Mind Health Psychiatry & Associates

Texas Telemedicine Legal Guidelines

Texas Senate Bill 1107 defines  a "Telehealth Service" as a health service, other than a telemedicine medical service, delivered by a health professional licensed, certified, or otherwise entitled to practice in the state and acting within the scope of the health professional ’s license, certification, or entitlement to a patient at a different physical location than the health professional using telecommunications or information technology. 

Before Senate Bill 1107 was enacted, physicians had to establish in-person contact with the patients prior to offering them telemedicine services. The bill removed this requirement by explicitly stating that rules enforced by the Texas Medical Board (TMB) must enable “the establishment of a practitioner-patient relationship by a telemedicine medical service.” .

This no longer limits healthcare professionals to offer telemedicine and telehealth services only to their existing patients. Patients can now reach out to healthcare providers and request remote appointments and other services without having to establish an in-person connection first. Texas law recognizes the establishment of the practitioner-patient relationship when a patient enters a virtual appointment with a healthcare professional. This is a significant improvement to the prior in-person meeting requirement. 

Texas law further doesn’t limit the provision of telemedicine and telehealth services exclusively to patients located within the state’s borders. The healthcare professional merely need to obtain an out-of-state license, certification or otherwise entitlement to practice in the state in which they are rendering remote services.

Emergency Procedures Specific to TeleMental Health Services

There are additional procedures that we need to have in place specific to TeleMental Health services. These are for your safety in case of an emergency and are as follows:

• You understand that if you are having suicidal or homicidal thoughts, experiencing psychotic symptoms, or  in a crisis that we cannot solve remotely, we may determine that you need a higher level of care and TeleMental Health services are not appropriate.
• We require an Emergency Contact Person (ECP) who we may contact on your behalf in a life-threatening emergency only. Please provide this person's name and contact information at the time of your appointment. Either you or we will verify that your ECP  is willing and able to go to your location in the event of an emergency.
• Additionally, if either you, your ECP, or we determine necessary, the ECP agrees to take you to a hospital.  Your signature on the policies/procedures indicates that you understand we will only contact this individual in the extreme circumstances stated above.
• You agree to inform your clinician of the address where you are at the beginning of every TeleMental Health session.
• You agree to inform your clinician of the nearest mental health hospital to your primary location that you prefer to go to in the event of a mental health emergency.

In Case of Technology Failure

During a TeleMental Health session, you and your clinician could encounter a technological failure. The most reliable backup plan is to contact one another via telephone. Please make sure you have a phone with you, and your clinician has that phone number.

If you and your clinician get disconnected from a video conferencing or chat session, end and restart the session. If you are unable to reconnect within ten minutes, please call your clinician.

If you and your clinician are on a phone session and you get disconnected, please call your clinician back or contact her or him to schedule another session.

If the issue is due to your clinician's phone service, and the two of you are not able to reconnect, she/he will not charge you for that session.

Structure and Cost of Sessions

We offer in-person appointments. However, based on your ability to make in-person sessions, your clinician may provide phone, email, chat, or video conferencing if your treatment needs determine that TeleMental Health services are appropriate for you. If appropriate, you may engage in either face-to-face sessions, TeleMental Health, or both. You and your clinician will discuss what is best for you.

The structure and cost of TeleMental Health sessions are exactly the same as face-to-face sessions described in our general informed consent forms. 

Messages and emails are billed at your clinician's hourly rate for the time he or she spends reading and responding.

We require that you maintain a credit card on  file and authorizations to charge credit card on file  for ease of collection of copays/co-insurance and billing.  You  will be charged at the time of service. This includes any therapeutic interaction other than setting up appointments. Visa, MasterCard,  Discover, or American Express are accepted for payment (3% fee applies), and we will provide you with a receipt of payment and the services that we provided upon request. 

Frequently Asked Questions? 

What is Telemental Health?

Telemental Health is similar to "telemedicine" but you are consulting with a  licensed, certified  mental health professional.  Most mild to moderate psychiatric conditions can be effectively managed through tele-psychiatric consultations. This is offered to you in the comfort of your home, office or wherever life takes you through our safe, secure portal. 

Do you offer In-Person Visits?

Yes, Limited In-Person Appointments are Available in the state of  Texas.

Is telepsychiatry an effective alternative to an in-person session?

Numerous studies conducted over the years have demonstrated that telepsychiatry is equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction. A peer-reviewed study we co-authored in the APA’s Journal of Rural Mental Health also showed patients with hybrid telepsychiatry plus in-person visits were seen 7 days faster and were 34% more likely to be seen 1x/month.

What mental healthcare services are offered to patients through telepsychiatry?

Essentially all services that an on-site psychiatrist would provide are offered through telepsychiatry. This includes administering comprehensive intake assessments, psychiatric evaluations, and medication management.

Are patients comfortable with receiving mental health care virtually?

Yes. Telepsychiatry allows patients to gain access to vital mental health care much faster than in-person care in many situations. Sessions are scheduled within days, eliminating the need to identify a psychiatrist nearby– who may be located hours away, as is the case in many areas – then wait several months for an initial appointment. In addition, many individuals appreciate the privacy and flexibility virtual care affords. 

Where do patients receive services?

Through a HIPAA-compliant video software for intake and follow-up appointments. Limited In-Person Appointments are Available in the State of  Texas.

What Ages Do You Treat?

We treat children, adolescents and adults-ages 12+

Do you treat Anxiety? 

Yes. However,  treatment plans with long term  benzodiazepines/controlled substances are prohibited in this practice. 

Do you prescribe medications for ADD/ADHD?

Yes. We utilize other FDA approved medications with indications for ADD/ADHD. We do require psychometric and urine drug testing prior to treatment. 

Which EMR and video conferencing software is used?

Psychiatric providers working with Mind Health Psychiatry & Associates have the option of using their existing and video conferencing software or using our ICANOTEs, DoxyMe or Grow Therapy platforms. These platforms are secure and HIPAA-compliant video and EMR platforms with a robust set of features including tools for patient scheduling, documentation, e-prescribing, and workflow automation.. 

What Forms of Technology-Assisted Media are Utilized?

Email: We utilize a secure email platform that is hosted by Google Suites for Healthcare with Paubox encryption services. We have chosen this technology because it is encrypted to the federal standard, HIPAA compatible, and has signed a HIPAA Business Associate Agreement (BAA). The BAA means that the companies are willing to attest to HIPAA compliance and assume responsibility for keeping your PHI secure.

          If we choose to utilize emailing as part of the services you receive from us (to provide/receive clinical information and to receive psychological evaluation reports), we encourage you to also utilize encrypted email for protection on your end otherwise, when you reply to one of your clinician's emails, everything you write in addition to what he/she has written to you (unless you remove it) will no longer be secure. Our encrypted email service only works to send information and does not govern what happens on your end.

         We also strongly suggest that you only communicate through a device that you know is safe and technologically secure (e.g., has a firewall, anti-virus software installed, is password-protected, not accessing the internet through a public wireless network, etc.). If you are in a crisis, please do not communicate this to us via email because we may not see it in a timely matter. Instead, please see below under "Emergency Procedures."

         Email is billed at your clinician's hourly rate for the time she or he spends reading and responding to them. Finally, you also need to know that we are required to keep a copy or summary of all email as part of your clinical record that address anything related to therapy.

Social Media - Facebook, Twitter, LinkedIn, Instagram: It is our policy not to accept "friend" or "connection" requests from any current or former client on any of our clinician's personal social networking sites such as Facebook, Twitter, Instagram, Pinterest, etc. because it may compromise your confidentiality and blur the boundaries of your relationship. 

Electronic Record Storage: Your communications with us will become part of a clinical record of treatment, and it is referred to as Protected Health Information (PHI). Your communications with us will become part of a clinical record of treatment, and it is referred to as Protected Health Information (PHI). 

Electronic Transfer of PHI for Billing Purposes: If your clinician is credentialed with and a provider for your insurance carrier, please know that we utilize a billing service, who has access to your PHI. Your PHI will be securely transferred electronically to your insurance carrier. This billing company has signed a HIPAA Business Associate Agreement (BAA). The BAA ensures that they will maintain the confidentiality of your PHI in a HIPAA compatible secure format using point-to-point with federally approved encryption. Additionally, if your insurance provider is billed, you will generally receive correspondence from your insurance company, our billing company, or both.

Electronic Transfer of PHI for Certain Credit Card Transactions: We utilize ICANotes as the company that processes your credit card information. Additionally, please be aware that the transaction will also appear on your credit card bill or statement.