About Total Clarity Psychiatry
Total Clarity Psychiatry, PLLC is a physician-owned telepsychiatry practice that contracts Andrea Skrocki, PMHNP-BC, to provide adult (+18) psychiatric services throughout all of Michigan. Patients will have the convenience of self-scheduling their appointments, eliminating the need to wait days or even months for availability. Additionally, patients can easily message Andrea through a secure patient portal, fostering improved communication and ensuring timely responses. This streamlined process enhances the overall patient-provider experience, allowing for more efficient care and stronger, uninterrupted support throughout the patient's mental wellness journey. Total Clarity Psychiatry is experienced in sensitive issues including LGBTQI.
Services available:
Diagnostic evaluations (60-75 minutes)
Personalized treatment plans
Psychiatric medication management (if warranted)
Supportive therapy
PGT - pharmacogenetic testing with GeneSight (if appropriate)
Telepsychiatry visits from the comfort of your home or workplace
Symptoms treated:
Anxiety
Depression
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Attention-Deficit/Hyperactivity Disorder (ADHD)
Bereavement and Prolonged Grief Disorder
Insomnia and Sleep Disorders
Substance Use Disorders, in sustained recovery
Behavioral Health Concerns
Binge Eating Disorder (BED)
Trauma and Abuse Recovery
Women’s mental health
Post Partum Depression and Anxiety
Premenstrual Dysphoric Disorder (PMDD)
Men’s Issues
LGBTQ+
College stressors
Telehealth allows flexible and accessible care, ensuring patients can receive timely support from the comfort of their homes, or other quiet space. Each treatment plan is personalized, and we offer ongoing guidance and support to help individuals reach their mental health goals.
Values and mission:
Andrea is an advanced practice registered nurse (APRN) who is board-certified as a Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) with over a decade of experience specializing in adult psychiatric care. She takes a holistic approach, integrating supportive therapy and psychotropic medication management when appropriate. Andrea is passionate about what she does and is dedicated to helping individuals regain control of their mental health and overall well-being.
Andrea believes that wellness is multidimensional, influenced by lifestyle, environment, genetics, spirituality, and both mental and physical health. She uses a patient-centered, culturally sensitive approach to help individuals overcome psychological and emotional barriers while maintaining the highest standards of care. Each patient receives an individualized treatment plan tailored to their specific needs to achieve optimal outcomes. Andrea strives to create a supportive and therapeutic environment, incorporating goal setting, positive reinforcement, reframing, active listening, and self-development techniques to help patients build a more stable sense of self.
Appointment Details:
Initial Appointment (Diagnostic Evaluation) : The first visit will last approximately 60-75 minutes, during which time Andrea will gather a full history, conduct screenings, and discuss an appropriate treatment plan.
Follow-Up Appointments: Follow-up visits are typically 15-20 minutes, with longer visits available, if needed. Treatment progress, goals, and medications (if prescribed) will be discussed and re-evaluated. Depending on the acuity of symptoms and treatment plan, patients will generally meet back with Andrea 2-3 weeks after their initial visit to discuss progress. From there, a patient can expect a visit every 1-2 months, depending on what the treatment plan is. Once a patient is stable, with no medication changes, follow up visits are generally every 3 months.
Supportive Therapy: Andrea offers supportive therapy as part of the treatment process. She will often recommend finding a specialized therapist for more complex mental health needs (e.g. PTSD, OCD, etc.), in addition to medication management treatment.
Service Fees:
Diagnostic Evaluation & Treatment Plan (first visit): $265
Medication Management/Follow up visits: $150
No show fee, less than 24 cancellation: $75
Note: TCP is out of network with all insurance carriers; cash pay
Payment & Insurance Information
Total Clarity Psychiatry does not accept insurance and is considered out-of-network with all insurance providers. Payments can be made using an HSA, FSA, credit card, debit card, or Apple Pay. A “superbill” (itemized medical invoice) can be provided for patients to submit to their insurance for potential reimbursement toward their out-of-network deductible, depending on their insurance policy.
To accommodate cash-pay patients, fees have been reduced and are often more affordable than insurance reimbursement rates.
Important Medicaid Notice
Patients with Medicaid insurance are not eligible for treatment at Total Clarity Psychiatry, even if paying out of pocket. This is against Medicaid regulations and could result in loss of benefits, as Andrea is not a Medicaid provider.
Don’t let the fear of not using your insurance hinder you from seeking
the best mental health care available.
Fee Schedule
Payment and Fees
Self/Private Pay: We DO NOT accept insurance. Your credit card on file will be charged at the time of your appointment. Please keep it updated. Out of network with all insurance carriers.
Fees:
New Adult (18+) Patient Intake & Evaluation: $225
Adult Medication Management Follow-up: $125
No-Show or No-Call Fee: $75
Paperwork or Record Transfer: $45+ (depending on complexity)
Prior Authorization for Medication Denial: $25+ (depending on coordination time)
Late Payment Fee: $45 (payment due at the time of visit)
Important Notes:
MEDICAID PATIENTS ARE NOT ALLOWED TO SCHEDULE WITH CASH PAY PRACTICES (TCP) DUE TO STATE RESTRICTIONS
Prior Authorizations: Once approved, these are typically valid for one year. You can use your private insurance for prescription coverage at pharmacy. (just not MEDICAID).
Out-of-Network Insurance: Let us know if you'd like a "super bill" after each visit to submit to your insurance. Check with your insurance provider for more details.
Andrea treats adults (18+) and does a prescreening to ensure that Total Clarity Psychiatry can treat your needs via telehealth.
Frequently Asked Questions
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New adult patient psychiatric evaluation visits:
60-75 minutes in duration and cost $225
Follow up medication management visits:
typically 15-20 minutes in duration and cost $125
NOTE:
We are OUT OF NETWORK, and do not accept insurance. Your credit card, HSA/FSA, or debit card will be charged day of visit.
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We do not accept any insurance. Our fees are reduced and comparable to others in the state of Michigan.
Total Clarity Psychiatry is a private-pay practice and does not accept insurance. This decision allows Andrea to provide more personalized care, as she is not bound by insurance company guidelines. By operating “out of network”, Andrea can spend more time with each patient and tailor the treatment plan to their specific needs without external limitations.
Additionally, many individuals today have high-deductible insurance plans or no insurance coverage at all. Total Clarity Psychiatry’s private-pay fees are often more affordable than the reimbursements insurance companies provide, which could involve higher patient out-of-pocket costs.
For patients with insurance, Total Clarity Psychiatry can provide a 'Super Bill'—an itemized receipt of services rendered—that can be submitted to the insurance company for potential reimbursement based on the individual's out-of-network benefits. It’s recommended to confirm coverage details with your insurance provider.
Payment is processed through the credit card on file (including credit, debit, HSA/FSA cards, or Apple Pay) immediately after services are provided with Andrea at Total Clarity Psychiatry. Patients will not receive unexpected bills later with little explanation.
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No. If you have Medicaid, you will not be able to establish with Total Clarity Psychiatry and pay out of pocket, instead of using your insurance. Doing so could jeopardize your state-assisted benefits. Providers must be credentialed with Medicaid to accept it, and Andrea is not credentialed with Medicaid.
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Currently, Total Clarity Psychiatry is offering telepsychiatry appointments exclusively. The long-term plan is to establish a physical office in Northern Michigan, allowing patients to benefit from both in-person appointments (at least once annually) and telepsychiatry services with Andrea for greater convenience.
Please note that patients must be physically located in Michigan during their appointments and must reside in the state for more than 51% of the year.
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Total Clarity Psychiatry does not complete paperwork related to disability, court, or workers' compensation services. These matters are best addressed through in-person consultations and ongoing visits, that can be costly when not covered by insurance. Some disability, workman compensation or court cases have limitations with telehealth providers, and some even limit further to only MD to complete the documentation.
Andrea is available to assist patients with accommodation paperwork in specific situations, such as for professional exams (e.g., LSAT, MCAT) and other academic accommodations. Additionally, letters for Emotional Support Animals can be provided based on the patient’s individual needs and requested accommodation, excluding those related to airline travel.
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Yes, Andrea can order labs. It is recommended that your annual wellness labs (i.e., complete blood count, metabolic panel, thyroid, lipid, A1C, PSA, etc.) are ordered and managed by your Primary Care Provider since Andrea does not treat medical illness. She will order Vitamin D or other labs, as needed, in collaboration with your PCP.
Andrea usually orders labs through LabCorp.
Andrea is also able to order Pharmacogenetic Testing for psychotropic medication through a company called GeneSight, if warranted and covered by your insurance.
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Yes, Total Clarity Psychiatry requires at least 24 hour notification to cancel your appointment otherwise you jeopardize the no show fee. The fee for a no show is $75. This fee will be charged at the discretion of Andrea and your communication with her.
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Both psychiatrists and psychiatric nurse practitioners (PMHNPs) can diagnose and treat mental health conditions. Psychiatrists are medical doctors (MDs or DOs) who have completed medical school and residency with specialized training in psychiatry. Psychiatric mental health nurse practitioners (PMHNPs) are licensed and board-certified advanced practice registered nurses (APRNs) who have specialized training in psychiatry.
After learning this, you may be wondering what exactly a psychiatric nurse practitioner can do. Along with the ability to perform physical evaluations, this specialty qualifies PMHNP’s to:
Evaluate, diagnose and treat psychiatric and mental health conditions
Work with individuals, families and groups
Perform psychotherapy
Prescribe medication
Coordinate care with other healthcare professionals
Intervene for those experiencing a health/behavioral health crisis
How should I address Andrea?
Andrea is a psychiatric nurse practitioner, and not an MD or DO. Please feel free to call her by her first name, “Andrea”, and not “doctor”.
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A typical psychiatric interview can last from anywhere between 40-75+ minutes. At Total Clarity Psychiatry we pride ourselves on getting to know you and taking the time to listen and ask the appropriate questions. We don’t want to you to feel rushed.
While these questions are the most common ones, Andrea’s clinical judgment will guide the number of questions based on how much information is needed during the first visit. Andrea will send all potential patients several electronic screening documents that include a brief medical history, allergies, current and past medication trials, current and past psychiatric history, and reasons for seeking help. This helps her get a brief understanding of your needs and to ensure that Total Clarity Psychiatry is the right fit for you.
What brings you here today?
Why did you decide to schedule the appointment?
Example: "I’ve been feeling anxious and it’s getting worse."
When did you start feeling this way?
Helps Andrea understand how long the issue has been affecting you.
How have you tried to handle this concern so far?
Identifies your coping mechanisms (e.g., walking, talking to friends).
What is different now compared to before?
Helps Andrea see what might have worked in the past but isn't working now.
What does your average day look like lately?
Shows any changes in your daily routine, like sleep or hygiene.
What bothers you the most about this situation?
Helps identify your main priority or concern.
How are your relationships with family and friends?
Gives insight into your support system.
Have you sought support from others?
Looks at any other support groups or friends you've reached out to.
Has anyone in your family had a similar concern?
Family history might indicate genetic patterns.
Have you or anyone in your family been hospitalized or used psychiatric medication?
Helps Andrea understand any family history of mental health issues.
Do you have any other medical history?
Physical health issues can affect mental health.
Have you received medical treatment or prescriptions for other concerns?
Helps Andrea consider how other medications might affect you.
How often do you use alcohol, tobacco, or other substances?
Substance use can impact your mental health.
Have you seen another mental health professional before?
Helps Andrea understand past experiences and whether a different approach is needed.
Do you have any questions for me?
Gives you the opportunity to ask anything about the treatment process.
How to Prepare for Your Psychiatry Evaluation Appointment:
Write down your medical history and any relevant prescriptions.
Answer comfortably: You don’t have to share everything at once. Be honest about what you’re ready to discuss.
Prepare questions for Andrea: Writing them down can help you remember what you want to ask.
These questions are designed to give Andrea a complete understanding of your health and needs.