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FAQ

What is telepsychiatry, or telemedicine psychiatry?

Telepsychiatry, also known as e-psychiatry, is the application of telemedicine in psychiatry. As of 2013, telepsychiatry has been the most successful of all the telemedicine applications to date, as it typically only needs adequate video conferencing equipment between the patient and the psychiatrist. Through the mobile app, you can see a psychiatrist face-to-face from the privacy and comfort of your own home to address common behavioral health challenges. Psychiatrists are different than therapists in that they have the ability to prescribe medications for the treatment of diagnosed mental disorders.

What is an online psychiatry session like?

An online psychiatry session is essentially the same as an office visit but more convenient since you are seen from the location of your choosing, eliminating the need for travel. Prior to the visit, you will be asked about your current emotional symptoms, potential factors contributing to these symptoms, and the change in any symptoms compared to the last visit. Using all this information your psychiatrist will come up with a thorough assessment and treatment plan. This will be an ongoing conversation and, as they get to know you better over time, the plan can change as your needs change.

Is my online psychiatry visit private and secure?

Yes, it is of utmost importance to maintain patient privacy and keep information secure. The technology used is via a private, secure, HIPAA-compliant platform allows you to safely and confidentially consult with me online. All forms submitted are HIPAA compliant. All credit card information is encrypted and 100% backed by a CyberInsurance policy. 

HIPAA Privacy Rule Link

What is the difference between a therapist and psychiatrist?

A patient would see a psychiatrist for medication management and a psychologist for talk therapy. Sometimes the best form of treatment is a combination of both talk therapy and medication management. Psychiatrists and therapists are each able to evaluate a person to determine whether one or both treatments approaches are necessary, and can make recommendations based on their assessment.

What is telemedicine software?

Telemedicine software is the platform or technology infrastructure that allows private, secure, HIPAA-compliant, and high-quality medical consultations via videoconference. The software typically has algorithms that help dispatchers choose, notify, and confirm the most appropriate clinician for the patient based on specialty, sub-specialty, hospital privileges, and availability timeframe. Telemedicine software allows providers to connect with patients, share video and images, as well as collaborate with other clinicians in real-time. It can be integrated with electronic health records and scheduling systems.

Virtual medical consultations are not like typical videoconferences. They must be HIPAA-compliant which means they must be secure and private. They must also provide clear high-quality video and audio of both clinician and patient. High-speed internet is required to ensure no interruptions or degradation of quality.

What software and equipment do I need for a telepsychiatry appointment?

Individual telepsychiatry visits are conducted through video conferencing. You need a webcam/video camera and microphone compatible with our software. You will also need a broadband internet connection (DSL, Cable, T1, or higher).

Is my video-conference with you secure?

Yes. The video chat is encrypted and private just between us. I do not record our sessions. 

Are there guidelines that needs to be followed in order to practice telepsychiatry?

Yes, we have telepsychiatry guidelines in place which follow federal and state laws and regulations.

Are there any limitations to telepsychiatry treatment?

Yes, and they are covered under bills from the State of Virginia.

What conditions do you treat?

Below is a list of issues I handle through my practice of telepsychiatry, with an emphasis on ADHD-specific care. If you do not see your condition listed you can contact me further to find out if I can help.

  • Alcohol Use/Abuse/Dependence
  • Nicotine - Smoking Cessation
  • Anxiety Disorders
  • Agoraphobia
  • Generalized Anxiety Disorder
  • Obsessive-Compulsive Disorder
  • Panic Attacks
  • Post-traumatic stress disorder
  • Phobias
  • Social Anxiety Disorder
  • Attention Deficit Hyperactivity Disorders (ADHD)
  • Intermittent Explosive Disorder 
  • Mood Disorders
  • Depression
  • Bipolar Disorder
  • Schizophrenia
  • Parent-child
  • Sleep Disorders
  • Insomnia
  • Sleep terrors/night terrors
  • Some behavioral aspects related to Dementia

How much does this cost?

I run a cash-first model, but please don't let that scare you from making an appointment. I only charge your credit card after the appointment. In addition, I give you a "Superbill" which is specifically gridded PDF form that you can print and pop in the mail. You will receive a check directly from your insurance company within a few weeks. All you need to do is to make sure you have out of network benefits. If you do not, then it's just a cash-visit only. If you have out of network benefits, and your claim is denied, I will work with you to try and figure out why. All you need to do is to make sure you have out of network benefits, or if you want my care regardless.

As an example: I just received a copy of this from a patient. A person with Optima was charged $175 for a follow-up appointment and reimbursed $165.25 from Optima directly with a check. So the total cost of the appt was only $18.75. Motto: please don't let the cash model discourage you if you need help. If your plan reimburses, the reimbursement is very good, and you will get most of your money back.

Not every plan reimburses out of network providers. Please check with them first, then decide if you'd like an appointment. The high reimbursement rate thus far (about 85% or higher) is ultimately determined by your deductible having beeing met, and the patient being present for the entire appointment. If the patient is not present, different codes which do not reimburse as much.

 

Initial appointments: $450; again, reimbursable by insurance. 1 hour.

Follow-up appointments: 30 minutes is the typical average, sometimes more, sometimes less. $225 for a follow-up. Also reimbursable.

 

As of 11/9/21:

Anthem: reimburses PPO and POS, not HMO

Optima: covers most appointments (out of network providers)

Tricare: covers most appointments (out of network providers)

Cigna/Aetna/Medicaid/Medicare: please call them to inquire about out of network reimbursement

Why a cash-first model?

By charging cash, I really will just be charging your credit card after the appointment.  This allows me to cut through the red-tape of insurance, and I can schedule patients quickly, urgently, and as often as they need my help. 

The cash-first model is the standard in larger cities. It works and works well. It's a newer concept in this area. By not taking insurance directly, I don't have to wait to get on your specific insurance panel, a process that can take months and hundreds of dollars. I can see patients quickly, which is particularly helpful with children who may be under time-pressure from their school or parent to be seen by a child psychiatrist and get the necessary intervention.

https://www.choosingtherapy.com/superbill/

Is my privacy protected with telepsychiatry?

Yes. Electronic interactions with health care providers are subject to the same state and federal privacy and confidentiality laws as in-person interactions, including HIPAA. These. transmissions use security protocols that are HIPAA and HITECH compliant. Video conferences may not be recorded by either party without written consent. Your psychiatrist will keep a confidential medical record of your care and a complete privacy policy will be provided to you upon registration.

Some aspects of the remote interaction with your physician may not be confidential. These would all be the same privacy consent for in-person appointments, such as sharing notes with referring providers or other healthcare professionals involved in the patient’s care, but not psychotherapy notes unless deemed necessary for the health of the patient.

Why would I see a psychiatrist online?

One in four Americans is affected by emotional distress at some time in life, but only one in eight seeks care. From chronic concerns such as depression and anxiety to recent stress caused by events such as grief, divorce, parenthood, or other major life changes, online psychiatry allows for reliable and convenient visits with licensed and highly trained physicians. I can schedule you, see you at a time a place of your choosing, reduce the number of hours spent driving to and from the appointment, eliminate the awkwardness and privacy issues of a waiting room, work to get you an appointment quickly and prescribe electronically. Psychiatry is one of the only specialties that allow for real-time synchronous telemedicine.

How do I make an appointment with you?

First, you will submit a screening form on my website: www.matthewsachsmd.com. Based on your initial answers, I can quickly decide if I can be helpful with your specific needs. I then open a “Patient Portal” called “My Medical Locker,” where you fill out additional paperwork, answer other historical questions, electronically sign consent forms, schedule appointments, and make payments.

Can my child see a psychiatrist?

Yes, Dr. Sachs is board-certified in psychiatry for children and adolescents and licensed in the states of North Carolina and Virginia for all types of mental health issues and the prescriptions that go with them. A parent or someone older than 18 MUST be at the appointment though since we are discussing medication.

Can I see a psychiatrist online if I am traveling or in another state?

Unfortunately, unless it’s an emergency, I can only see you in North Carolina or Virginia. Under current laws, you will need to be physically located in your home state during each session but will update if there is a change to the law.

What are the benefits of telepsychiatry?

Video-based telepsychiatry sessions are affordable and readily accessible for almost any mental health condition. The following are the benefits of electronic mental health services.

  • Improve access to mental health specialty care especially in rural areas
  • Care comes to the patient’s location in the same state
  • Reduce trips to the emergency room because appointments with me can be made quickly
  • Reduce delays in care and long waits for appointments
  • Improve continuity of care with primary care doctors or therapists 
  • Eliminates driving, scheduling time off work, and/or childcare since the appointment comes “to you”
  • Eliminate the awkwardness of a waiting room experience
  • Reduce the stigma barrier of psychiatric appointments
  • Allows for self-scheduling and control over your mental health care

Most people are comfortable and more relaxed talking to someone else on a screen. People feel safer in their homes and like the privacy that online psychiatry offers. There are many other conveniences, such as privacy since there are no waiting rooms filled with people you may or may not know. Appointments are more convenient and occupy a smaller portion of your day since traveling is not involved. There are substantial research articles and clinical evidence of the effectiveness of online psychiatry. Telepsychiatry is as accurate as an in-person visit for diagnostic correctness, treatment effectiveness, quality of care, and patient satisfaction. Patients of all ages report favorable impressions of telepsychiatry. People with severe anxiety or autism may benefit even more due to the privacy and less stressful environment of having an appointment from their own home.

Additional Information Resources:

Virginia PDF document icon

Telepsychiatry Guidance in the State of Virginia

Senate Bill PDF

SENATE BILL NO. 1220