


      Medication refills are typically processed  during your visit electronically and sent to the  pharmacy of your choice in New Mexico.  Unfortunately, we will not be able to process  prescription refill requests for controlled substances  without a visit, this includes all stimulants, hypnotics  and benzodiazepines.  Controlled substance  mediations will not be prescribed on initial visits.  No exceptions to this policy will be made.  

     If you miss an appointment and are unable to  be rescheduled prior to running out of your  medications then there will be a $25.00 fee to  process prescription refills in the interim, as  permitted by your insurance carrier.  However, this  courtesy will only be extended twice in a 12 month  period.  Please allow 48 hours to process your refill  request.  Requests submitted after Thursday, 6pm  local time may not be processed until the following  Monday.  

     For patients taking controlled substances you  may be required to submit to a random urine  drug screening during your office visit.  If drug  diversion is suspected you may be asked to come  into the office or visit your local pharmacy for  a random pill count as well.  Drug tests are  performed to determine if an individual is taking  controlled substances that are being prescribed and  to ensure that no illicit drugs are being taken  concurrently.  Non-compliance with either drug  screening or pill count requests will result in  discontinuation of any controlled substances being  prescribed and possibly dismissal from the practice.

      Due to increasing administration costs, there  will be a $25.00 fee for lost or misplaced  prescriptions, as well as prescription requests when  you do not have an appointment with Dr. Williams,  as permitted by your insurance carrier.  If you  miss your appointment and need a refill there is a  $25.00 administrative fee to process a refill request  until you can be rescheduled, as permitted by your  insurance carrier.  This policy is not applicable to  prescriptions for controlled substances.  If you have  a lost, misplaced, or stolen prescription for a  controlled substance a police report will be  required in addition to the $25.00 fee to replace  the prescription.  No exceptions will be made.

   Benzodiazepine Prescribing Policies:

      Benzodiazepines are controlled substances that  are intended for short-term use, primarily in the  treatment of anxiety related disorders.  Chronic use  of these types of medications results in dependence  and can create more anxiety in the long run.  Dr.  Williams will not prescribe these medications for  periods that exceed F. D. A. guidelines.  If you are  already taking these types of medications and would  like to be our patient then we will work together to  find other solutions to help manage your anxiety.  Together we will develop a plan to safely and  gradually wean you off of these medications.  We  will integrate alternative options into your treatment  plan to address your symptoms and facilitate your  recovery.  

      Insurance benefits and billing:

      Health insurance is a contract between you  and your insurance company.  For those companies  with which we partner we will file claims as a  courtesy to our patients.  However, we cannot bill  your insurance company unless you provide a copy of  your insurance information and complete the  necessary paperwork.  We will not become involved  in disputes between you and your insurance  company regarding deductibles, co-payments, co-  insurance, covered charges, secondary insurance, “usual  and customary” charges, etc., other than to supply  factual information as requested.  If you choose  to use your insurance benefits you are responsible  for calling your insurance company to obtain co-  pay, deductible and benefit information.  If you  have an over-payment on your account it will be  credited to your account for future visits.  It is  your responsibility to be aware of your plan's annual  visit limits, deductible amounts, the percentage of  your charges that your insurance company will pay,  and any non-covered services.  If requested, you will  be provided with an invoice for services that contains  all information necessary for you to bill your claims.  Any monies owed are due at the time of the  appointment and should be settled prior to the start  of your visit.  We accept the following insurances:  Medicare, Medicaid, BCBS of New Mexico, Molina,  Presbyterian, Aetna, Humana, Multi-plan, New  Mexico Health Connections, True Health New  Mexico, Health-smart, Western Sky, CareConnect  Health Plan, Magellan, TRICARE, UMR and  Optum/United Healthcare (Medicare only, no  commercial plans).  If you are not insured by one  of our partner insurance companies or are uninsured  the following fee schedule is applicable to cash pay  patients.  Initial visit- $250.00, second visit- $150.00,  every visit thereafter- $100.00.  

            Minor children:

      Children under the age of 18 years old must  be accompanied to the visit by a parent, legal  guardian or court appointed individual.  The adult  accompanying the individual may be asked to show  proof of their legal right to make healthcare  decisions for the minor child.  If a parent would  like for someone other than themselves, such as a  friend or family member to bring the child to the  visit a form needs to be filled out allowing Nirvana  Mental Healthcare Services, Inc. to release  confidential healthcare information to the individual  and also to make decisions on behalf of the parent  in their absence.  The accompanying adult is also  responsible for any monies due at the time of the  visit.

    Medical records, letters and forms:

      Nirvana Mental Healthcare Services, Inc.  charges a fee for medical records, letters and forms  that need to be completed on the patient's behalf.  The fee varies, with a processing fee of $50.00 and  $5.00 additional per one-sided page per form, as  permitted by your insurance carrier.  The fee is due  at the time of drop-off.  Please allow one week from  the date of the request for the forms to be  completed and ready for pick-up.  Long-term  disability and family medical leave forms require a  six month established relationship with the practice  to be completed on the patient’s behalf, in addition  to any applicable fees.

     Termination of patient relationship:

      If you have not been treated by Dr. Williams  for 6 months or longer you are no longer considered  a patient, therefore no requests for form or document  completion or prescription refills will be granted.  You may re-establish care by scheduling an  appointment to be seen.  Any combination of three  no-shows or cancellations without 24 hour advance  notice is grounds for permanent discharge from the  practice.