Skip to main content

Meadowlark Clinical Consulting

Clear psychiatric guidance for complex primary-care cases.

Meadowlark provides PMHNP-led, clinician-to-clinician eConsults with organized written recommendations your team can use while continuing to treat the patient.

Chart-ready written recommendations 24-48 business-hour target Treating clinician stays in control
Schedule a 15-Minute Clinic Call View a Sample eConsult

For focused, non-urgent adult cases. No direct patient care, prescribing, refills, or crisis coverage.

The Clinic Problem

Most clinics are already managing psychiatric complexity without enough psychiatric support.

Meadowlark gives primary-care teams a simple way to add structured psychiatric input for selected adult cases while keeping care inside the clinic relationship.

The Patient Stays With You

Your team keeps the patient relationship and prescribing role instead of sending every complex behavioral-health question into a long referral queue.

The Provider Gets Structure

Instead of informal hallway advice or trial-and-error medication changes, your clinician receives an organized written report with practical options and guardrails.

The Clinic Avoids A Full Hire

Clinics can access focused psychiatric decision support without recruiting, credentialing, scheduling, and managing another full-time psychiatric role.

Potential Consultation Topics

Focused questions that benefit from organized psychiatric review.

Appropriate questions may involve diagnosis, medication sequencing, side effects, monitoring, or when to manage in-house versus refer. Not every case is appropriate for written consultation.

  • Diagnostic clarification
  • Partial response after multiple medication trials
  • Sequencing, switching, augmentation, or deprescribing considerations
  • Psychotropic polypharmacy
  • Adverse effects, interactions, or unclear medication benefit
  • Monitoring considerations
  • Medical, sleep, metabolic, thyroid, hormone, or medication-related contributors
  • Referral and escalation thresholds

What Is Not Included

Boundaries are part of the model.

  • Direct patient visits
  • Direct prescribing or medication refills
  • Patient portal messages or prior authorizations
  • Emergency, crisis, on-call, or same-day psychiatric coverage
  • Replacement of the treating clinician
  • Medical director services unless separately contracted
  • Legal, forensic, disability, custody, or workers' compensation opinions
  • Billing, coding, reimbursement, or outcome guarantees

How It Works

A simple written workflow your team can understand quickly.

1

Clinic Fit Call

A short introductory call clarifies your clinic type, prescriber mix, behavioral-health pressure points, and the kinds of adult cases your team wants support with.

2

Set Up The Workflow

Your clinic receives a clear process for what to send, where to send it, how the written report returns, and who on your team receives the response.

3

Submit A Focused Question

Your clinician submits the clinical question, current treatment, past trials, safety concerns, relevant labs, and medical context using the agreed clinic workflow.

4

Receive A Written eConsult

Most complete, accepted cases target a 24-48 business-hour response. The treating clinician reviews the recommendations, decides what to implement, and continues patient care.

Sample eConsult Preview

From a messy psychiatric question to a clear next-step plan.

This fictional example shows the kind of clinical thinking a written eConsult can organize for a treating provider. It is not medical advice and does not use patient information.

Fictional Clinic Snapshot

Should we switch antidepressants now?

A primary-care clinician requests help with a 38-year-old patient whose anxiety improved somewhat on sertraline, but depression, fatigue, brain fog, sexual side effects, poor sleep, and severe premenstrual irritability remain.

Current treatment
Sertraline 100 mg daily for 10 weeks; trazodone and hydroxyzine as needed. The patient reports morning grogginess and limited functional improvement.
Current symptoms
PHQ-9 18, GAD-7 11, low motivation, non-restorative sleep, reduced exercise tolerance, heavy menses, cold intolerance, and marked mood worsening 7-10 days before menses.
Relevant results
Ferritin 10 ng/mL, low-normal hemoglobin, vitamin D 24 ng/mL, TSH within the reported reference range, low-normal free T4, and free T3 2.2 pg/mL.
Important gaps
No formal bipolar screen, sleep-apnea or restless-legs screen, prospective cycle tracking, full iron studies, or repeat standard thyroid panel is documented.
Clinic question
Is this a failed SSRI, or should the team address medical contributors and clarify the diagnosis before changing medication?
Meadowlark eConsult Excerpt

A prioritized plan for the treating clinician

What may be going on

This looks more like a partial antidepressant response complicated by several treatable contributors than a straightforward sertraline failure. The leading issues are likely iron deficiency in the setting of heavy menses, possible premenstrual dysphoric disorder or premenstrual worsening of depression, medication-related fatigue and sexual side effects, and an unassessed sleep disorder. Thyroid disease is not established by the submitted results and should be confirmed rather than assumed.

Recommended next steps, in order

  • 1. Confirm safety and the diagnosis. Review suicidal thinking, mania or hypomania, psychosis, substance use, pregnancy possibility, adherence, dose timing, activation, and the exact benefit and side-effect burden from sertraline. Screen for sleep apnea and restless legs.
  • 2. Address the iron deficiency. Ferritin of 10 ng/mL supports depleted iron stores in this context. Obtain or review CBC, ferritin, iron, TIBC, and transferrin saturation; evaluate heavy menstrual bleeding or another source of iron loss; and treat the deficiency through the clinic's usual protocol or in coordination with primary care or gynecology.
  • 3. Confirm the thyroid picture. Repeat TSH and free T4 and review supplements, biotin use, recent illness, and laboratory timing. An isolated free T3 result is not enough to diagnose hypothyroidism or select thyroid medication. If standard testing remains abnormal or symptoms and results conflict, coordinate primary-care or endocrine follow-up.
  • 4. Define the menstrual pattern. Have the patient complete daily mood and cycle ratings for two cycles. A clear luteal-phase pattern would support a PMDD-focused treatment plan instead of another nonspecific antidepressant trial.
  • 5. Avoid changing several variables at once. If sertraline remains partly helpful and there is no urgent safety concern, keep it stable briefly while the iron, sleep, cycle, and medication-side-effect questions are clarified. This makes the next decision easier to interpret.

Medication paths after the first steps

  • If premenstrual symptoms are the main remaining problem: Consider an evidence-based SSRI strategy using continuous or luteal-phase dosing. Continuing sertraline or switching to fluoxetine are reasonable examples, with the final choice based on prior benefit, side effects, interactions, and patient preference.
  • If fatigue, low motivation, and sexual side effects remain dominant: Consider bupropion XL as an augmentation or switch option after screening for bipolar-spectrum symptoms, seizure risk, eating-disorder history, uncontrolled hypertension, and anxiety activation.
  • If pain, hot flashes, or menopausal-transition symptoms are prominent: An SNRI such as venlafaxine or duloxetine may fit better than another SSRI for selected patients, with appropriate blood-pressure and tolerability monitoring.
  • If bipolar screening is positive or antidepressant activation is present: Do not continue routine antidepressant escalation. Arrange direct psychiatric evaluation and use a mood-disorder treatment pathway.

Follow-up and decision point

Reassess in 2-4 weeks using PHQ-9, GAD-7, sleep quality, daytime function, cycle ratings, adherence, and side effects. Review the iron and thyroid workup before labeling the medication ineffective. Make one major treatment change at a time and document the target symptom that change is meant to improve.

When direct psychiatric care is the better route

Refer or transfer care for suicidal intent, mania, psychosis, severe functional decline, complex polypharmacy, pregnancy-related complexity, eating-disorder instability, or diagnostic uncertainty beyond outpatient primary-care management. If the clinic prefers not to manage the psychiatric component, Meadowlark Mind & Body may be an option for direct in-person or telehealth care, subject to availability, location, and clinical fit.

Fictional demonstration only. Actual eConsults depend on the submitted clinical information and remain consultative. The treating clinician is responsible for evaluation, diagnosis, informed consent, prescribing, monitoring, follow-up, documentation, and final decisions.

Who It Is For

Built for clinics that need consistent psychiatric input without building a new role around it.

Adult family medicine and internal medicine
Rural primary-care clinics
NP- and PA-heavy teams
Independent outpatient practices
Clinics without embedded psychiatry
Teams that value written, chart-reviewable recommendations

Clear Scope

The right support for the right clinical situation.

Crisis Or Emergency

Use existing emergency, crisis, higher-level-of-care, or same-day clinical protocols. This service is not emergency coverage.

Direct Psychiatric Care

Use direct psychiatric care when the patient needs evaluation, ongoing specialty treatment, or when your clinic prefers not to manage the psychiatric component. Meadowlark may be an option for in-person or telehealth care when clinically appropriate.

Embedded Care

Use embedded or collaborative-care models when your clinic needs integrated staffing, regular team-based care, or program-level coverage.

Focused eConsult

Use Meadowlark when a treating clinician has a focused, non-urgent adult question that can be reviewed through organized written information.

Service Model

Predictable psychiatric decision support without adding another employee.

Meadowlark Clinical Consulting gives clinics a structured written support pathway for selected adult behavioral-health cases that do not require emergency care or direct psychiatric takeover.

What Clinics Receive

A Written Clinical Decision-Support ReportClear recommendations for the treating clinician

Your team submits a focused adult case question. Meadowlark returns a structured written eConsult that helps the treating clinician decide what to do next.

  • Structured case submission template
  • Clinical formulation and practical next-step options
  • 24-48 business-hour target for most complete, accepted cases
  • Medication sequencing, monitoring, safety, and escalation considerations
  • Lab, sleep, thyroid, hormone, metabolic, and medication-overlap considerations when relevant
  • Referral thresholds, including when direct care at Meadowlark or another specialty setting may be more appropriate

How Service Is Scoped

Fit, Volume, And Pricing ReviewMatched to your clinic's actual workflow

A short fit call clarifies whether this service matches your clinic, how often you expect to use it, and what level of monthly support makes sense.

  • Reviewed around number of prescribers and clinic locations
  • Scoped around expected monthly eConsult volume and case complexity
  • Can include leadership-friendly utilization summaries if useful
  • Designed for focused adult clinician-to-clinician questions, not public patient case submission
  • Final scope is confirmed before your clinic begins submitting eConsults

Why pricing is reviewed privately: Clinics vary by number of prescribers, expected case volume, case complexity, submission quality, turnaround needs, and reporting needs. A short fit call keeps the offer precise, professional, and matched to the clinic's actual workflow.

Clinical Leadership

Led by Brandon Jaggi, PMHNP-BC.

Brandon Jaggi, PMHNP-BC, is a Wyoming-based board-certified Psychiatric Mental Health Nurse Practitioner and owner of Meadowlark Mind & Body.

His background includes inpatient and outpatient psychiatric settings, outpatient medication management, complex psychotropic medication decisions, anxiety, depression, ADHD, insomnia, trauma-related symptoms, mood disorders, polypharmacy, and integrative psychiatric care.

Brandon's broader clinical interests include the overlap between psychiatric symptoms and sleep, thyroid, metabolic health, hormones, medications, lifestyle, and lab patterns. That perspective is useful when clinics are trying to understand whether a psychiatric presentation may be affected by medical, medication-related, sleep-related, or hormone-related factors.

Meadowlark Clinical Consulting is PMHNP-led clinician-to-clinician consultation. It is not psychiatrist consultation, direct patient care, prescribing takeover, or emergency coverage.

FAQ

Common questions from clinics.

Is this direct patient care?

No. This is clinician-to-clinician written consultation. Meadowlark does not directly evaluate the patient unless a separate direct-care arrangement is created and clinically appropriate.

Does Meadowlark prescribe medications for our patients?

No. The clinic's treating clinician remains responsible for prescribing, informed consent, monitoring, follow-up, and final clinical decisions.

Is this crisis care or same-day psychiatric coverage?

No. This service is not for emergencies, crisis situations, suicidal intent, homicidal intent, acute psychosis, severe mania, withdrawal, delirium, or same-day psychiatric decision-making. Clinics should use their existing emergency and higher-level-of-care protocols.

Is the consultant a psychiatrist?

No. Meadowlark Clinical Consulting is led by Brandon Jaggi, PMHNP-BC, a board-certified Psychiatric Mental Health Nurse Practitioner. The service should not be represented as psychiatrist consultation.

What types of cases may fit?

Focused, non-urgent adult questions may fit when the treating clinician is seeking written psychiatric input on diagnosis, medication sequencing, adverse effects, monitoring, polypharmacy, relevant medical contributors, or referral thresholds. Meadowlark may decline cases that are incomplete, outside scope, urgent, or not appropriate for written consultation.

What information is usually needed?

Case submissions generally need a focused clinical question, relevant history, current symptoms, diagnoses, current and past medications, medication response, side effects, safety concerns, screening results when available, vitals or labs when relevant, and medical context. Meadowlark provides a clear submission format so the clinic knows what to include.

What happens if information is incomplete?

Meadowlark may request additional information, return the case, or decline the eConsult if the submission is incomplete, unclear, outside scope, or not appropriate for written consultation.

How are cases submitted?

Accepted clinics use the agreed clinic workflow, not the public website form. Meadowlark provides a clear process for what to send, where to send it, and how the written report returns.

How fast are reports returned?

Most complete, accepted eConsults target a 24-48 business-hour written response. Complex cases, incomplete submissions, holidays, or unusually high volume may require clarification or additional time.

What states are eligible?

Meadowlark Clinical Consulting is currently focused on Wyoming and Nebraska clinics. Eligibility for patient-specific consultation depends on licensure, patient location, clinic setup, coverage requirements, and the agreed submission workflow.

Can the written response be placed in the medical record?

The response is designed to be clear and reviewable. The treating clinic is responsible for deciding how to incorporate consultation recommendations into its own medical record and workflow.

Is reimbursement guaranteed?

No. Meadowlark does not guarantee billing, coding, reimbursement, referral reduction, patient outcomes, or cost savings. Clinics are responsible for their own billing and reimbursement decisions.

Can patient information be entered on this website?

No. Do not submit patient information, protected health information, clinical histories, medication lists, dates of birth, medical record numbers, or case details through this website.

Why is pricing not listed publicly?

Clinic needs vary by prescriber count, expected volume, case complexity, response needs, and reporting needs. Pricing is reviewed during a brief clinic fit call so the service matches the actual workflow.

Request Information

Schedule a clinic fit call.

Use this form for clinic and business inquiries only. It is not a patient-care, referral, or case-submission pathway.

Do not include patient information or protected health information in this form.

Do not include patient names, dates of birth, medical record numbers, diagnoses, medication lists, clinical histories, or case details.

Where does this form go?
Submitting this form opens an email draft addressed to bjaggi@meadowlarkmindandbody.com. The website does not store form submissions. Your email app must send the message for Meadowlark to receive it.

Prefer direct contact?
Call 307-300-5885
Email bjaggi@meadowlarkmindandbody.com