***Now scheduling appointments for Maryland and North Carolina residents ages 16 and up via telehealth only. Please call (704) 559-1860 to schedule your appointment.
Due to the complexities of billing, I am unable to accept most insurances at this time (with the exception of North Carolina United Healthcare, North Carolina Oscar Health, and North Carolina Oxford through a service called Headway- you can learn more about this service at their website). I am happy to provide a "superbill" or invoice for those insurance companies that I am not "in-network" with. This can be submitted to your insurance company if they provide any out-of-network benefits. See below for fees and other policies.
Psychiatric care refers to therapy and/or medication management for people with mental health disorders. I treat patients with mood disorders, including depression and bipolar disorder, anxiety disorders, PTSD and trauma-related disorders, ADHD, OCD, chronic pain, eating disorders, personality disorders, developmental disorders, schizophrenia, addiction, mental health disorders in pregnancy and post-partum, and more. I treat patients ages 16 and up.
I am trained in a variety of therapeutic approaches, including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Acceptance and Commitment Therapy, Exposure and Response Prevention, Mindfulness, Interpersonal Therapy, and more.
Some patients may also need medication
management. I am comfortable prescribing a wide range of medications as appropriate, including SSRIs, SNRIs, tricyclic antidepressants, mood stabilizers, antipsychotics (including clozapine). I prescribe benzodiazepines, opiate pain medications, and stimulant medications when appropriate, but please see below for controlled substance laws and policies.
What to Expect at the First Visit: Prior to our first visit, I will send new patient forms via email (using IntakeQ, a HIPAA-compliant electronic form service). You can upload any records you have to Doxy.me at the time of the appointment or you may send them ahead of time by replying encrypted to my email address. The initial visit or second opinion consultation typically lasts between 60-90 minutes. We will discuss your history and go over the information you submitted in the new patient packet. Towards the end of the appointment, I will discuss her initial thoughts about your diagnosis and treatment options. Treatment options may include therapy and/or medications, and I will work with you to figure out which options work best for you. I will also discuss scheduling (including frequency and duration) of future appointments with you. If I feel you would be best served by another provider, I will refer you to another provider for future appointments. Payment will be collected at the end of each appointment unless you elect to leave a credit card on file, in which case your credit card will be automatically billed within three business days of the appointment. Note that payment for initial consultation/second opinion is required whether or not you continue treatment with me. Before or after our appointment, I may also contact a family member or friend who knows you well (with your consent) to get their thoughts on how you are doing and how I can be most helpful.
Privacy: Patient privacy and confidentiality is a top priority. You will establish a preferred method of communication and emergency contact during your initial appointment and this may be updated at your request at any time during your care. I will obtain your consent for non-urgent communication with outside parties. Physicians may consult with other treating providers to provide safe and effective health care. Physicians are required to check local databases when prescribing controlled substances and I check these databases for each patient I treat. In an emergency situation, providers have the obligation to act in the patients best interest consistent with state and federal laws. Please see Notice of Privacy Policies for more information. You will be asked to sign a form indicating that you have received and read this Notice of Privacy Policies before we begin treatment.
Non-Discrimination Policy: Equal care will be provided to all patients, regardless of age, race, ethnicity, physical ability or attributes, religion, sexual orientation, gender identity, or gender expression.
Payment: A credit card is kept on file for all patients. Cards are charged automatically on the day of the appointment (unless you are using Headway to go through your insurance company, in which case Headway will provide information on when payment is due and will bill your insurance company directly). Payments are taken electronically through a secure online credit card processor. However, please know that I cannot control where and when payment receipts are sent. I require an active credit card to be kept on file for each patient. Patients who miss two or more appointments may be required to pre-pay at the time of scheduling an appointment.
Insurance: I do not accept insurance or bill insurance companies directly with the exception of North Carolina United Healthcare, North Carolina Oscar Health, and North Carolina Oxford through a service called Headway (you can learn more about this service at their website). I can provide a bill for services that you may submit to their insurance company for payment at the time of an appointment. Please note that insurance companies may not reimburse for telemedicine or telephone sessions, or for missed appointment charges. I accept no responsibility for non-payment for services by the insurance company.
Medicare: I have opted out of Medicare. If you have Medicare and would like to see me, you are required to sign a written agreement that states that you will not submit claims to Medicare for reimbursement.
Scheduling: You will schedule your appointments at the end of each session or as needed.
Reschedule or cancellation: Please allow 48 business hours for cancellation. If you do not provide 48 business hours notice, you will be billed the full payment amount for the time that was reserved for you. You may cancel appointments by calling the office line and leaving a message indicating the cancellation.
Missed appointment or "no-show": Patients who do not show for appointments are charged the full rate of the session to their on-file payment method. In some circumstances, telephone or telemedicine appointment can be provided during the reserved appointment time if there are problems with transportation. Patients who arrive late can be seen for the duration of their appointment session at my discretion; rates remain the same. Patients who miss more than three or more appointments may not be able to be safely treated within this practice, and those patients may be required to search for care elsewhere.
Communication with providers: Appointments and payment should be done at the time of each visit. For communication outside of appointment times, please call the office and leave a message for the provider. Please allow up to 72 business hours for a response. I am frequently able to respond within 24-48 business hours. While I occasionally use email for specific communications, my email inbox is not routinely monitored for new patient messages and if you need an immediate response, please call my office.
Medication refill requests: Refill requests should be made during an appointment time. If you find you need a refill of medication before the next appointment, please call and leave a message for me with your date of birth and pharmacy information. In some circumstances, medication requests can be fulfilled outside of business hours, at the providers discretion; usually I will schedule an appointment for the patient to be seen. I do not prescribe medications for patients who have not been seen within three months. I do not respond to or honor pharmacy requests for refills - medication will only be prescribed via communication with patient and provider. Any controlled substance prescription requests must be done in person.
Controlled substances: I prescribe benzodiazepines, opiate pain medications, and stimulant medications when appropriate, but I do not typically prescribe these as first-line treatments. Please note that I do not provide early refills on these substances under any circumstances. As with all medications, I reserve the right to limit starting or escalating the dose of any medication if I feel the risks of doing so outweigh the benefits. As noted above, providers are required to check local databases when prescribing. If you are being prescribed a controlled substance from another provider, please make me aware of this when we begin treatment or whenever you are prescribed the controlled substance. These medications can be dangerous in combination, and it is important that all members of your treatment team are aware of what you are taking. Not disclosing other controlled substance prescriptions could be grounds for terminating treatment.
In the past, controlled substances could only be prescribed during in-person visits. During the COVID-19 pandemic, the requirement for in-person visits has been lifted, allowing for the prescription of controlled substances via telemedicine services. However, we do not know if/when this requirement will be put back into place. If the requirement for in-person visits is reinstated in the future, I will no longer be able to prescribe these medications without at least one in-person visit. If they are needed, I can refer you to a primary care provider and/or psychiatrist in your area who would be able to prescribe these medications, and you can decide whether or not you wish to continue seeing me. So to summarize: controlled substance prescribing via telemedicine is okay for now, but it may become complicated again. We can talk about it more if you have questions!
Telehealth: I see patients only via telemedicine at this time. I find that patients typically have a very positive experience via telemedicine and it does not hinder my ability to diagnose or treat you. You can access all sessions by going to https://doxy.me/drmelissashepard. From there, you can sign into my personal waiting room and I will connect with you at the start of your appointment. Most insurance companies are reimbursing telemedicine sessions at the same rates as in-person sessions; however, please call your individual insurance company to be certain of its latest reimbursement policies. Also, please ask which modifier your insurance company requires for proper reimbursement of teletherapy/telemedicine services and let me know so that I can use the proper codes on my invoices.
Telephone appointments: Telephone appointments are available in some instances and will be billed at the same rates as in-person sessions. Please note that many insurance companies do not reimburse for telephone appointments.
FEES & PAYMENT
Unfortunately, due to the complexity of billing requirements and low reimbursement rates for mental health services, I am not able to accept insurance at this time. I have opted-out of Medicare and those with Medicare will need to sign an agreement stating that they will not submit claims for reimbursement to Medicare.
As noted above, payment in the form of credit card is due at the time of service and will be collected at the end of each appointment. Payments are taken electronically through the telehealth program I use, Doxy.me, which allows for HIPAA-compliant payment processes. A credit card is also kept on file. I can provide an invoice which you are free to submit to your insurance company for potential reimbursement as an "out-of-network" provider. Please contact your insurance company to determine whether you are eligible for reimbursement and what your reimbursement rates could be.
Rates are similar to other area psychiatrists, and noted below (however these may be
subject to change)
Initial Evaluation or Second Opinion/Consultation: $600.00
55-Minute Session: $300.00
25-Minute Session or medication management only: $200.00