Frequently Asked Questions

 

 

Frequently Asked Questions About Depression, TMS, Ketamine, and Mental Health Treatments

BILLING & INSURANCE FAQS

 

What insurances cover TMS services?

 Currently, Colorado Recovery Solutions is an in-network provider with TriCare, Medicare, Aetna, TriWest (VA), United, Optum, Anthem/BCBS and Cigna. However, we are expecting to be in-network with several other insurance companies in the very near future.

 If we are out of network with your insurance, we can still submit a prior authorization on your behalf, if you meet treatment-resistant criteria for depression or OCD. If TMS is authorized by your insurance, we will negotiate a “single case agreement” with your insurance for you to be covered. You can call your insurance directly or we can help verify your benefits for TMS, if you send a picture of the front and back of your insurance card to team@coresolutions.health. NOTE: Medicaid does not cover TMS.

 What insurances cover Ketamine infusion?

 Government and commercial health insurances generally do not cover Ketamine Infusions. This service is currently private pay only.

 How much does each service cost if I am self-pay?Advance Care accepted for help with co-pay or deductible balancesCareCredit accepted for help with co-pay or deductible balances

 

 Call us at (719)622-6522 for private pay rates and fees. Care Credit and Advance Care assistance with financing for mental health treatments is also available.

 ***If you would like to bill your own insurance for services, we will provide you a “superbill” (i.e. a final statement).***

 

TMS FAQS

 Are there any lifestyle limitations for Transcranial Magnetic Stimulation (TMS)?

 Due to the serious risk of seizures when combining alcohol or illicit drugs with TMS, you must not use illicit or recreational drugs (including marijuana) and alcohol while being treated with TMS. Otherwise, TMS does not usually interfere with your normal daily life activities – including attending school, working, and driving. A mild headache or scalp soreness may occur in the first few sessions and then resolve soon after.

 What is the difference between a standard 20 minute TMS session and the 3 minute (Theta Burst) TMS session?

 Theta-burst may feel more intense due to a faster stimulation rhythm compared to the 20 minute Standard session. Otherwise, the efficacy of both treatment times is similar.

 What insurances cover TMS services?

 Currently, Colorado Recovery Solutions is an in-network provider with TriCare, Medicare, Aetna, TriWest (VA), United, Optum, Anthem/BCBS and Cigna. However, we are expecting to be in-network with several other insurance companies in the very near future (i.e. Kaiser, Beacon).

 If we are out of network with your insurance, we can still submit a prior authorization on your behalf, if you meet treatment-resistant criteria for depression or OCD. If TMS is authorized by your insurance, we will negotiate a “single case agreement” with your insurance for you to be covered. You can call your insurance directly or we can help verify your benefits for TMS, if you send a picture of the front and back of your insurance card to team@coresolutions.health. NOTE: Medicaid does not cover TMS.

 How long does it take to complete TMS to be effective for depression?

 Typically, 20 to 40 sessions are needed to achieve full remission of depression. At Colorado Recovery Solutions, we provide 30 TMS sessions at 5 days for 6-8 weeks. Once the patient reaches their 30th session, they then have 6 taper treatments where the patient will come in two days per week for 3 weeks. So, a total of 36 sessions in most cases, depending on your response. 75% of patients achieve full remission of depression at session 30.

 What type of TMS device do you use?

 Our TMS device was created by Brainsway. To know more about this brand go to www.brainsway.com. Brainsway is the only TMS manufacturer who has developed patented “Deep” TMS technology; which may be, on average, 18% more effective that other conventional (or “figure 8”) TMS devices. Brainsway TMS devices are FDA approved to treat Major Depressive Disorder, Anxious Depression, OCD and Nicotine Dependence.

 Are there any side effects after TMS sessions?

 Mild headaches and scalp tenderness may be common after the first few treatments; mild drowsiness within one hour after the session, and rare risk of seizure (typically only when combined with alcohol).

 Who is TMS intended for?

 TMS may be indicated if you have:

 — Treatment-resistant Obsessive Compulsive Disorder (OCD)

–Anxious Depression

–Moderate to severe Major Depressive Disorder

–Substance Use Disorders, including nicotine dependence.

 –Treatment-resistant depression where medications haven’t worked. Individuals have generally failed 2-4 antidepressant and augmentor medication trials as well as a course of psychotherapy, before starting TMS (criteria may vary based on your insurance).

 –not been satisfied with the results you get from your medication(s) –not tolerated the side effects of your medication(s)

 –an illness that limits your ability to take medications for depression –depression and anxiety symptoms that interfere with your daily life

 Who is qualified to administer TMS?

 Our TMS technicians are trained and certified through Brainsway and supervised by Psychiatrist Dr. Ashley Johnson. As recommended by the Clinical TMS Society, our TMS service is overseen by Dr. Ashley Johnson, a residency-trained psychiatric physician (psychiatrist) and board-certified by the American Board of Psychiatry and Neurology. Our team ensures patients are provided with the highest standard of care and compassion.

 Who is NOT a good candidate for TMS?

 TMS may be contraindicated if you have:

–implanted devices

 –implants controlled by physiological signals; this includes pacemakers, implantable cardioverter defibrillators (ICDs), and vagus nerve stimulators (VNS);

 –non-removable ferromagnetic objects/plates in or around the head; this does not include metallic fillings in teeth.

 You may be at high risk if you have uncontrolled epilepsy, a history of severe head injury, or other serious neurologic issues. A medical screening will be conducted to determine if you are a good candidate for TMS.

 What type of TMS device do you use?

 Our TMS device was created by Brainsway. To know more about this brand go to www.brainsway.com. Brainsway is the only TMS manufacturer who has developed patented “Deep” TMS technology; which may be, on average, 18% more effective that other conventional (or “figure 8”) TMS devices. Brainsway TMS devices are FDA approved to treat Major Depressive Disorder, Anxious Depression, OCD and Nicotine Dependence.

 Are there any side effects after TMS sessions?

 Mild headaches and scalp tenderness may be common after the first few treatments; mild drowsiness within one hour after the session, and rare risk of seizure (typically only when combined with alcohol).

 

KETAMINE FAQS

 Are there any lifestyle limitations for ketamine?

 You should not drive, make any legal decisions, or operate heavy machinery until at least 24 hours after a ketamine infusion.

 How is ketamine administered?

 Ketamine Infusion is administered by a nurse at our clinic, through an IV needle and dripped into your bloodstream over approximately 40 minutes. Ketamine infusions are typically administered in 6 infusions over 2 weeks for a broad range of treatment-resistant emotional conditions and chronic pain conditions.

 What insurances cover ketamine infusion?

 Government and commercial health insurances generally do not cover Ketamine Infusions. This service is currently private pay only.

 How long does it take to complete Ketamine IV infusion to be effective?

 Ketamine infusions are generally administered over 40 minutes with a 20 minute post-infusion recovery period for a total appointment time of about 60 min.

 Treatment is typically complete after six infusions, administered over 2 weeks on Mon-Wed-Fri. Patients MUST be accompanied by a driver BEFORE an infusion will be administered.

 Are there any side effects with Ketamine IV infusion?

 Common side effects of ketamine infusion include: dizziness, weightlessness, nausea, dissociation, hallucinations, hypertension, nightmares, and rapid heart rate. These side effects typically resolve soon within an hour of completing a ketamine infusion. You should not plan to engage in rigorous activity in the evenings following a ketamine infusion. A medical screening and informed consent will be conducted for every individual prior to administering ketamine infusions for emotional disorders or chronic pain.

 Who is Ketamine IV Infusion intended for?

 Ketamine infusion is indicated for patients who are suffering with chronic pain and/or a broad range of emotional disorders.

 Who is NOT a good candidate for Ketamine?

 People who are in active substance addiction of any kind; people who have abused ketamine in the past; uncontrolled hypertension, and people who experience disturbing dissociation and active hallucinations. All medical conditions will be screened prior to initiating Ketamine infusion.

What safety screening protocols are used for ketamine treatment?

To ensure patient safety, patients may be subject to routine drug screening including a urine or blood screening or a saliva mouth swab during ketamine treatment. Patient safety testing may also include a pregnancy test.

 

 

 

MEDICATION MANAGEMENT FAQS

 Do you accept insurance coverage for medication management?

 Medication Management is currently private pay only; however, a “superbill” (i.e. a final statement) will be provided for you to submit to your insurance provider for reimbursement of some or all of your costs. CareCredit can also be used to cover psychiatric medication management at Colorado Recovery Solutions.

 Who is psychiatric medication management intended for at your clinic?

 Colorado Recovery is intended to provide advanced neuropsychiatric treatments for emotional disorders or chronic pain. Our medication management services are typically geared towards exhausting medication trials, so that individuals eventually meet “treatment-resistant” criteria for insurance coverage of TMS. We recommend if at all possible, antidepressant and augmentor medication trials be completed through your primary care or an outside psychiatric prescriber.

 Do you offer genetic testing for psychiatric and neurologic medications?

 We do! We currently use Tempus for genetic testing (aka pharmacogenomic testing). This is just a simple swab of the mouth on site then express mailed to Tempus. Results typically arrive within 2 weeks and most insurances will cover some or all of the costs. This test can give better insight into what medications may be more effective or better tolerated based on your genetic profile.

 

CLINIC FAQS

 What are your typical office hours?

 We are open Monday through Friday from 8 AM-5 PM

 Is your clinic open during holidays?

 We are closed on all major holidays.

 What is your COVID protocol, if any?

 We follow CDC guidelines to prevent spread of COVID. We currently ask unvaccinated or immune-compromised patients to wear a mask while in office to prevent any spread. Our staff are required to be vaccinated if working on site.