California Telepsychiatrists
American Telepsychiatrists
Frequently Asked Questions by Primary Care Doctors
Q: What can you do for me?
A: We can assist you in many ways. If you have a complicated psychiatric patient, you can refer him/her to us for treatment. If you have a patient with a psychiatric issue and just want a consultation, you can obtain that too. If you have a lot of patients with psychiatric need, we can design a system as comprehensive as having a psychiatric consulting service (with subspecialty) available to you for all of your clinic hours over televideoconference or telephone with the patient in the room, or you can have a more cost effective "batch consult" system using services available a few hours a week. You can have a system designed where either your staff or our staff provide a standardized psychiatric interview to your selected patients recorded for audio and video and stored for later consultation (store-and-forward). Any need that you have, we can find a solution for you.
Q: Who pays for this?
A: In many instances, Medicaid will pay for our consultative services. We can also design a program specific to your needs and budget if you want to pay for consultative services.
Q: How much do you charge?
A: We tailor a program specifically to meet your needs and budget.
Q: What IT interface do you use?
A: We can use your IT department to build the interface, or you can use our IT department to build the interface. The key is to keep everything HIPAA compliant. We can connect to your system through a secure Virtual Private Network (VPN). We have our own, or we can use your existing system. Even though our system is proven safe and secure, some agency IT departments take their duty to make certain no virus ever gets through and no data is ever compromised so seriously that they block their agencies from using outside contract doctors. In such instances we can even set up a system that is completely separate from their system so that there is no interface at all.
Q: Can you keep our system safe from viruses and hackers?
A: Between our IT department and yours, we can together do everything possible to block hackers and viruses.
Q: Talk to me about HIPAA.
A: We take HIPAA regulations very seriously, and we make certain that any system we develop for any agency is completely HIPAA compliant.
Q: How do you handle a crisis or emergency patient?
A: The same way a doctor in your building would handle an emergency patient. We would call security in your building if needed. If the patient needs to be put on a 72 hour hold, we can arrange for our doctors to be certified to write holds at your facility, and between our IT departments we can arrange for an on-line electronic signature system to sign the hold paperwork. Your staff would arrange for transport to the appropriate emergency department or critical care unit for further evaluation.
Q: Are your doctors Board Certified?
A: All of our doctors are Board Certified.
Q: How do you credential your doctors?
A: California Telepsychiatrists/American Telepsychiatrists uses the credentialing service of the Federation of State Medical Boards.
FEDERATION CREDENTIALS VERIFICATION SERVICE (FCVS)
Verifying credentials is an essential building block of medical regulation - and FCVS leads the way with permanent records and data security.
FCVS establishes a permanent repository of primary-source verified credentials for physicians and physician assistants, saving duplicate efforts by state medical boards and hospital/HMO/Mental Health Administrative & Service Agencies.
Established in 1996 FCVS has verified the credentials of more than 127,000 physicians to date. FCVS collects and stores high-quality, primary-source verification of core credentials, which include physician identity, medical education, graduate medical education, examination history, Educational Commission for Foreign Medical Graduates certification and disciplinary history. Primary-source verification ensures that state medical boards receive information verified directly from the source, eliminating the potential for fraudulent documentation.
FCVS lightens the workload of credentialing staff and reduces duplication of effort.
Q: Don't we still have to do our own credentialing?
A: CMS
Publishes Final Hospital Telemedicine Credentialing Standards
On May 5, 2011, CMS published a final rule revising the hospital conditions of participation (COP) related to the credentialing and privileging of physicians who provide telemedicine services. CMS includes both teleradiology (non-simultaneous) services and telehealth (simultaneous) services within the definition of telemedicine. In short, the final rule allows the governing body of a hospital or critical access hospital (CAH) to rely upon the credentialing and privileging decisions made by a distant-site hospital or telemedicine entity when making its own decisions on privileges for the individual distant-site physicians and practitioners providing such services. Certain conditions must be met under this rule, including a written agreement with the distant-site hospital or telemedicine entity to ensure that the distant-site entity, acting as a contractor of services, furnishes its services in a manner that enables the hospital or CAH to comply with all applicable COPs and standards for the contracted services, including the credentialing and privileging requirements regarding its physicians and practitioners providing telemedicine services. The rule is effective July 5, 2011.
For more information on the Federation of State Medical Boards credentialing, click Here.
Q: What is your malpractice insurance like?
A: We have excellent professional liability insurance that covers all of our doctors with $1,000,000 per incident and $3,000,000 aggregate per year.
Q: What about general liability insurance, and do you list our agency as co-insured?
A: We can list your agency as co-insured.
Q: How do you prescribe medications? What about Schedule II and III meds?
A: Most medications can be prescribed electronically or by fax. Schedule II meds that require an original signed Rx can be sent via overnight courier directly to your office if needed.
Q: How do you follow up with labs?
A: We have psychiatric nurses who make sure abnormal labs are followed up on.
Q: How do patients contact your doctors if there is a problem?
A: All of our doctors have toll-free phone numbers with 24/7 messaging service that automatically translates the verbal message into text and emails (via secure, encrypted email) it to the doctor with the original tape of the verbal message.
Q: Do you need a local staff person in the room?
A: It is easier to work if there is a staff person in the room, but it is not absolutely necessary.
Q: How do we get records to you?
A: You can grant us access to your electronic medical record, or you can fax us the necessary documents. If you don't have an EMR, we can arrange for one to be set up for you free of charge.
Q: Do you have your own Electronic Medical Record (EMR)? What about a Patient Health Record (PHR)?
A: Yes, we use a fully functional EMR and PHR.
Q: Are your doctors willing to use our EMR?
A: Yes.
Q: How do we get your notes?
A: If they are not in the EMR, we can fax or email the notes to you in whatever form you prefer.
Q: Do you have references?
A: Yes.
Q: Do you have subspecialists in psychiatry?
A: Yes. We offer Child & Adolescent, Forensic, Geriatric, and Substance Abuse specialists.
Q: Can your doctors work evening and weekend hours?
A: Yes.
Q: What happens if the system breaks down?
A: There is a backup system.
Q: Do your doctors have their own IT support?
A: Yes. We offer our doctors 24/7 IT support to make certain the link to patients is always secure and working at its highest performance level.
Q: Do you have your own psychiatric certified nurses?
A: Yes.
Q: Do you offer translation services?
A: We can offer translation services to you at cost.
Q: What is the turn-around time for the store-and-forward system?
A: Approximately a week, but we can adjust that time to meet your needs.
Q: If I call when a patient is in the room, will a psychiatrist answer?
A: Cost wise, we offer a tiered system. If you want 99% probability that you will have a psychiatrist in the room within 5 minutes of your call, we can arrange that. If you're okay with a 75% probability that you will have a psychiatrist in the room within 10 minutes of your call, we can arrange that as well.
Q: If I call for a consultation, who is treating the patient, me or you?
A: If it's a consult, then we would give our professional opinion and recommendations, but you would prescribe the medications and manage the patient.
Q: If I refer a patient to you, how will I know he/she is receiving the services?
A: With the patient's signed Release of Information form, we would provide you with documentation of the diagnosis and treatment (limiting the information to medically pertinent issues but protecting the patient's personal confidentiality).
Q: What if there's a bad outcome?
A: We can participate in mortality & morbidity reviews as needed.
Q: Can you give psychiatric Grand Rounds?
A: Yes, this can be arranged.
Q: Do you offer just a curbside consult service?
A: Yes.
Q: Do you offer services outside of California?
A: Yes. We currently have doctors licensed in CA, HI, TN, FL, WA, IL, NY, and NM.
Q: Do you discriminate?
A: California Telepsychiatrists/American Telepsychiatrists is an equal opportunity agency and does not discriminate on the basis of race, religion, color, sex, age, non-disqualifying physical or mental disability, national origin, sexual orientation, or any other basis covered by local law. All matters related to employment are decided on the basis of qualifications, merit and business need.
Q: How can I contact you to discuss my needs?
A: Call Dr. Schaeffer at 916-320-4422 or use the Contact Us form.
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