Telehealth has made psychiatric care more accessible for many people across Alabama, especially for patients who live farther from a psychiatric provider, have busy schedules, or simply prefer the convenience of meeting from home.
But how does telehealth medication management in Alabama actually work?
In many ways, it is very similar to an in-person psychiatric appointment. Your provider will still review your symptoms, medications, side effects, medical history, treatment goals, and progress. The biggest difference is that some information and certain requirements may need to be handled a little differently when appointments occur virtually.
At Integrative Health Services, Emily Trentacoste-Martin, CRNP, PMHNP-BC provides psychiatric evaluations and medication management through telehealth for eligible patients throughout Alabama, along with in-person appointments in Pelham and Gardendale.
What Happens During a Telehealth Medication Management Appointment?
During a virtual psychiatric appointment, your provider may discuss:
- Current symptoms and mental health concerns
- Changes in mood, anxiety, sleep, concentration, or behavior
- How well your medication is working
- Possible medication side effects
- Current medications and supplements
- Medical history
- Therapy participation
- Substance use when clinically relevant
- Treatment goals
- Whether medication needs to be continued, adjusted, or changed
Telehealth does not mean a lower standard of care. Alabama’s telemedicine rules generally require providers to exercise the same level of professional care whether services are delivered in person or remotely.
Your Provider May Still Need Your Weight, Blood Pressure, or Other Vitals
One important difference with telehealth is that your provider cannot automatically obtain your vital signs during the appointment.
Depending on your medication and medical history, Emily may ask you to provide information such as:
- Blood pressure
- Pulse or heart rate
- Weight
- Height
- Other vital signs
- Recent laboratory results
Some psychiatric medications can affect blood pressure, heart rate, weight, metabolism, or other areas of physical health, so monitoring may be an important part of safe medication management.
Your provider may ask you to obtain these readings at home, through your primary care provider, at a pharmacy, or during an in-person visit.
Will I Ever Have to Come In Person?
Possibly.
Whether you need an in-person appointment depends on several factors, including the type of medication being prescribed, Alabama regulations, your provider’s clinical judgment, and your insurance plan.
Mental health services have some exceptions from Alabama’s general telehealth in-person requirements. However, controlled substances have additional rules.
Under current Alabama telemedicine law, controlled substances prescribed through telehealth generally require an appropriate in-person encounter within the preceding 12 months.
There can also be additional requirements for certain controlled medications prescribed by a nurse practitioner. Alabama requires CRNPs who prescribe controlled substances to hold specific controlled-substance authority, and Schedule II prescribing has additional requirements.
Because regulations can vary by medication, patients should not assume that choosing telehealth means they will never need to come into an office.
What Is a Collaborating Physician?
In Alabama, a Certified Registered Nurse Practitioner such as Emily practices under an approved collaborative practice agreement with a physician.
A collaborating physician is not someone who sits in every appointment or personally makes every treatment decision. Instead, the physician and nurse practitioner work within an established collaborative relationship that includes medical oversight, consultation, protocols, and quality review.
Alabama describes medical oversight as ongoing collaboration that can include consultation, review of medical records, discussion of treatment and diagnoses, and other activities intended to promote appropriate patient care.
For certain controlled medications, the collaborating physician may also have a more direct role.
For example, Alabama’s rules for some Schedule II medications require physician evaluation and collaboration when deciding whether treatment should continue after the initial treatment period.
So depending on the medication you take, your treatment plan may occasionally involve Emily’s collaborating physician as well.
Will My Insurance Require In-Person Visits?
Your insurance company may have requirements that are separate from Alabama licensing rules.
Depending on your insurance plan and medication, your insurer may have rules regarding:
- Whether telehealth medication management is covered
- How frequently appointments are covered
- Whether certain appointments must occur in person
- Prior authorization for certain medications
- Laboratory testing
- Drug screening
- Documentation of symptoms or diagnosis
- Step therapy requirements
- Controlled-substance monitoring
Policies can also change.
That is why we recommend checking your individual insurance benefits rather than assuming that every telehealth service or medication requirement is covered the same way.
Helpful questions to ask your insurer include:
“Is psychiatric medication management covered through telehealth?”
“Do I have to see my psychiatric provider in person at any point during the year?”
“Are there different requirements if I am prescribed a controlled substance?”
“Are drug screens or laboratory tests required for coverage?”
“Do any of my medications require prior authorization?”
Knowing these requirements ahead of time can prevent unexpected problems with coverage.
Could I Be Asked to Complete a Drug Screen?
Yes, in some circumstances.
Drug screening may be requested based on the medication being prescribed, clinical circumstances, practice policies, state or federal requirements, or requirements from your insurance company.
A request for a drug screen should not automatically be viewed as an accusation that someone is misusing medication.
For certain medications, particularly controlled substances, monitoring can simply be part of safe prescribing and responsible medication management.
Where Do I Need to Be During My Telehealth Appointment?
You generally need to be physically located in Alabama at the time of your appointment for Emily to provide Alabama telehealth services.
Telehealth care is legally considered to occur where the patient is physically located at the time the service is delivered.
So if you normally live in Alabama but are vacationing in another state, tell your provider before your appointment. Your provider may not be legally permitted to treat you while you are physically located outside Alabama.
How Can I Make Telehealth Medication Management Easier?
Before your appointment:
- Find a private, quiet location.
- Have your medication list available.
- Write down any side effects or changes you’ve noticed.
- Know the name of your pharmacy.
- Have recent blood pressure, weight, or other requested readings ready.
- Keep a list of questions.
- Tell your provider about medications, supplements, alcohol, or substances that could affect treatment.
- Be honest if symptoms are getting better—or worse.
The more accurate information your provider has, the better they can evaluate how your treatment is working.
Telehealth Medication Management Throughout Alabama
Emily Trentacoste-Martin, CRNP, PMHNP-BC, provides telehealth psychiatric medication management for eligible children, adolescents, and adults throughout Alabama.
Integrative Health Services also has three locations in Pelham, Alabaster, and Gardendale, with Emily rotating between our Pelham and Gardendale offices for in-person medication management.
This allows patients throughout Shelby County, Jefferson County, and other parts of Alabama to combine the convenience of telehealth with access to in-person psychiatric care when it is clinically or legally necessary.
- To request a psychiatric evaluation or medication management appointment with Emily, contact Integrative Health Services at 205-644-1166 or use the Book an Appointment option on our website.
- Learn more about medication management and therapy by exploring our blog posts.
- Convenient care should still feel personal, thoughtful, and thorough. Get started with IHS today.
Additional Therapy Options Available in Pelham, Alabaster/Calera, Gardendale, and Surrounding Areas
Integrative Health Services offers comprehensive mental health counseling for children, teens, adults, and families throughout Alabaster, Pelham, Calera, and Gardendale. Our clinicians provide anxiety therapy, depression counseling, trauma therapy, EMDR therapy and Brainspotting. Our team also offers play therapy, LGBTQIA+-affirming therapy, marital and premarital counseling, and medication management.
Insurance coverage and prescribing requirements vary. This article is educational and should not be interpreted as a guarantee that a particular medication or service can be provided through telehealth.
