How can I determine if I need to begin services?

Whether you are new to psychiatric care or considering resuming medication, the decision to begin mental health services is a personal one. Scheduling an appointment does not necessarily mean you will start medication right away. During your appointment, you and your provider will assess your current mental health and medical history to develop an individualized treatment plan tailored to your needs. We are committed to providing you with comprehensive information about any recommended medications, including when to expect effects, how they work, and potential side effects. This allows you to make an informed decision about the best approach to support your well-being.

How can I book an appointment?

Click "Book Here" at the top of this page and follow the booking link for the billing company that corresponds with your insurance—Alma, Grow Therapy, or Headway. There, you can enter your insurance details, select a convenient time, and choose between an in-person or telehealth appointment. (In-person appointments are available only on Sundays.) You will also be prompted to provide additional personal information. Once completed, your appointment will be confirmed, and you will receive a confirmation email.

Shortly after booking, you will receive an email from Optimantra, where you will complete your medical history, fill out required questionnaires, and access your telehealth appointments if you have chosen virtual care. Completion of your intake forms and questionnaires is required prior to your first appointment.

The pharmacy informed me that my medication is too expensive. What are my next steps?

First, please verify with the pharmacy that your insurance information is accurate and that they are in-network with your insurance Next, ask the pharmacy staff if a prior authorization is required or if the medication is considered 'non-formulary.' Any issues related to these matters will be addressed by our office staff.

Alternatively, you can visit www.GoodRX.com, a free website that offers medication coupons and helps you compare prices across pharmacies. To use a GoodRX coupon, you will need to provide the pharmacy with the BIN, PCN, Group, and Member ID, which can be found below the listed price. The pharmacy will then process your prescription at the discounted rate.

What determines if a medication is considered non-formulary, and what is a prior authorization?

Each insurance provider maintains a formulary list, which includes their preferred medications. Unfortunately, these lists are frequently updated without prior notice and can vary significantly between insurance companies. As a result, it is not always possible for us to determine in advance whether a specific medication will be immediately covered by your insurance. While medications on the formulary list are easier to have covered, it is still possible for non-formulary medications to be approved. In such cases, we will initiate a prior authorization, which is a form submitted to your insurance provider to determine if you meet their criteria for approval of the medication.

At Transformation Psychiatry and Wellness, we believe that your medication should be tailored to meet your individual needs, rather than being limited to the options selected by your insurance provider.

What is the process when my medication requires a prior authorization?

Occasionally, your pharmacy may send a fax to our office notifying us that a prior authorization is required, but this is not always guaranteed. For the quickest processing, we recommend contacting us directly to inform us of the specific medication requiring authorization. Additionally, it would be helpful if you could send us a photo of the front and back of your insurance card to ensure we submit the correct form for your plan and an updated list of all prior mental health medications you have taken.

Once we submit the prior authorization request to your insurance company, it typically takes 24-72 hours to receive a response. Upon approval, we will contact your pharmacy to confirm they can process your medication and provide an estimated pickup time. Finally, we will update you with the details.

What should I do if I experience an adverse side effect?

While new medications often produce only the intended effects, they may also cause temporary side effects, such as changes in sleep patterns or mild nausea, as your body adjusts. These side effects typically resolve within a few weeks. However, if symptoms persist beyond two weeks, we recommend scheduling an earlier appointment with your provider to discuss your concerns and reassess whether this medication is the right choice for you.

In the event of a medical emergency, such as shortness of breath or chest pain, please seek immediate care at the nearest emergency room. Afterward, we encourage you to schedule an appointment with your provider to address concerns and create a new treatment plan.