Question 1

How do I get started as a patient?

Accepted Answer

First off, congratulations on taking the first step toward improving your or your child's mental health!  Dr. Butterfield is excited to accompany you on this journey.  In order to be seen by Dr. Butterfield, start by looking over the website to be sure you feel Atala Health will be a good fit.  Please call (727) 295-3370 and leave a message; Dr. Butterfield will return your call within 2 business days.  She will provide a free 10-15 minute consultation regarding your concerns. At that time, if you both agree that this is the right practice for you and/or your child, you will schedule an appointment.  Intake paperwork will be e-mailed to you at that time to be filled out prior to your appointment with Dr. Butterfield.

Question 2

What is the difference between a psychologist and a psychiatrist?

Accepted Answer

This is a great question because these two degrees are so commonly confused.  Both clinical psychologists (PhD) and psychiatrists (MD) specialize in the treatment of mental disorders and have the title of Doctor after completing their degrees.  Both specialties require extensive training after graduating college.  Psychologists attend graduate school (and often a post-doctorate program) to obtain their doctorate degree.  Psychiatrists attend medical school to obtain their medical doctor degree followed by 4 years of residency (for general psychiatry) or 5 years residency (for general psychiatry with a child and adolescent specialty).  Because they attended medical school, psychiatrists are trained to prescribe medications (as well as provide therapy) and treat the medical illness associated with mental illness.  Dr. Butterfield is a child and adolescent trained psychiatrist.

Question 3

Dr. Butterfield is a child and adolescent psychiatrist, so does she see adults?"

Accepted Answer

Yes, indeed!  In psychiatry residency, child and adolescent psychiatrists spend the first 3 years treating adult patients before specializing in children.  Dr. Butterfield focuses on people between the ages of 3 and 60.  In fact, she feels that her training in child psychiatry actually improved her work with adults because she better understands the impact of child development and attachment on the struggles that we feel in adulthood.  She feels she has a more comprehensive understanding of a person as a whole by evaluating their life since birth.

Question 4

Why doesn't Dr. Butterfield take insurance?

Accepted Answer

Having taken insurance at her last practice, Dr. Butterfield learned that she spent more time talking on the phone with insurance companies trying to get her patients the care that they needed, than actually talking to her patients.  As the insurance companies continue to limit the coverage for mental health and increase the amount of documentation required, it makes it more difficult for doctors to make the medical decisions that they feel is in the best interest of the patient.  Dr. Butterfield wants to be able to provide the best care for all of her patients based on her medical knowledge. 
 
Insurance companies do not adequately allow for the extensive amount of time, detail, and flexibility it often takes to complete a comprehensive psychiatry assessment and treatment. Dr. Butterfield has established this practice to provide more detailed care, better accessibility, and longer visits than are generally available in insurance models. This model is about offering more than the “15-minute medication check” allowed by many insurance companies.
 
Patients also have the option to keep their mental health diagnosis private if they don't submit it to their insurance company.  If you do want to submit your visits as an out-of-nework claim to your insurance, Dr. Butterfield can provide the needed documentation in the form of a "superbill."

Question 5

Why would I want to pay privately for treatment?

Accepted Answer

By choosing to pay privately for psychiatry services, one may find more flexibility, detail/time, convenience, and privacy.
 
Flexibility: Often in our medical system, we work on diagnoses, and insurance requires a certain level of pathology to qualify for reimbursement.  Many patients instead want to work on exploring health, building skills, or having a safe place to process difficult educational, work or family changes. If one would like the focus of visits to be about personal goals and not ones that are dictated by insurance requirements, private pay may be a great option.
 
Detail/Time: Good work takes time.  Dr. Butterfield regularly spends 60-90 minutes with patients at a first visit and 2 or more hours preparing for that visit and time coordinating care with providers and family after the visit.  This is a total paradigm shift over the “15-minute med check” authorized by many insurances. 
 
Convenience: Many insurance companies require that you select a provider that has been approved by them, known as “in-network.” With private pay, the patient regains control of seeking his or her preferred service provider that is compatible to his or her needs, specialty training, and comfort level.
 
Privacy: Last, by choosing to pay privately for services, the patient is electing to seek more confidentiality as private health information is not required to be shared with insurance if not paying for services through them. Some people also choose private pay when they are worried about having a pre-existing condition on their health record.

Question 6

Can I submit a bill to my insurance on my own?

Accepted Answer

For those with private insurance, a superbill (itemized health care receipt) may be requested for the patient or family to submit.  Many PPO plans may reimburse for labs, a portion of office visits, and medications.  We cannot make any guarantees of insurance reimbursement, and some insurances may require additional documentation, contracting, or business information we are unable to provide.  Administrative fees for doing insurance paperwork and responding to insurance inquiries sometimes exceed the reimbursement patients receive from their insurance.  If insurance reimbursement is a priority, we recommend pursuing an in-network practice instead of working with this office.

Question 7

What CPT codes are used?

Accepted Answer

New patient visit codes are 90792
Follow-up 30 minute medication only visits are often 99214 or 99213+ 90833. 
Weekly 60 minute therapy visits are 99213 + 90838 or 90836
ICD-10 and DSM-5 diagnoses are used when possible but may not cover all symptoms or services discussed.

Question 8

I just want medications; why does Dr. Butterfield require therapy?

Accepted Answer

Dr. Butterfield is dedicated to providing the most comprehensive care to her patients.  For most disorders, if medication is indicated, therapy is also recommeded for the most complete treatment.  With diagnoses of anxiety and depression, it is important to work on the root cause of the symptoms through therapy in order to fully treat the problem.  ADHD can sometimes be treated without therapy, but often it is accompanied by other symptoms or behavioral concerns that do require therapy for complete treatment.  Medications are wonderful and often needed, but without working on the deeper issues, it is like putting a bandaid on a broken bone.  It may cover up the injury on the skin level, but if you don't actually repair the bone, the the injury will not fully recover.

Question 9

Is Cricket the Therapy Dog boarded in psychiatry too?

Accepted Answer

Not exactly... but she has her own snuggle therapy techniques that are very effective!