(Almost every question can be answered here, so please read thoroughly)
Appointments and Scheduling
Monday - Thursday 7:30am - 5:30pm
Office hours are by appointment only. Therapy sessions are 45 minutes in length. Medication appointments are 25 minutes in length.
Medication management appointments (less frequently than twice monthly) are scheduled during the school day. Be mindful that early morning and lunch-time appointments fill up early. After school hours and late appointments are reserved for weekly to twice monthly patients only, as children receiving therapy at this frequency clearly cannot miss school.
The time for your sessions is reserved specifically for you. If you cannot attend your appointment, PLEASE NOTIFY THE OFFICE AT LEAST 2 BUSINESS DAYS IN ADVANCE to avoid being charged for an appointment.
Please be mindful that my schedule is often full for up to three months ahead, especially for 'preferred' appointment times (early morning and early afternoon) so rescheduling will require accepting whatever appointments become available on a wait list.
Emergencies and the Urgent Line
Dr. McCarthy will do her best to respond to you as soon as possible. If you cannot await a response, please call 911 or go to your nearest emergency room. Dr. McCarthy's urgent pager (703-313-2315) should ONLY be used for extremely urgent matters, which are defined as:
- Suicidal thoughts or thoughts of harming others,
- Unexpected medication reaction with serious symptoms, or
- Any unusual behavior that your fear to lead to physical harm.
When paging Dr. McCarthy (after the tone prompt, enter your number followed by the # sign - you will then hear confirmation tones and can hang up), Dr. McCarthy will do her best to respond to you as soon as possible. If you cannot wait for a response, please call 911 or go to your nearest emergency room. NOTE: PRESCRIPTION REFILLS ARE NOT CONSIDERED EMERGENCIES (please see prescription refill policy). Always leave a detailed voicemail message on Dr. McCarthy's office line (703-288-3535).
Prescription Refill Policy
In general, all refill requests should be made during appointment times. Remember all refill requests require a minimum 24-hour (office hours) turn-around time. At the time of your appointment, you will be supplied with enough refills to last until your next appointment. Refill requests outside of visits are only for unusual/extenuating circumstances.
Prescription refills will incur a $20 refill fee FOR ALL REFILLS requested outside an appointment time, without exception.
Dr. McCarthy requires all patients taking medication to be seen for an appointment a minimum of every three months in order to obtain prescription refills. If you have not had an appointment within three months, Dr. McCarthy will not be able to fill your prescription. Remember that Dr. McCarthy's schedule fills up months ahead, so plan accordingly.
If your prescription is a controlled substance (as is the case for most medications for ADHD), please see the "Controlled Medications" section as there are special policies for these prescriptions.
Prescription Refills for Non-Controlled Medications
If a refill is needed for a non-controlled medication outside of an appointment, call your pharmacy and ask them to fax a refill request to Dr. McCarthy at her fax: 703-288-4334. Also leave a voicemail with Dr. McCarthy indicating that you have arranged for the refill request to be faxed from your pharmacy. Please allow at least 24 hours (business days) for this request at a minimum. Remember, you must have an appointment already scheduled on Dr. McCarthy's calendar to request a refill.
Prescription Refills for Controlled Medications
As with non-controlled medications, in general, all refill requests should be made during appointment times. Exceptions are made for changes to your medication between appointments or the unforeseen need for refills/rescheduling issues beyond your control.
Stimulants (most medications for ADHD, including Ritalin or its generic equivalent methylphenidate, Adderall, Focalin, Concerta, Vyvanse, etc.), and benzodiazepines are controlled substances. Since these medications are easily abused and there is an illegal market for these medications, the DEA and the Virginia Board of Medicine monitor prescribing and refill practices for these medications. If you are prescribed one of these medications, it is critical that you follow the controlled medication policy. The policy is as follows:
- You MUST take these medications as directed.
- If you feel you need to adjust your dose to a higher dose of the medication, you must call the office and consult with Dr. McCarthy prior to making any adjustments to your dose.
- You must be responsible with your medication and take measures to ensure that your medication is not lost or stolen.
If you require an early refill of your medication because you have adjusted your dose without consulting Dr. McCarthy or because your medication was lost/stolen, you are in violation of the controlled medication policy. Dr. McCarthy understands that unexpected circumstances, out of your control, may result in you needing an early refill for your medication and will allow ONE violation of the controlled medication policy to allow for these circumstances. You will be charged $100 fee for an early refill of your controlled medication. Any subsequent violations of the policy will result in your termination as a patient with Dr. McCarthy. While this policy may seem harsh, due to the nature of these medications, Dr. McCarthy must be able to manage these prescriptions responsibly and in a manner to minimize any potential abuse.
If Dr. McCarthy has agreed to provide you with a controlled medication refill between appointments, you will need to make arrangements to pick up the controlled prescription at Dr. McCarthy's office. Dr. McCarthy will not send controlled medication prescriptions in the mail. You must allow at least 24 hours (business days) to pick up the prescriptions.
To make a refill request for controlled medications, leave Dr. McCarthy a message on her voicemail (703-288-3535) with your exact medication request. Dr. McCarthy will leave your prescription in the designated controlled area in the office within 24 hours during regular business days.
Prior Authorization/Insurance Requests for Medication
If your insurance company or your pharmacy informs you that your medication requires a prior authorization, please follow these instructions precisely.
- Call your insurance company (pharmaceutical division) and ask them to fax Dr. McCarthy the Prior Authorization form for the medication at 703-288-4334.
- Tell your insurance company to fill in all your identifier information, including name, medication, and all of the insurance identifier numbers.
- If your insurance company insists that "The Doctor must call," you will be charged for Dr. McCarthy's time in making this call. Insurance phone line wait times can take up to an hour. All companies have a simple form which can be faxed to my office. If they tell you they do not have such a form, call back and get another representative on the line and Dr. McCarthy is confident they will fax it. Dr. McCarthy will complete the Prior Authorization forms within 24 business weekday hours.
- Remember that prior authorization seems to be an annual requirement for each medication and dosage change, so plan accordingly.
**NOTE: Recent Pharmaceutical/Prescription Medication Insurance Coverage Changes – Starting July 1, 2014
Starting 7/1/2014, some insurance companies (including United Healthcare/Optum Rx) have unilaterally decided not to cover many of the excellent evidence-based treatment medications for ADHD. Unfortunately, there is nothing Dr. McCarthy can do about this – the companies have simple made the decision not to cover many superb medications.
If you have insurance coverage affected by these changes, you will likely receive a letter from your insurance company telling you your doctor should consider alternative/lower cost options. Dr. McCarthy will not be able to "suddenly switch your medication" over the phone, and unfortunately, many of the medications they do cover are antiquated and are unlikely to be effective or well-tolerated for your child.
For example, United Healthcare/Optum Rx will no longer cover Daytrana patch, Intuniv, any version of Ritalin LA (name brand or generic), generic Concerta, Metadate CD, or Quillivant XR.
THERE IS NOTHING Dr. McCarthy can do regarding this unfortunate new situation in our changing healthcare situation. It is truly unfortunate that certain insurance companies are now taking upon themselves to decide what is the best treatment for your child.
During your next appointment, Dr. McCarthy will work with you to figure out what is the best option possible for your child during this time of changing health care policy. Again, Dr. McCarthy cannot, via a phone conversation, switch your child's medication to the limited options allowed by your insurance company.
Special note about United Healthcare/Optum Rx insurance policy regarding Concerta and Metadate CD prescriptions:
Curiously, this insurance company WILL COVER both NAME BRAND Concerta and Metadate CD and not the generic versions. You do not need to ask Dr. McCarthy for a new prescription for these "name brand" alternatives. Simply tell your pharmacist that you are delighted with switching to the name brand, and it will be covered (as per the website for this type of insurance).
If you have any concerns about your insurance company's decision not to cover your child's medication, I support your filing a complaint with the company, notifying your employer's HR department, and notifying advocacy organizations like CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder NAMI (National Alliance on Mental Illness) or your local congressman about the lack of parity between mental health needs as compared to other fields of medicine.
Email and Cell Phone/Texting Policy
For reasons of privacy/confidentiality, Dr. McCarthy does not conduct treatment through email or texting. Conducting treatment via email violates Dr. McCarthy's commitment to privacy and confidentiality, lacks the back and forth of natural conversation, and is fraught with the opportunity for misunderstanding. Dr. McCarthy's policy is to meet to discuss things or at least have a telephone conversation. Dr. McCarthy will use email only if she has specifically requested you send her specific information by email and she is expecting it. All email messages sent to Dr. McCarthy at her request should be accompanied with voicemail messages asking her to look for the email message.
Dr. McCarthy does not communicate by text. Texting is intrusive during sessions with other patients, is not guaranteed privacy/confidentiality, and is NOT a means of contacting Dr. McCarthy.
Fees and Payment
Please contact the office for a schedule of current fees. Your payment is due in full at the time of service. Payment may be made by cash or check.
Dr. McCarthy does not participate with insurance plans and is an "out-of-network" provider. She is not a Tricare provider. At the time of service, you will receive a receipt that you can submit to your insurance company. Please contact your insurance company to understand your reimbursement for an out-of-network provider. You are responsible for requesting reimbursement from your provider.
There will be a monthly billing charge of $25 for patients who have forgotten to pay their bills. If three months pass without payment of the bill, Dr. McCarthy will provide you with a list of other providers, and send your bill to the collector's agency. Dr. McCarthy will not schedule follow-up appointments or provide refills for patients with outstanding bills.
If you are experiencing a true life-threatening emergency, please call 911 or go to the nearest emergency room prior to contacting Dr. McCarthy. For extremely urgent matters only, you can contact Dr. McCarthy through her pager (703-313-2314) - after the tone prompt, enter your phone number followed by the # sign - you will then hear confirmation tones and can hang up. Also leave a message on her voicemail at 703-288-3535.