How does it work?

Once you sign a contract, our partners Nate Perry and Dr. Caroline Fisher come into your office and set up the work flows and processes within your medical record. Once the groundwork is laid, they meet with your providers to be sure everyone understands and feels comfortable with the work flow and the service line. Nate then acts as your first psychiatric assistant to ensure things flow smoothly. When the service line is purring like a kitten, we replace Nate with a psychiatric assistant specially trained for your practice.

Our psychiatric assistant is on site in your clinic and available for crises and warm handoffs. Your providers decide which patients are referred. When a patient is referred to the service, the psychiatric assistant does a structured, thorough interview. Our consulting psychiatrist writes up the probable diagnoses and recommendations for your providers on how to treat the patient. Then, the psychiatric assistant regularly calls the patient to perform structured outcome measures to ensure the patient is getting better. If not, the consulting psychiatrist sends more recommendations. Dr. Fisher makes a point of checking in with the providers regularly and is available for texts and phone calls whenever you need her. We truly become part of your team.

What is the basis for the collaborative care program?

The Collaborative care program was based on the IMPACT model developed at the University of Washington, and expanded to utilize bachelors level humanities employees. This program utilizes billing and coding as part of the expanding collaborative care health models. You can learn more about Collaborative Health care with the reading recommendations located here on Amazon.

Does collaborative care really work?

Absolutely! We started our collaborative care model with one doctor and one bachelors level liaison in a pediatric office. Within 4 years, we had expanded to serving 3 counties in 22 primary care offices with 9 doctors and 16 Bachelors level care managers. Specialty office wait times within the department dropped from 18 months for med management, to 3-4 months. More people were being served and treated in their communities, by their PCP’s, thousands of patients received expedient care, and our primary care offices saw increase in their billing.

Does collaborative care pay?

Billing is where guidance from Germane & Wise becomes a linchpin service for primary care integration. The billing schedule for COCM codes can be complex. Germane & Wise has years of experience implementing these codes and getting on a workable fee schedule across numerous EMR’s to get your clinic paid for its primary care integration work. We are constantly watching this evolving process and our team of experts can help you achieve positive returns on your investment. We can show you how to work with your Coordinated Care Organizations, and maximize billing for your urban and rural health communities. For more information on Medicare billing, please visit https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/Behavioral-Health-Integration-FAQs.pdf

Why integrate mental health care instead of just referring to a specialist?

Referring to a specialist is a viable option, especially when dealing with severe persistent mental illness. However, mental health integration into your primary care settings can expedite the improvement you and your patients are looking for, along a wide range of mental health conditions. A 2018 study by the University of Washington shows an improvement or remission in condition up to 6 weeks sooner with front loaded care management than without (http://aims.uw.edu/cmt/apa/patientengagement/story_html5.html?ProductID=6287)

What is a psychiatric assistant?

A psychiatric assistant is a specially trained medical assistant that can act as a care manager within your practice. One or two certified psychiatric assistants acting as care mangers in a few primary or specialty care clinics can really expand the reach of your established psychiatric/psychological work force. Germane & Wise has spent years writing curriculum that trains these care providers up to tackle complex mental health issues under the supervision of a mental/behavioral health practitioner. We emphasize motivational interviewing, suicide intervention and impart the basic knowledge they need to identify potential issues with treatment (non-adherence, possible drug side effects, etc.) The psychiatric assistant can help your patients find outpatient therapy options in their area, check insurance, and most importantly, thrive within their new treatment plan.

Is our practice too small for you to work with?

Probably not! We work with practices with just a few providers as well as large ones.

What’s it going to cost?

Stark Law requires that services like ours are cost neutral. Unlike an in-house system, we take on the training and personnel costs. You will need to find room for us in your practice, and you will need to work with us to ensure the patient experience is truly integrated, which may mean a little training for your staff.

Can you do collaborative care for kids? How about geriatric patients?

Yes to both. We treat patients of all ages. Dr. Fisher is board certified in child psychiatry and adult psychiatry, and has treated pediatric patients, geriatric patients, and those in between.