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.
Medications:
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.