Digging Out of the Pandemic Chaos:
BIG PRACTICE CHANGE
Beginning in the summer of 2022, Dr. McCarthy’s practice will be transitioning to an online portal. This portal will enable you to securely upload confidential reports and complete any outcome measure instruments sent to you. All billing and payments will also be managed through the new online portal. As part of the streamlined billing procedures, your credit card will be charged on the date of service. Your portal will receive confirmation of your secure credit card payment transaction, along with the paid receipt indicating treatment and diagnosis codes which you can submit to your insurance company for reimbursement.
Big Change Preview Highlights:
To help with this transition I have hired a new Clinical Director, Dr. Tiffany Elias. Dr. Elias will help all patients get set up with the new portal and ensure your understanding of our new billing procedures. After the successful transition to the online portal, Dr. Elias will take over management of my appointment schedule and other administrative needs.
Setting up Your Portal
Our goal is to have all current patients with a portal account by mid-June 2022. Creation of a portal requires your input for demographic details, credit card information, and uploading of a signed Patient Policy agreement. Please click the portal request button below to submit your current email so that Dr. Elias can reach out to you to set up your portal
Those patients who have not requested a portal will be contacted via phone by Dr. Elias, who will ask for your email address so she can send you a portal invitation.
Initial Psychiatric Evaluation
The Initial Psychiatric Evaluation usually involves a one-hour Consultation. The nature of this first meeting varies on the individualized needs of the patient. For younger children, Dr. McCarthy meets with parents alone for the initial visit; for adolescents, Dr. McCarthy meets first with your teen. If the concerns are more complicated, the initial meeting evaluation may be extended to 90 minutes. McCarthy will need between 2 to 3 appointments to complete a full evaluation, and discuss her initial impressions, diagnosis, and set you on your path to a solid treatment plan.
During the psychiatric consultation evaluation, Dr. McCarthy will assess whether your needs are a good fit for her practice and areas of expertise. If your treatment needs demand a higher level of care or a likelihood of frequent emergency services beyond what Dr. McCarthy can provide in her solo practice schedule, Dr. McCarthy will coordinate treatment recommendations and referrals so that you can receive the most optimal services with provider availability that is necessary to support your needs.
There are generally three types of follow-up appointments:
20 to 25-minute medication management sessions
20- to 25-minute Medication Management sessions
For medication management adjustments, follow-up check-ins, and refills. Time spent with Dr. McCarthy depends on the time needed to be reserved before the end of each 30-minute slot for Dr. McCarthy to finalize electronic refill/postdated prescriptions or for her to make phone calls to collaborate with any other treatment team therapists after you walk out of her door.
Weekly/every other week individual psychotherapy sessions for patients that have a regular after-school scheduled therapy slot (after 3:30 pm) with Dr. McCarthy, or 45-min sessions for more complex medication management follow-up visits, parent visits, or psychoeducational sessions.
Dr. McCarthy can pack a lot into every single appointment, and even more into a solid “Power Hour.” Dr. McCarthy will schedule solid hours for parents to re-group and re-organize a treatment plan, provide more psychoeducation to make you an expert regarding your child’s needs, and for more intensive weekly psychotherapy for teenagers motivated for fast-paced intensive psychotherapy.
Scheduling Follow-Up Appointments
At the end of every appointment, Dr. McCarthy will schedule a follow-up appointment depending on the current treatment plan. Every patient should walk out of her office with the next appointment date entered on their calendar.
After June 2022, all patients must be seen at a minimum of every three months for any prescription refills and to remain in Dr. McCarthy’s practice. As Dr. McCarthy's calendar fills up far ahead of time, it is important to always have a follow-up scheduled. Please bring your child’s school calendar to every visit. These spots fill up many months ahead of time.
After the transition to the portal, the clinical director Dr. Tiffany Elias will manage Dr. McCarthy’s calendar and appointment scheduling by phone. This website and menu icons will evolve to outline the new scheduling procedures later in the summer.
Medication Management Follow-Up Appointment Schedule
At the beginning of medication treatment, most patients will be seen more frequently to ensure the most optimal and top-notch individualized care. For patients with a stable and solid maintenance treatment response, Dr. McCarthy will schedule follow-up medicine check-in appointments every three months.
Federal DEA prescribing law requires that patients who are taking many types of psychiatric medication must be seen for an appointment assessment at a minimum of every three months. This is also the Academy of Child and Adolescent Psychiatry's minimum standard of care. If you have not had an appointment within three months, Dr. McCarthy will not be able to fill your prescription.
After School Weekly or Biweekly Psychotherapy Appointments
Therapy sessions with Dr. McCarthy are standing weekly or twice monthly appointments, with a reserved regular occurring time slot on a specified day of the week. After-school and evening appointments beginning at 3:30 PM are thus reserved for patients that work with Dr. McCarthy in these therapy sessions weekly or every other week so that the kids with such weekly appointments do not have to miss any school.
Note: Solo Practice Schedule not set up for Crisis Management
With her return of pre-pandemic M-F solo practice office hours setup, and along with her future book publication demands and presentation venues that will take Dr. McCarthy away from her office, Dr. McCarthy cannot provide crisis, weekend, or emergency services outside of the M-F scheduled office hours. See the “Urgent and Emergency Issues” section below for details.
Rescheduling after the BIG CHANGE
In the summer of 2022, the system for rescheduling will change with the transition to the portal, and this website will provide the new policy instructions to submit rescheduling requests by contacting the Clinical Director.
Rescheduling for now:
Of course, plans change, and Dr. McCarthy will always adapt and do her best to reschedule for changes that you cannot predict and are out of your control. For now, call the office at 703-288-3535 and either Dr. McCarthy or her Clinical Director will call you with the next patient opening or put you on a waitlist for a cancellation. If you don’t hear back right away, it is because Dr. McCarthy’s schedule is fully booked for several months ahead (i.e., waitlist). If your plans change, please contact the office as soon as possible in order to reschedule the visit.
Please keep in mind that an in-person appointment can be transitioned to a telemedicine or telephone visit if that helps prevent the need to reschedule.
Best Alternative to Rescheduling: Telemedicine PIVOT POWER option
Instead of rescheduling, you change your appointment with Dr. McCarthy to a telemedicine visit—even at the very last minute!
Most reasons for cancellations, even at the very last minute, allow for pivoting the scheduled appointment time to be used flexibly: you can switch the appointment mode to phone, telemedicine link, or visit with a parent only (e.g., If a child has unforeseen sports practice or tests at school). Parent-only visits are ALWAYS productive.
If you are not in her waiting room at the scheduled appointment time, she will call you at the scheduled appointment time in order to best use the appointment time reserved especially for you.
Although Dr. McCarthy firmly limits taking on new patients, she remains highly overbooked. If you cancel your appointment there may be slim pickings or no availability and you may have to wait a while on her waitlist for whatever becomes available. Remembering that Dr. McCarthy cannot fill prescriptions for patients who have not had appointments within three months, it is definitely wiser to keep the scheduled appointment and take advantage of the appointment PIVOT option. Your appointment time is reserved for you, and Dr. McCarthy will happily adapt to fit your needs, whether in person or by phone, parent only, or telemedicine.
If Dr. McCarthy must cancel your appointment because of unforeseen circumstances in her own schedule, she will move mountains to fit you in pronto, and this will NOT affect your treatment plan or refills whatsoever.
See “Cancellation Policy” for more details
Billing and Fee Schedule
With the oversight of the Clinical Director, fees for all services will be charged at the time of service to your credit card on file.
There will be a $25 charge for each prescription that is not arranged for during a scheduled office visit. Sending prescription refills is not a “call-in” like in the old days and must be done electronically from the office itself with multiple rotating secure passwords, taking up to 10 min to complete the process per prescription. Changing pharmacies also requires this additional processing time. This will be charged to your credit card on file at the time Dr. McCarthy completes your prescription refill pharmacy submission. If you come to your scheduled appointment this policy should never need to be implemented, Dr. McCarthy gives plenty of medication to last until the next follow-up visit for her regularly scheduled patients who have been seen within the 3-month required window. By following the policy, you should never run out!
Dr. McCarthy will charge for services that require more than 10 min of her time outside of appointments. Examples of additional charged service time include telephone collaboration with other providers, the preparation of written reports, letters, completion of forms, completion of letters for 504 Plans/IEPs, NCAA medication exemption forms and appeals, completion of college accommodations paperwork, Written reports to agencies, professionals, schools, and insurance companies will be billed at the same hourly rate as appointment sessions. Review of documents, such as test reports or hospital records, will also be billed at this rate. Phone calls and these additional services are not covered under insurance plans.
Repeated extensive time spent >15 min for Dr. McCarthy calling your insurance company or time writing up appeals for medication Prior Authorizations will be billed at the standard session rate. Very rarely, insurance companies demand extended telephone calls with Dr. McCarthy, called “peer to peer” appointments. This demand requires Dr. McCarthy to schedule an appointment time with the insurance company doctor who makes decisions about your care so that she can explain her reasoning for wanting to start a specific medication. This will be billed at the regular hourly rate and is thankfully a rare insurance demand.
As part of medication management, there must be a strong working relationship and communication with any other treatment providers, therapists, teachers, and pediatricians. Most phone calls with other providers allow for excellent collaboration between appointments. These calls are brief and will not be billed as an additional service. Only calls that are ten or more minutes will be billed. Telephone calls 25 minutes or longer will be billed at the same rate as psychotherapy and medication management.
Collaboration with other treating professionals is integral and essential to ensure excellent care and outcomes. Dr. McCarthy will usually not treat patients who work with therapists with whom she does not have a collaborative relationship. If you independently decide to transfer your child’s care to another therapist with whom she does not have a strong working relationship, Dr. McCarthy may refer you out to ensure you have a collaborative treatment team, and recommend you work with a psychiatrist connected with your new therapist.
Payment Policies: NEW – Online Billing via Portal
BIG CHANGE: Credit cards will be charged at Time of Service
Starting summer 2022, Dr. McCarthy will transition to the Luminello electronic portal system, which will allow for immediate, automatic billing and payment through your pre-registered and securely stored credit card on the day of service.
For your convenience, we will keep your current credit card on file for all patients. This information is entered by you and managed securely in the Portal. It is completely private and secure, and we will not handle or have access to your credit card information. Through the support of the Clinical Director, all services will be billed to your stored credit card on the day of service. Your portal will receive confirmation of your secure credit card payment transaction. Through your portal you will also be able to view a detailed billing history, indicating treatment and diagnosis codes, which you can submit to your insurance company for reimbursement. Note: your billing history from dates prior to conversion to the portal will be available with requests sent to firstname.lastname@example.org.
Payment in the Now
Until you have fully transitioned to the new portal system. . .
Payment is due in full at the time of service by cash or check. Payment for all past appointments is required before being seen for the next appointment. All outstanding pandemic balances must be paid by August 1, 2022, for patients to remain active in Dr. McCarthy’s practice. After August 1, 2022, all unpaid balances will be sent for collection to a hired collection administrator. Dr. McCarthy will not provide refills or services for patients with unpaid balances >3 months old.
If you need a copy of your current invoice or need to know what you owe for previous visits with Dr. McCarthy, please email email@example.com
Dr. McCarthy is considered an “out-of-network provider” and does not participate in insurance plans. You will need to file your own claims with your health insurance carrier. Dr. McCarthy has worked very hard to ensure that she codes for the most optimal coverage from most insurance companies. Coverage for mental health varies widely between insurance policies, so please consult with your insurance company in advance to understand your coverage if you plan to file claims.
For returned checks, a $30.00 fee will be charged for each returned check. If you forget to pay your bill the day of the appointment, after one month you will be billed a $30 monthly processing fee for the overdue bill. After three months of overdue bills and billing fees, Dr. McCarthy will not provide refills, and her assistant will refer you to collections and out of her practice.
Cancellation Policy (two Business Days)
Please provide two business days' notice for cancellation to avoid being charged for the appointment.
No-Shows and appointments canceled with less than 48 hours notice (two business days) will be automatically charged to the credit card on file at the time of the missed scheduled appointment
Two business days (M-F) advance notice means, for example, that appointments on a Monday should be canceled by the previous Thursday). This 48 hours policy is a longstanding and common practice of other mental health professionals.
Your credit card will automatically be charged at your regular rate at the time of your canceled reserved session.
Cancellations often mean a waitlist and limited appointment options.
If you cancel, and no appointment is available soon enough, Dr. McCarthy or the Clinical Director will put you on the waitlist. Due to Dr. McCarthy’s very full practice, your rescheduled appointment may be further out, and past the 3 months prescription window, Rescheduling requires flexibility to take whatever time next becomes available during the school day.
REMEMBER, you are able to pivot your in-person visit to a visit through telemedicine, by phone, or a parent-only visit, even at the last minute, in order to avoid a last-minute cancellation!
If you are sick, sniffly, contagious, or with recent exposure:
Kindly switch to telemedicine to protect other patients and as a courtesy to Dr. McCarthy and her family. Dr. McCarthy will do the same for you.
Sometimes things just happen…
Remember, Dr. McCarthy remains a softy and is super nice
In truly unforeseen circumstances, most patients will be given a one-time courtesy for late cancellations like more serious illness and really big things in life that are simply beyond your control. As you can see, Dr. McCarthy is very human too.
With the flexible PIVOT appointment options and the importance of a commitment to regular visits for positive treatment outcomes, most patients don’t have to worry about being placed on the waitlist.
Contacting Dr. McCarthy
Call the Office Number 703-288-3535
If you need to reach Dr. McCarthy between appointments, please call the ACTUAL OFFICE number 703-288-3535 (a landline), listen to the instructions, and leave a voicemail message with your name, telephone number, and concerns.
Office voicemail messages will be heard Monday through Friday between 7:30 AM and 5:30 PM. Messages left after Friday at 5:30 pm will not be heard until the following Monday.
This landline office number is completely confidential and will ensure your private information is received and addressed by Dr. McCarthy or her Clinical Director.
In the rare event that the landline office number is compromised (like a storm outage), please call Dr. McCarthy’s emergency personal number 703-304-9689.
With the transition, Dr. McCarthy is rather excited that the policy for requesting refills is entirely different and entirely electronic. When in the rhythm of the post-pandemic office policy, with your visits scheduled as they deserve to be within the required 3 months window, you should not need to routinely request refills outside of your appointment times.
All refill requests require 48 hours' notice (two business days, M-F) when Dr. McCarthy is actually in the office. This means if you request a refill on a Friday, it will be processed and sent to your pharmacy by the following Tuesday.
If there are any problems with your refills, by all means, please leave a voicemail on the office number 703-288-3535 so that Dr. McCarthy can fix things for you.
Administrative, Billing, and Portal Questions
Dr. McCarthy’s new Clinical Director, Dr. Tiffany Elias, will assist you in setting up your portal for credit card billing, answer any portal questions, and provide you with a copy of any outstanding bills, so that you clear your overdue pandemic balance by June 1, 2022. After the portal transition, Dr. Elias will take on other administrative matters, and the management of Dr. McCarthy’s calendar.
Dr. Elias’ role is currently only for transition to the portal and finalizing collections for past balances. Do not email her any questions about care, treatment , scheduling or re-scheduling visits, medication, and it is certainly never appropriate to email her emergency information. For all these concerns or other questions, contact Dr. McCarthy.
All patients must submit the Portal Set-up request ASAP so that Dr. Elias can contact you through email or phone to set you up in the portal.
The administrative email is firstname.lastname@example.org. Dr. Elias generally will respond to administrative email or portal set-up questions within 48 hours on business days M-F.
Urgent and Emergency Issues
If you have an urgent matter: Always FIRST CALL and listen to the outgoing message directions on the office number 703-288-3535.
Dr. McCarthy will listen and respond to routine voicemail messages on her office number 703-288-3535 during business hours M-F between 7:30 am and 5:30 pm.
Except for the periods in which Dr. McCarthy is on vacation or out of town (be sure to read Out of Office coverage instructions below). Dr. McCarthy’s emergency phone line is 703-304-9689. This emergency phone line is for emergencies only, and to reach Dr. McCarthy for urgent matters that cannot wait to be heard during normal business hours. All other messages should be left on her regular office 703-288-353 voicemail.
Dr. McCarthy will respond to the emergency phone line messages as soon as possible. As a solo practitioner, Dr. McCarthy is seeing patients nonstop during the workday. She sometimes cannot interrupt a visit or leave a child alone in her office to respond to emergency calls that happen during another child’s session. Please keep your phone by you (and not on DND) to be at the ready for her return call. In the event of a true emergency or urgent issue which requires immediate assistance, or if you cannot wait for her return call, please contact the local emergency room crisis intervention services, or call 911.
Dr. McCarthy’s limited and fully booked solo practice does not provide crisis, same-day, weekend, or emergency visit services. Some patients develop psychiatric disorders that necessitate access to providers 24/7, need a more frequent urgent psychiatric care pattern due to the acuity of the situation, and cannot be adequately served in Dr. McCarthy’s limited solo M-F practice appointment set-up. If your child is showing signs of needing a higher level of care, Dr. McCarthy will work hard to gradually refer you to an excellent, broader, and bigger practice service provider with staffing resources beyond her solo setup. It is imperative you have the clinically appropriate practice with more urgent provider access services to address your child’s well-deserved and specific needs.
Out-of-Office or Vacation Contact Coverage
During the times when Dr. McCarthy is out of town or on leave, coverage instructions for patient services and contact information for emergency covering physicians and services will be left on the outgoing message of the office number 703-288-3535. With her commitment to supporting developing countries, Dr. McCarthy sometimes travels to places where there is no cell phone access, so always be sure to first call the actual office number 703-288-3535 (NOT the emergency cell phone number, since it may not even be with her) to hear the coverage contact instructions.
Emails or Texting
Texting—don’t do it
Dr. McCarthy does not provide treatment or advice via text messages to protect your privacy. If you text her on her emergency phone line, your text may be seen by other patients on telemedicine visits, by other kids in the session who may be using the office iPad for mindfulness apps and other cool therapy instruments, and most likely will be never seen by Dr. McCarthy.
Given the nature of the times, there may be infrequent exceptions. With limited patients who are respectful of the “no-texting” policy, and more often with young adults or college students, Dr. McCarthy may intermittently send super brief limited info like confirmation of appointments or a thumbs-up 👍 about wrinkles in refill authorization issues in the most discreet manner, to make treatment as streamlined as possible. These patients understand that they should not initiate texts to Dr. McCarthy for treatment or refill requests, and if they inadvertently text Dr. McCarthy out of pandemic habits and they get no response, it means she did not see it.
Bottom line: Dr. McCarthy wants to serve your every need!
If you text her and you do not get a response, don’t take it personally—it means she did not see it. You can together rejoice in the transition out of the pandemic chaos into a happier era! You simply need to follow the contact protocol and call the actual office number 703-288-3535 so that Dr. McCarthy is certain to get your important message and have the privilege of helping you with any concerns.
Child Custody Policy
NO CUSTODY OR COURT INVOLVEMENT
It is important that you understand the policies and procedures regarding the treatment of minors whose parents may be engaged in, or may in the future engage in, custody or other legal actions against a parent or other family member, so that you can make an informed decision about receiving or continuing to receive services from Dr. McCarthy. Dr. McCarthy’s role is to provide psychiatric services so that your child may feel better and/or improve functioning. Her role is not intended to gather information for the courts or to make judgments related to your family.
Therefore, if Dr. McCarthy takes you into her practice, you agree that you will not call upon Dr. McCarthy to ever provide treatment records or to testify in a future divorce or custody action. The courts can appoint, or private individuals may employ, professionals who have had no prior contact with your family to conduct independent evaluations and make recommendations to the court. Dr. McCarthy’s policy is to have no court involvement because that could confuse or harm her therapeutic relationship with your child and stand in the way of effective treatment. Both parents of the child must express understanding of and agree to engage with your child’s psychiatrist only under these conditions. By signing the office policy treatment agreement, you are agreeing for both parents to not ever involve Dr. McCarthy in any type of custody proceeding. Dr. McCarthy has no expertise in the area of forensic psychiatry but is delighted to facilitate referrals to leading experts in this important field.
Dr. McCarthy will release information only with your written permission unless otherwise required by law, including but not limited to:
Suspected abuse or neglect of a minor, elder, or dependent individual
A patient is in imminent danger of harming him or herself or another person
A patient communicates a serious threat of physical violence against another person
As discussed above, emails and text messages do not guarantee confidentiality and are not Hippa compliant. Uploading forms, mental health information, neuropsychological testing, and any other clinical information should be done through the secure portal that will be launched in the summer of 2022. Anything you upload to the portal will be in the permanent portal medical report record. This means that even for future disability insurance, accommodations in college, or transfer to adult psychiatry providers, all correspondence will be accessible to patients as they grow.