Greeting Letter to Patient

Dear New Patient:
We would like to welcome you to Awakenings, an online clinical telepsychiatry practice.  We have designed a unique and convenient new format to perform face to face psychiatric evaluations in real time, via computer Skyping, an online application that allows for us to communicate via computers in our own private settings, eliminating the need to travel to a physical location. 
Psychiatry is the one specialty of medicine where this type of interaction is allowable given that we do not perform physical exams, and in certain cases can be preferable, i.e., parents who would like to meet but have issues obtaining daycare, patients with disabilities where travel is cumbersome and difficult, patients who have hectic work schedules and would have difficulty taking time off of work, patients who live a long distance away from major cities and routes, etc.
Telepsychiatry eliminates the worry of having to travel, finding parking, searching for train and/or bus schedules that are accommodating and on time, inclimate weather conditions, rushing before work or after work, waiting in the waiting room to meet with the doctor, or the physician being unavailable to due office issues, illness, etc.  It is a virtual experience that ensures efficiency and convenience at every appointment, for both the doctor and patient.  We encourage that the patient be in a comfortable setting, which may include having children in the background, pets, family members, music, etc…. essentially, whatever conditions make each patient feel at ease during the session.  This is the intention, for patients to communicate from the privacy and comfort of their homes.
When you schedule an appointment, your time slot is guaranteed and the physician will be available to you for the entire duration of the scheduled appointment time.  Due to demand, we are asking that you please be on time for our online session, as we want to maximize our available time with one another and also be timely for the next patient.  If you do need to cancel or change your appointment, we do ask for a 24 hour notice prior to your scheduled time, or we will have to charge for the appointment.  If you are unable to provide 24 hour notice due to an emergency, we will reschedule the appointment at no additional charge.
At this time, we do not accept insurance.  We do provide an invoice that you can submit to your insurance for “out of network provider” reimbursement. Most insurance companies reimburse between 70% and 100% of the cost of the session.
Payment in full is due prior to the scheduled session.  There are no exceptions; payment must be confirmed prior to your scheduled appointment or we will have to reschedule. This policy is due to our office not being equipped to track billing after sessions, and keep running balance invoices. You are welcome to pay either by direct deposit to our Bank of America account, or thru Paypal.   We ask for your email address so that we can send you an invoice with your preferred payment method.  Paypal is convenient in that the transfer can be confirmed usually within 30 minutes, but if making a direct or online deposit to our Bank of America account, it would need to be done prior to 4pm the day preceding your appointment for our office to confirm the payment.
The current list provides length and type of session and cost:
1) Initial Psychiatric Evaluation:  This will be an hour session or longer, and will be utilized to gather clinically relevant data as well as historical background.  In this time, we will cover psychiatric history, family history, substance abuse history, medication history, past medical history, social and developmental history, legal history, and any current psychological or social stressors that may have impacted mental health issues.  We will offer an initial diagnostic impression as well as any appropriate treatments and/or recommendations, referrals.  This may include prescribing medication, psychotherapy, or obtaining medical work-ups and/or laboratory data.               
             -Cost of Initial Psychiatric Evaluation:    $350
             -Cost if requesting summarized, written evaluation:  $250 
                        *in addition to $350
             -Cost of 15 minute Medication Management sessions:  $145
             -Cost of 30 minute Med Mgmt/Therapy sessions:  $200
             -Cost of 50 minute Med Mgmt/Therapy sessions:  $300
Please note, in addition to traditional psychiatric practices and pharmacotherapy, we also provide spiritual counseling.  If a patient would only like spiritual counseling, and the psychiatrist will not be functioning in a traditional M.D. capacity, ie, no prescribing, no formal psychiatric diagnostic interview/mental status exam, we do offer a different rate for this type of session to make it more affordable.  We can also incorporate spiritual counseling as a component of formal psychiatric treatment as a psychiatrist as well;  in this instance, the same M.D. rates listed above would apply based on length of session desired.
            -Cost of Spiritual Counseling only:  $200 for 40 minute session
Finally, for Forensic Psychiatric Evaluations:                      
             -Cost if requesting forensic comprehensive evaluation:  $300 per hour
                       *Standard evaluations are at minimal 4 hrs to prepare, therefore $3000 
                         retainer will be required at time of evaluation.  Hours include the 
                         initial and any follow up evaluations, write-up, time to  review any 
                         other data relevant to the report, i.e, previous psychiatric records/ 
                         speaking with previous clinicians, speaking to attorneys/counsel, 
                         corresponding with court, etc.                         
                       *Additional hours [>4] are often necessary, and the patient will be 
                         advised of likely hours needed to complete the case and full payment 
                         beyond the retainer will be due prior to the submission of the report.               
                             *If forensic evaluation is requested, please be advised we will need to 
                               speak directly with your attorney throughout the case.
Lastly, please be reassured that the same parameters of treatment apply in Skype sessions; i.e., full confidentiality and no disclosure of treatment without the patient’s direct written permission.  We will keep brief, electronic records of treatment, mostly to track medication management, accessible only by our office. 
You will be able to conveniently schedule appointments directly online, and can also contact the office by email and/or phone [message machine only, checked Monday thru Friday, not on weekends and/or holidays].  If it is an emergency, please contact 911 or go to the nearest ER.  Our office will make every effort to get back to you as soon as possible.  Please be aware of your prescription quantities as well, so we can provide refills in a timely manner Monday thru Friday [ie, a message left on Saturday morning would be retrieved Monday the earliest].
We very much look forward to working with you and welcome you to the practice!
Christine S. Naungayan, MD, CEO and Founder 
Victor Silva, General Manager     
Teresa Cummings, Clinical Coordinator