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

Yes to both. We treat patients of all ages. Our clinicians are board certified in child psychiatry and adult psychiatry, and have treated pediatric patients, geriatric patients, and those in between.

How does psychiatric collaborative care work?

Once you sign a contract, our partners come to your office and set up the work flows and processes within your medical record system. Once the groundwork is laid, they meet with your providers to be sure everyone understands and feels comfortable with the work flow and service line.

One of our practitioners will serve as your first psychiatric assistant to ensure things flow smoothly from the beginning. When the service line is purring like a kitten, we replace our practitioner with a psychiatric assistant specially trained for your practice.

That 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 then writes up 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. We make a point of checking in with your providers regularly and are available for texts and phone calls whenever necessary. 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.

As the patient’s primary care provider, won’t I be liable for your work?  

Consulting with a specialist who knows more than you do about a particular pathology will always reduce your liability. When two independent providers have been consulted, the care offered starts to look like the community standard of care, which helps you reduce your liability. Therefore, by referring your patients with mental health challenges to us, you are improving your liability outlook.  

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

Yes to both. We treat patients of all ages. Our clinicians are board certified in child psychiatry and adult psychiatry, and have treated pediatric patients, geriatric patients, and those in between.

My clinic just signed a contract with Germane & Wise. Which of my patients should I send to you?

Please send us any patient with mild to moderate mental health concerns, or people who score between 10 and 20 on the PHQ9 or 7 and 21 on the GAD-7. These patients, across the board, experience better outcomes when treated through our collaborative health care model. 

Patients we have treated successfully include those suffering from: 

• Depression 

• Anxiety 

• Obsessive Compulsive Disorder (OCD) 

• Mania 

• PTSD (Post Traumatic Street Disorder) 

  
  
  
  
  

My clinic just signed a contract with Germane & Wise. Why should I send patients presenting mental health issues to you?

You should send mental health patients to us because we offer: 

• Case management that involves consistent follow ups, leading to better care 

• Much faster remission times  

• An opportunity for you to expand your capacity to treat patients with mental health concerns 

• Workflows for suicidality that reduce the on-call burden on the PCP team 

• Control over patient care. You are still calling the shots when it comes to your patients’ care while enjoying increased confidence that your mental health patients are getting appropriate treatment 

• Better control over your schedule. We recognize that patients presenting mental health concerns can require more time and attention from you, sometimes on a crisis basis, diminishing your ability to serve your full patient panel. Germane & Wise steps in to manage these patients’ ongoing care, allowing you to better manage your day-to-day patient visits.

Will you help me treat patients scoring higher than 20 on the PHQ9 or the GAD-7? 

We are calibrated to serve patients who present moderate scores on standardized measures. We’ll take all referrals you offer, but for the most severely impaired patients, the treatment approach is to co-manage their care with you until they can be placed with a community mental health provider.

Will Germane & Wise provide ADHD evaluations for my patient?

We do not provide ADHD testing or screening. We can assess patients and determine whether it is likely that they have ADHD, but we don’t offer objective psychological testing for this condition.

Is there a minimum or maximum size of clinic or health system for which you will consult?

No, our model is scalable. We can serve any size clinic or system.