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Frequently Asked Questions
Prospective patients often contact us to ask various questions about our practice. To save you time, we've collated our answers to those frequently asked questions here. We've grouped them in three categories: finance-related, services-related and questions about psychiatrists compared with other mental health providers. Of course, if you don't see your question listed, or if you need some clarification, you should always feel free to get in touch.
Credit: Matt Manley
Finance-Related Questions
Do you take insurance?
No. Like many private psychiatry practices, we are not in-network with any insurance carriers and do not bill them directly. However, we do provide a "superbill" with which patients may claim out-of-network benefits. Certain insurance plans, such as PPO plans, will accept such documentation subject to policy terms. To check how much you would be reimbursed, contact your carrier and quote the following CPT code pairs: both 99204 & 90838 for the initial evaluation, and both 99214 & 90833 for follow-up appointments.
Do you take Medicare?
No. We are a cash-only practice and do not take insurance, including Medicare. We only provide a superbill to support claims for out-of-network benefits. You would need to check with your insurance provider to ascertain whether your policy provides for such benefits.
Do you offer free consultations?
Unfortunately, due to the volume of patients, we are unable to offer free consultations. The only route to become a new patient at our practice is to schedule an appointment for an initial evaluation. However, you are welcome to get in touch with us by email to clarify anything before booking.
When will my card be charged?
New patients are requested to provide valid payment details when booking their initial evaluation. These payment details are vaulted securely by our payments processor. Your card will be charged after each appointment according to the prevailing fees schedule. In advance of each appointment, we pre-authorize the card to ensure that the payment details are valid. This pre-authorization is not a charge, but instead reserves an amount on your card that can be charged after the appointment. If we are unable to pre-authorize the card we will notify you as we may need to cancel the appointment.
Services-Related Questions
What are the pros and cons of tele-psychiatry?
For patients, the pros are obvious. You can seek care at a time and place that's convenient to you. Forget about a stressful, time-consuming trip and the potential awkwardness of a psychiatrist's waiting room. Just grab your mobile or laptop to connect with your doctor. You don't even need to get out of bed!
At a macro level, the flexibility of tele-medicine can also help fill shortages in the availability of psychiatric care. Psychiatrists are generally scarce, but in some regions of the United States they're an endangered species. This is often the case in rural communities, but even some cities face extreme shortages. For example, according to the American Board of Psychiatry and Neurology, only about 50 psychiatrists are based in Fort Worth, which is home to nearly a million people. By contrast, a similarly sized population in Boston is served by 10 times as many psychiatrists. Some states have attempted to tackle this regional scarcity problem by liberalizing the ability of nurses to practice independently. However, the broader adoption of tele-psychiatry offers an alternative way to alleviate regional scarcity without compromising on expertise or the quality of patient care.
So what's the catch? Well, not much. Unlike most other medical specialties, psychiatrists typically don't need to perform physical evaluations. So psychiatry is uniquely placed to take advantage of modern technology. The main drawbacks are regulatory. First, since medical licensing is done by states, patients must be physically located in a state in which their doctor has a license. According to the Federation of State Medical Boards, 94% of physicians are licensed to practice in just one or two states (although at Apraku Psychiatry we cover more ground). Second, federal law places restrictions on providers' ability to prescribe controlled substances through tele-medicine. This narrows the potential set of treatments that can be offered, although controlled substances are anyway not indicated for most psychiatric problems. If they are, your provider will say so and may be able to work with your primary care provider to have them prescribed.
At a macro level, the flexibility of tele-medicine can also help fill shortages in the availability of psychiatric care. Psychiatrists are generally scarce, but in some regions of the United States they're an endangered species. This is often the case in rural communities, but even some cities face extreme shortages. For example, according to the American Board of Psychiatry and Neurology, only about 50 psychiatrists are based in Fort Worth, which is home to nearly a million people. By contrast, a similarly sized population in Boston is served by 10 times as many psychiatrists. Some states have attempted to tackle this regional scarcity problem by liberalizing the ability of nurses to practice independently. However, the broader adoption of tele-psychiatry offers an alternative way to alleviate regional scarcity without compromising on expertise or the quality of patient care.
So what's the catch? Well, not much. Unlike most other medical specialties, psychiatrists typically don't need to perform physical evaluations. So psychiatry is uniquely placed to take advantage of modern technology. The main drawbacks are regulatory. First, since medical licensing is done by states, patients must be physically located in a state in which their doctor has a license. According to the Federation of State Medical Boards, 94% of physicians are licensed to practice in just one or two states (although at Apraku Psychiatry we cover more ground). Second, federal law places restrictions on providers' ability to prescribe controlled substances through tele-medicine. This narrows the potential set of treatments that can be offered, although controlled substances are anyway not indicated for most psychiatric problems. If they are, your provider will say so and may be able to work with your primary care provider to have them prescribed.
What problems do you treat?
We treat a wide range of psychiatric issues facing adults. Common issues include depression, anxiety, bipolar disorder and obsessive compulsive disorder. We also give guidance for mental health concerns related to life transitions, attention difficulties, mood swings, anger, traumatic events and problematic eating.
What are the treatment options?
Treatment options will be discussed in detail during your appointment. Depending on your situation, they may include a course of prescribed medication. Complementary treatment may include lifestyle advice and talk therapy as well as referral to a trusted therapist for a specific type of therapy that is known to be effective for your condition. In addition, we believe that patient education is an integral part of the healing process. Knowledge about what ails you is often the first step to overcoming it. We therefore take the time to educate you about the science underlying your condition.
Do you do therapy?
The primary services offered at Apraku Psychiatry are diagnosis (figuring out what's wrong), medication management (identifying which medications might be appropriate, if any) and psycho-education (teaching you about the science underlying your condition). In the process of dialogue, Dr. Apraku also provides some supportive talk therapy. Depending on your situation, this type of therapy may not be an adequate substitute for regular, high-frequency meetings with a dedicated therapist, such as a psychologist or counselor. As part of your treatment plan, Dr. Apraku may therefore recommend that you also see a therapist for a specific type of targeted therapy. If this happens, we will try to support you by providing referrals to trusted therapists who specialize in providing the therapy you need.
Do you prescribe controlled substances?
No. Federal law places restrictions on the prescription of controlled substances via tele-medicine. This includes stimulants (e.g. Adderall and Ritalin), benzodiazepenes (e.g. Xanax and Klonopin), and some sleep medications (e.g. Ambien and Lunesta). However, if a controlled substance is medically indicated, we will say so and may be able to work with your primary care provider to have it prescribed.
Do you treat attention disorders (e.g. ADHD)?
Yes, but with two caveats. First, a definitive diagnosis of attention disorders such as ADHD may require an in-depth neuropsychological evaluation, which we do not provide. Second, first-line treatment of ADHD often includes controlled substances, which we do not prescribe. Nevertheless, if you are open to alternative treatments, we would be glad to see you for an evaluation.
Questions About Psychiatrists
What is a psychiatrist?
Psychiatrists are specialized medical doctors who have completed a four-year specialty training program ("residency") in addition to earning a medical degree. For more informtion on what it takes to become a psychiatrist, click here.
What is the difference between psychiatrists and psychiatric nurses?
These providers differ in the training they have undertaken and the level of care they are licensed to provide. Psychiatrists are medical doctors who have spent at least 12 years in higher education. By contrast, registered nurses hold an associate's or bachelor's degree in nursing, which can take around two years to complete. Some nurses pursue an additional two years of training to earn a master's degree in nursing, allowing them to practice as psychiatric nurse practitioners. Given this accelerated timeline, many states place restrictions on psychiatric nurse practitioners' ability to practice without supervision by a physician.
What is the difference between psychiatrists and psychologists?
Psychiatrists and psychologists provide complementary mental health services. While psychiatrists typically focus on biological modifications through medication management, possibly in combination with some therapy, clinical psychologists are exclusively trained to facilitate behavioral modifications through therapy, and often specialize in providing a specific type of therapy that may be effective for certain conditions.
