SUMMARY: Welcome to information on our membership model for psychiatric care! We are excited by this progressive model that will offer flexible communication and appointment options for prescription management. Membership tiers range based on clinical need, and create predictability in monthly psychiatry costs. The model emphasizes accessibility, and ease of use.
Q: Why is Dr. Byrne switching to a membership model of care?
A: She has noticed over time that the traditional model of care no longer meets the needs of her patients. Many patients would prefer to be able to text her between appointments and have the flexibility to do phone or voice message check-ins rather than always scheduling fixed video appointment times. As a physician, she has also noticed the traditional model of care does not allow her to practice to the best of her abilities, as she wants to be able to provide the right care at the right place at the right time and have the flexibility to fit urgent issues into her schedule.
Q: What are the main differences between traditional care with another Lepage psychiatrist or psychiatric nurse practitioner and Dr. Byrne’s membership model of care?
A: A new patient begins by completing history questions in her portal, and those answers are sent to her to review before the initial online appointment with Dr. Byrne. In this ‘asynchronous’ model, you then can communicate with Dr. Byrne anytime day or night on a secure encrypted platform, that only you and she can access. You log in anytime to communicate – at times that work for you. (‘Synchronous’ refers to appointments or communication with both people present at the same time; ‘asynchronous’ refers to communication back and forth between two people such as via voice or text.)
| traditional care | membership model of care | |
| initial appointment | fixed 60 minute time block | flexible first appointment time 15-90 minutes depending on need |
| monitoring and follow-ups | fixed 25 minute time block | flexible options to monitor and follow-up including text, phone, video, or voice message, easy to reschedule, easy to communicate urgently |
| prescriptions | done during the scheduled appointment; outside of scheduled appointment there is an additional fee | done when patient needs them, no extra fees |
| payment | each appointment has a fixed price and patient given a superbill, extra services are billed extra, can be difficult to predict total cost | monthly membership rate making it easier to predict total costs; no superbills available |
| AI and automations | none currently | secure voice recognition AI allows Dr. Byrne to get a rich data set from your messages, in the future if desired to include data from monitoring devices like an Oura ring (sleep, stress levels, activity levels, etc.) |
Q: What does this membership cost and what does it include?
A: There are currently 3 tiers of membership. New patients should expect to be on the MANAGE tier for the first 2 months with Dr. Byrne, and patients may need less or more time at this tier before stepping down to the PREVENT tier. Patients who are not currently seeing a psychotherapist and would like Dr. Byrne to also do psychotherapy should expect to be in the COACH tier. (Patients may move up and down between tiers if their needs change.)
MANAGE $349/month
- Initial online appointment with Dr. Byrne (i.e., ‘video synchronous’ appointment)
- Asynchronous check-ins every 1-4 weeks
- As-needed synchronous video or phone check-ins
- Option for quarterly synchronous video check-ins
- Prescriptions sent to your pharmacy of choice
- Great fit for patients who:
- are new to psychiatric medication
- would like to switch medications
- would like to be assessed for adult ADHD
- are dealing with life stressors
- looking for a second opinion
PREVENT $199/month
- Quarterly asynchronous check-ins
- As-needed synchronous video or phone check-ins
- Monthly emails with clinical updates and education
- Prescriptions sent to your pharmacy of choice
- Eliminate or reduce medications as needed
- Great fit for patients with:
- stable depression
- stable anxiety
- stable bipolar disorder
- stable ADHD
- other stable diagnoses
COACHING $1,950/month
- Unlimited asynchronous check-ins
- Synchronous video or phone check-ins two times per month
- As-needed synchronous video or phone check-ins
- Prescriptions sent to your pharmacy of choice
- Great fit for patients who:
- are going through a life or career transition
- would benefit from a combination of coaching and brief psychotherapy
- need help with burnout or moral injury
- have more serious conditions
Q: How will I be billed for the membership?
A: For new clients, after completing the initial paperwork online, Dr. Byrne will confirm you are a good fit for the practice within one business day. You will be scheduled for a first appointment and invoiced at a prorated amount for that month plus $349 for the next full month to get started, then you will be auto-billed monthly between the 25th and the 31st for your membership tier level for the upcoming month. If you have difficulty making payment, please let us know ASAP so we can discuss options for your care. If payments are missed with no prior notice, we will assume you are no longer interested in Dr. Byrne’s membership model and we will reach out to you to determine how you would like to transition care.
Q: How will I get prescriptions with the membership model?
A: Dr. Byrne has the flexibility to send prescriptions when you need them. Once your medications are stable, she will send 90 day supplies of medication to your pharmacy of choice. There are no extra fees for prescriptions. If you are in a PREVENT tier and need a higher level of care due to a crisis or a change in condition, Dr. Byrne will talk with you and switch your tier. There is no extra charge for prescriptions.
Q: What happens if I don’t like it after I have started? Can I quit the membership anytime? Can I receive a refund?
A: You can quit the membership anytime. If you have been working with Dr. Byrne for more than the initial evaluation session, it is considered a “doctor-patient relationship” and she will need to help you transition care to a new provider. This process typically takes at least 30 days, so you would be expected to make payment for the month in which you are transitioning care. In other words, if you tell Dr. Byrne you would like to quit the membership on January 15th, you are still responsible to make payment on February 1st as she is in a doctor-patient relationship with you and responsible to help you transition care. This will enable Dr. Byrne to give you the prescriptions you need and coordinate care with your new provider. We do not provide refunds for any reason, however as noted, you can cancel membership with 30 days’ notice at any time.
Q: Does Dr. Byrne use AI in her membership model? If so, what is it used for?
A: Yes. She will prompt you to do a voice “check-in.” That recording will be securely ported into her practice platform where it will be transcribed and AI will “assist” by looking at things like the emotional quality of your speech, etc. Then she will review both your transcript and the AI “assist” data and reach out to you. Next steps could include a video appointment, phone appt., an assessment, or a prescription, etc. That is all included in the cost of the membership.
Q: Why will Dr. Byrne ask me to do voice message check-ins rather than email or text or video?
A: Dr. Byrne will be using an AI-infused secure platform to monitor your progress and your patient story in real time. Using voice message check-ins provides important information about your mood and stress levels that might be undetectable to a human listener. It can sometimes even alert to a change in your physical health that you may be unaware of! Dr. Byrne will review your message and she will also review the insights that AI has pulled from your voice data, then she will text or call or schedule a video appointment with you based on what you need.
Q: What is the security level of Dr. Byrne’s texting and video service?
A: Dr. Byrne uses a HIPAA-compliant app called SPRUCE if you prefer a higher level of security. To use this app, you would need to install it on your smartphone and keep the alerts on so that you can communicate with Dr. Byrne directly. If you are comfortable with a lower level of security, you can select regular SMS text messaging and ZOOM video communication with Dr. Byrne (these are not HIPAA-compliant). One advantage of using ZOOM is that Dr. Byrne’s AI notetaker can join the call. At the end of the call, Dr. Byrne can then forward you a complete AI transcript of the session as well as a summary with action items and highlights. This can allow patients to fully focus on the video call rather than having to try to take notes and listen at the same time.
Q: Why is Dr. Byrne’s ADHD assessment priced differently and what is part of that assessment?
A: Typically, ADHD evaluations are done by Lepage psychologists and include the breadth to rule out a variety of other learning issues in addition to testing for ADHD; this level of testing is required by educational institutions if you will be applying for accommodations for school or college. The cost is $3,000. However, if you need an assessment for ADHD that does not involve learning issues, and you will NOT need accommodations from school or college, Dr. Byrne’s ADHD assessment can be a great fit. Her assessment includes up to 3 computer tests of attention, psychoeducation around ADHD, and if desired, can bring in a family member or friend to help clarify the diagnosis and treatment plan. The cost is a flat fee of $1,950.
Q: Can Dr. Byrne prescribe controlled substances like ADHD medications via this membership model?
A: The federal and state laws around controlled substances (ex: Ritalin, Adderall, Xanax, Klonopin, Ambien) are in a state of flux. At the moment, Dr. Byrne is able to prescribe controlled substances via telehealth in a number of states including North Carolina.
Q: How do I know if I am a good fit for this membership model?
A: You are a good fit for this model if:
- you like the idea of some non-scheduled communications and the flexibility that gives you to communicate with Dr. Byrne as needed, even without an appointment scheduled
- you like the idea of having Dr. Byrne “on call” for you when you need her, but would be just as happy to skip unnecessary appointments
- you want to have a fixed monthly budget for your standard psychiatry needs
Q: How do I know if I am not a good fit for this membership model?
A: You are not a good fit for this model if:
- you need superbills to submit to your insurance company (a membership model to health care has no associated CPT codes as it is a flat fee for all time with the patient and/or doing collateral services in a month, thus there is no superbill)
- you like the idea of always having fixed appointment times
- you don’t like to text or leave voice messages
- you prefer traditional healthcare services
We hope this has answered all of your questions!
Please email [email protected] or call 919-572-0000 (option 1) to let us know if you would like to move onto this membership model with Dr. Byrne. Please note that Dr. Byrne will not be continuing with the traditional model at all for any patients. If this membership model is not a good fit for you, you can use our traditional model of psychiatric care with our nurse practitioner, Kelly Mahoney, who will be remaining on the traditional model.
Please don’t hesitate to call us with any questions you may have! (919-572-0000)