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No. We are happy to get you started with a therapist prior to seeing a doctor/nurse practitioner. If you are already working with a psychiatrist or nurse practitioner outside of our facility, counseling at BMC-Troy is still an option. However, we would ask that you sign a release so that open communication can take place between your providers. This is for proper coordination of care. If you are not working with a psychiatrist/nurse practitioner elsewhere, and the therapist feels an evaluation from one of them is necessary, we would schedule you with a doctor/nurse practitioner at our office. This is always preferred, as we share your chart and communication is far easier.
Depending on the ages the doctor/nurse practitioner treats, you can start with one doctor/nurse practitioner, and see any of the other doctors/nurse practitioners as a ‘back up’, should the need arise, or should one of their schedules offer you appointment times/days that meet your personal schedule better on that particular day. Our doctors/nurse practitioners work in similar fashions, and are able to access the others notes, should the need arise for cross coverage, in order to assist you. There may be times when, with your insurance, you are only allowed to see a certain doctor/nurse practitioner. This varies by insurance, as some of our doctors/nurse practitioners participate in panels that the others do not. You may also find that your prescriptions are filled by a different doctor/nurse practitioner than you usually work with. Our doctors/nurse practitioners will, at times, help one another by sharing the responsibility of prescription refills for all patients at BMC-Troy.
Our nurse practitioners have had training in nursing, and additional training specifically in psychiatric care. Their title is PMHNP which stands for Psychiatric Mental Health Nurse Practitioner. They are able to do psychotherapy/counseling, as well as manage medications, with the supervision of one of our doctors. They can work with you independently and will ask the doctors any questions they have regarding your care. It is a team approach when you see a nurse practitioner, between you, one of our doctors and the nurse practitioner. At times, use of a nurse practitioner’s schedule can offer you more day and time options to come in for your visit.
All children under the age of 18 will need a parent or guardian present for visits with our doctors/nurse practitioners . However, this is not a requirement for individual and group therapy sessions unless instructed otherwise.
You should expect a big welcome and a warm atmosphere! During your first visit you will provide both background information and your current reason for seeking assistance. Once a member of our team has met with you a few times, they can better assist you to understand if your treatment requirements include therapy alone or medications and therapy. At the first visit with a doctor or nurse practitioner, you will be given a packet of rating scales that you will need to complete between the first and the second visit. Usually the follow up visit with our doctors/nurse practitioners is within 7-10 days of your initial visit. We ask that you work with our front staff to transfer the documents back to us electronically, through our secure email format, prior to your next appointment.
Typically, counseling is recommended. Our doctors/nurse practitioners will generally recommend a therapist at BMC-Troy that will suit your specific needs, as the doctors do not do the counseling themselves, and the nurse practitioner may be in the role of managing your medications only and not doing therapy for you. There are times when the nurse practitioner manages your medications and functions as your therapist as well. We understand that some of you may come in already working with an outside therapist, and we will try to accommodate your continuing with them, as long as our doctors/nurse practitioners feel comfortable with this. One of the benefits of seeing a therapist at BMC-Troy is that your doctor/nurse practitioner and your counselor can have a quicker, more efficient means of communicating about progression towards goals and treatment plans/recommendations. If you do continue to see a therapist elsewhere, we will need to have a release signed before our doctors/nurse practitioners can have any contact with them.
An initial intake with our doctors/nurse practitioners will be 40 minutes and follow up visits will be 20 minutes. Between all of our doctors, we treat all ages. If a patient is under the age of 18, a parent must be present for all visits with a physician or nurse practitioner. If a child or adolescent is receiving therapy, much of the time will be spent with them alone with their counselor. There may also be some time spent with the parents present. Therapy sessions are approximately 25 minutes for a half session and approximately 45- 50 minutes for a full session, though we recommend full sessions for most patients. Most group sessions will run 90 minutes unless noted otherwise.
Our doctors and nurse practitioners have a variety of days and times available for your appointments. Some evening and weekend hours may be available as well.
Our therapists provide a variety of appointment times. You will be given a general sense of your therapist’s availability upon scheduling. Most of our therapists have evening hours and some of them have weekend hours as well.
Our doctors/nurse practitioners will meet with you (and your parent if under the age of 18) to discuss how you are doing on a medication, and if the dosage of medication is the correct one for you. At times, they ask for input from others – like spouses or significant others in the case of adults, and teachers in the case of a child or adolescent. At times, feedback through rating scales are obtained, with your permission.
Please refer to our financial policy/payment responsibility link for more details. We are expected to collect your copay and deductibles at the time of service. Exceptions cannot be made. We do NOT pro-rate this fee.
If your prescription is a non-controlled medication, we require a 48-hour notice by phone to complete your request (248.528.9000 x 3). Please tell us the medication you are in need of and your pharmacy information. If you are on a medication that is federally controlled, there are a few options for how to have your medication sent, depending on which type it is.
If your medication is/must be sent in an encrypted, tamper resistant fashion, you will incur a $20.00 annual processing fee (beginning in January of each calendar year – it is NOT prorated).
At BMC-Troy, we understand that situations come up that require you to cancel or change your appointments, however, we do require 24-hour notice for all cancellations. Without 24-hour notice, you will be subject to a late cancellation fee of $90.00. We also charge this fee for “no show” appointments. Additionally, if you are more than 20 minutes late for your psychotherapy visit, you will need to understand and sign our late show policy. Please ask for details.
Our system sends out reminder texts/emails. Please note that a reminder of your appointment day/time is a courtesy, and may not occur for every clinician or every appointment. You are responsible to keep track of your own appointment.
You can call our after-hours number 248-764-8440 and leave a message for one of the doctors/nurse practitioners, or any of our therapists. Please note that this should be used for urgent purposes only. Anything else should be dealt with the following business day. If you are in a situation that is a life-threatening emergency, proceed to the nearest local emergency room.
BMC-Troy offers Genotyping. This is a genetic test that helps physicians and nurse practitioners understand more about what medications best suit your individual genetic profile. It is a simple cheek swab test. It takes less than 5 minutes to do and is not painful. It is typically not paid for by insurance companies. This test should cost no more than $330.00 plus our $25.00 service charge. We do not bill you for anything other than the $25.00 service charge. The Genotyping company bills you for the rest. We encourage you to call the company prior to having genotyping done if you have any billing questions. Not all patients need to undergo Genotyping. Your doctor or nurse practitioner can help you understand more about if it could be helpful in your situation.
The Qb machine is a FDA cleared device that looks at executive functioning. This means how a person does with things like focus, concentration, distractibility, fidgetiness, and restlessness. We perform the Qb test in persons wondering if they have AD/HD, or, in persons who are treated, in order to test how well their medication is working for them. This task takes approximately 30 minutes. When appropriate, we will do the Qb test as a baseline, and repeat it for comparison after treatment. Many insurances cover a part of the cost, and some cover it entirely. However, if it is not covered, it is a $250.00 charge, due on the day of the test.