Frequently Asked Questions
Insurance Friendly
Sliding Fee Scale is available for uninsured or underinsured patients.
We Accept Most Major Insurance Plans
Segal Telepsychiatry does not take any HMO plans.
Telepsychiatry
Most common questions about telepsychiatry
Telepsychiatry, or telemedicine, is a specifically defined form of video conferencing that can provide psychiatric services to patients living in remote locations or otherwise undeserved areas. It can connect patients, psychiatrists, physicians, and other healthcare professionals through the use of television cameras and microphones. Telemedicine currently provides an array of services, including but not limited to diagnosis and assessment; medication management; and individual and group therapy. It also provides an opportunity for consultative services between psychiatrists, primary care physicians and other healthcare providers. Telepsychiatry is also being used to provide patients with second opinions in areas where only one psychiatrist is available.
What is telepsychiatry?
Telepsychiatry is the practice of psychiatry conducted via a video conference connection. A live, secure video connection is established between an offsite location (a clinic, doctor’s office or home office) and a mental health facility. A typical psychiatric office visit is conducted except that the physician and the patient are not in the same physical location.
Is there a startup cost?
There is no start up cost associated with using the telepsychiatry platform unless you need to purchase a webcam and microphone. On average both can be purchased for less than a total of $200.
What equipment is required?
All that is needed for connection to our network is a Windows (XP SP2 or newer) or Mac (Intel based) system with Internet access, a webcam and a microphone. We recommend a Logitech HD Pro Webcam C920 for the video and a Phoenix Duet USB Speakerphone for the audio. We can test any webcam and/or microphone you may have to see if they would be appropriate for our solution.
Is there a fee to use the platform?
There is no fee to use our platform.
Is it secure and HIPPA compliant?
Yes, all communications are sent using 256-bit AES encryption. We take appropriate measures to comply with the all HIPAA privacy and security rules.
How can telepsychiatry benefit hospitals and mental health clinics?
Facilities in remote rural locations that have a difficult time recruiting can benefit from telepsychiatry. Telepsychiatry providers can be physically located anywhere in the United States, but as long as they have the appropriate licenses, they can see your patients. Another use for telepsychiatry is to fill a part-time position. If your facility has enough volume only for a half-time provider, you might have an easier time finding a telepsychiatry provider to fill that need than recruiting a psychiatrist to work on-site part-time. Telepsychiatry can be your back-up for vacations, leaves or after hours on-call coverage.
Do you offer support?
Yes, we offer 24-hour support, seven days a week. In addition, our trained IT professionals can assist with any technical difficulties you may encounter.
Is my existing camera and microphone compatible with your telepsychiatry platform?
Almost any third-party webcam or video conferencing equipment will work. In addition, we can test any webcam and/or microphone you may have to see if they would be appropriate for our solution.
Do you support other video conferencing equipment?
We are compatible with traditional boardroom-style video conferencing equipment like Polycom and/or Cisco (Tandberg) hardware codecs. There is no need to substitute your existing telemedicine equipment. Our heterogeneous solution is capable of connecting with almost any platform available.
TMS
Transcranial Magnetic Stimulation TMS
There is new hope for people who suffer with depression—Transcranial Magnetic Stimulation (TMS). It is especially helpful with treatment-resistant depression, for those who do not respond to antidepressants, as well as people who wish to avoid the side effects frequently caused by medication. TMS treatment usually includes four to six weeks of non-invasive, in-office treatments that take less than an hour each day, five days each week.
What is TMS?
TMS is a treatment that safely delivers magnetic pulses to areas of the brain that are responsible for mood. Instead of using invasive electrical currents like in electroconvulsive therapy (ECT), the magnetic pulses from TMS are similar in strength to those emitted during a typical MRI. The pulses are directed toward the prefrontal cortex of the brain to change the magnetic field and stimulate neurons within the mood center. This not only mitigates depression for a short time but can also result in long lasting relief.
What is TBS?
Theta Burst Stimulation (TBS) is a newer form of TMS. Here, the magnetic pulses are applied in a certain pattern, called bursts. Research studies with TBS have been shown to produce similar if not greater effects on brain activity compared to standard repetitive transcranial magnetic stimulation ( rTMS).
What is qEEG?
Quantitative Electroencephalography (qEEG) is a procedure that processes the recorded EEG activity from a multi-electrode recording using a computer. This multi-channel EEG data is processed with various algorithms, such as the “Fourier” classically, or in more modern applications “Wavelet” analysis). The digital data is statistically analyzed, sometimes comparing values with “normative” database reference values. The processed EEG is commonly converted into color maps of brain functioning called “Brain maps”.
The EEG and the derived qEEG information can be interpreted and used by experts as a clinical tool to evaluate brain function, and to track the changes in brain function due to various interventions such as TMS/TBS, Neurofeedback or medication.
Quantitative Electroencephalography (qEEG) processing techniques and the use of modern analytic software to processes the EEG/qEEG gives us the ability to view the dynamic changes taking place throughout the brain during cognitive processing tasks, and this novel approach can be used to assist us in determining which areas of the brain are engaged and processing efficiently.
Benefits of TMS
- Non-invasive—no anesthesia, electrodes or electrical current used
- Simple, in-office—administered by a technician and the patient can drive home afterward
- For treatment-resistant depression—those not helped by antidepressants can benefit
- No side effects—no reported nausea, weight gain, dry mouth or decreased sex drive
- Long-lasting—after initial 4-6 weeks, maintenance may or may not be needed later
How does TMS work?
TMS treatment is performed in a doctor’s office, while the patient is fully awake and seated in a comfortable chair. Because the magnetic pulses make a sound similar to that of a woodpecker, earplugs are provided. The TMS device is then placed in the proper position on the head and the magnetic pulses are delivered. The process usually takes between 4 and 20+ minutes.
Is it relatively simple?
- Patient takes a seat
- Device is placed on the head
- Pulses are delivered for a short time
- Patient returns to daily activities
Conditions treated by TMS?
In the United States, the FDA approved TMS in 2008 as a treatment to alleviate the symptoms of treatment-resistant depression. It has also been approved for depression in Canada, Australia, New Zealand, Europe, and Israel. In addition, it has been CE approved in Europe for the treatment of bipolar disorder, PTSD, chronic pain, OCD, and adult AD/HD.
Advantages over other treatments?
In the past, the most common treatments for depression have been medication and/or psychotherapy. With TMS, psychotherapy is still encouraged because it can help people maintain mental health. However, unlike antidepressants, TMS has few if any side effects.
Reported side effects of antidepressants include:
- Nausea
- Weight gain
- Fatigue or drowsiness
- Insomnia
- Dry mouth
- Decreased sexual desire or function
- Anxiety
- Irritability
- Dizziness
Side effects of TMS
Some patients report slight headaches or some discomfort at the treatment site just during the actual treatment. About a third of patients notice a prickly, tingly sensation on their scalp while the stimulating pulses are being administered. One in 10,000 patients experience a mild seizure; however, it should be noted that this risk is approximately the same as that cause by some antidepressants. In addition, the seizures related to TMS typically end when the magnetic stimulation is stopped.
Exceptions to TMS treatment
People who have metal implanted in or near their head should not have TMS. Exceptions include those with dental fillings, crowns and/or braces. Metals that prevent TMS treatment include:
- Pacemakers or implanted defibrillators
- Any stents from the neck up
- Aneurysm clips
- Metallic implants in ears or eyes
- Ammo fragments near the head
- Facial tattoos with metallic ink
- Any metal near the head that cannot be removed
TMS and insurance
As TMS is being used by more physicians and patients with notable positive results, more and more insurance companies now cover or partially cover the treatment. Major insurance companies in the United States that now cover TMS include Anthem Blue Cross Blue Shield and MHN (HealthNet). Several other state and national companies provide reimbursement when TMS is deemed appropriate. Your local TMS treatment provider can help you determine eligibility and many will submit the paperwork for you.
What is telepsychiatry?
Telepsychiatry is psychiatric care delivered through secure video appointments. It allows you to meet with a psychiatrist remotely to discuss symptoms, receive a psychiatric evaluation, and develop a treatment plan without needing to travel to an office.
What conditions can telepsychiatry help with?
Telepsychiatry can support people experiencing anxiety, depression, ADHD, mood struggles, difficulty concentrating, emotional overwhelm, or other mental health symptoms that interfere with daily life.
What happens during a telepsychiatry appointment?
Appointments begin with a comprehensive psychiatric evaluation. Your psychiatrist will ask about your symptoms, mental health history, lifestyle, and goals in order to understand what you are experiencing and develop a personalized treatment plan.
Is telepsychiatry secure?
Telepsychiatry sessions are conducted through secure, HIPAA compliant video platforms designed to protect patient privacy.
How many sessions will I need?
The number of sessions varies depending on individual needs, symptom severity, and treatment goals. Some patients benefit from ongoing long-term support, while others improve with shorter-term stabilization.
Is online psychiatry as effective as in-person treatment?
Yes, research shows telepsychiatry can be just as effective as in-person care for many mental health conditions, especially for medication management and ongoing psychiatric follow-ups.
Sources
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American Psychiatric Association
Telepsychiatry Toolkit
https://www.psychiatry.org/psychiatrists/practice/telepsychiatry - World Health Organization
Mental Health Services and Digital Care
https://www.who.int/health-topics/mental-health
655 Redwood Hwy, Suite 240, Mill Valley, CA
(866) 247-4292
info@segaltelenet.com
