concierge telepsychiatry practice

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I've decided to start looking into a completely online practice in psychiatry in Arizona, where I would have full scope of practice. I initially thought I would get credentialed, however, in order to be reimbursed by medicare, the "originating" location (where the patient is located) has to 1. be an underserved area (not hard to find) and 2. a location such as a hospital or clinic (seems really hard to me).

Has anyone "set up" telepsych agreements with private practices? I feel very overwhelmed thinking about this process.

I thought about a strictly cash payment model to take that daunting requirement (and paperwork) out of the mix. However: how do I get information such as vital signs in a telepsych practice? I don't think legally, I can rely on patients to take an accurate measurement and if I'm going to be prescribing meds for adhd I definitely want to keep tabs on bp as an example. Also, how the heck do I send people out of ecg's and lab work?

Is anyone out there that has figured out a streamlined business model that answers these questions?

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Specializes in Outpatient Psychiatry.

Just call around and find a clinic willing to do ECGs based on your order. You may even find a mobile ECG that can do a house call - I don't know. Labs can be done at places like Quest Diagnostics which is where I send people. There are also indendent imaging services where you can get a MRI or CT although I just order it at the local hospitals.

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Thanks, what do you do about blood pressure? I was thinking I would have to send the patient to their PCP to have certain meds "okayed" prior to starting...

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Specializes in Hospice.

We have pts call us all the time and say my psychiatrist wants a vitamin d and Cbc ..... Or clonidine levels ..... We just order and have to the results faxed

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Specializes in Outpatient Psychiatry.
Thanks, what do you do about blood pressure? I was thinking I would have to send the patient to their PCP to have certain meds "okayed" prior to starting...

we don't assess it by any physical means

ask about palpitations, increased HR, dizziness, etc.

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