FOR PHYSICIANS & CARE TEAMS

Your Patients. Our Support.

Navira works alongside your team. We communicate
directly, we do not disrupt care without a conversation, and
we have made the referral process as simple as possible.

Built Around Access, Not Barriers

Depression care often becomes a long, stepwise process. Navira was built to make evidence-based, non-medication treatment for depression easier to access when patients need it, not just when insurance approves it.

Neurologist-led

Treatment is led and supervised by Dr. Robert Myers, D.O., a board-certified neurologist. Every patient receives a focused neurologic evaluation and a personalized treatment plan.

Collaborative by design

We communicate directly with referring providers. We do not modify a patient's existing care plan without discussion. Your patient relationship stays intact.

Depression-focused

Navira is not a general wellness clinic. Our primary focus is TMS for depression, which means deliberate decisions about how we structure care, communicate with providers, and manage referrals.

Simple referral process

Phone, fax, and email referrals accepted. We assist with documentation and keep you informed at key points in care. The goal is to reduce your administrative burden, not add to it.

Two clear pathways

Navira offers both an insurance-supported pathway and a direct-pay option for patients who cannot manage the standard insurance-based schedule. We help patients find the path that works for them.

When to Refer

Consider referring a patient who:

SAFETY AND CONTRAINDICATIONS

TMS is contraindicated for patients with certain implanted metal or electronic devices in or near the head, including some aneurysm clips, cochlear implants, deep brain stimulators, or implanted stimulators. A history of seizures or intracranial mass lesions are also contraindications. Active use of recreational substances or misuse of prescription medications may reduce the effectiveness of TMS treatment and is reviewed on a case-by-case basis during the clinical evaluation. Dr. Myers reviews safety criteria with every patient.

01

Still struggling despite treatment

(In therapy/meds, some improvement but not better)

02

Prefers a non-medication approach

(Concerned about side effects, no long-term meds)

03

Better… but not themselves

(Low energy, brain fog, low motivation)

04

Treatment-resistant depression

(Multiple trials, limited response)

05

High functioning but declining

(Working/parenting, fatigue/burnout)

06

Recurrent depression

(History of episodes, worsening again)

How We Work with Your Team

We take the care relationship seriously. When you refer a patient to Navira, here is what you can expect:

We conduct a thorough evaluation before beginning any treatment.

We communicate with you at the start of care and at key points throughout.

We do not modify existing care plans without direct communication.

We can send treatment summaries at your request

We are available to speak with referring providers directly if questions arise.

How To Refer

Referrals can be made by phone, email, or fax. You do not need to complete a complex referral form. A brief summary of the patient’s history and your reason for referral is sufficient to get the process started.

Phone

(585) 598-4093

Fax

(585) 280-9626

Email

care@naviramed.com

WHAT TO INCLUDE

Provider FAQ

Will you take over my patient’s psychiatric or therapy care?

No. We focus on TMS as a treatment modality. We do not provide ongoing psychiatric medication management or therapy. Your patient’s existing care relationships continue as usual.

Yes. We communicate at the start of care and at key points in the treatment process. If you would like additional communication or a treatment summary, we can arrange that.

Navira does not prescribe or adjust psychiatric medications. Patients continue working with their existing prescriber for medication management.

Yes, and we encourage it. TMS may support the effectiveness of therapy by making the brain more receptive to change.

Insurance-covered TMS: 30-40 sessions, approximately 5 sessions per week, over 6-8 weeks. ExoMind accelerated TMS: 6 sessions, approximately 25 minutes each, completed over 3 weeks. Dr. Myers discusses both options with each patient.

The safest answer is to refer and let Dr. Myers evaluate. He will review the patient’s history, safety criteria, and clinical picture and give you a clear answer. If TMS is not appropriate, he will say so.

OMT Targets in Chronic Pain

Muscle Guarding

• Chronic pain often leads to reflexive muscle tightening (guarding), which limits motion and perpetuates pain.
• OMT techniques like muscle energy and counterstrain relieve hypertonicity, restore range of motion, and reduce nociceptive input.

Autonomic Nervous System Dysregulation

• Chronic stress/pain activates the sympathetic nervous system (fight-or-flight), worsening inflammation and reducing healing.
• OMT techniques (for example, craniosacral therapy, rib raising) help balance autonomic tone, decreasing sympathetic overactivity and enhancing parasympathetic function.

Somatic Dysfunction

• Chronic pain often localizes dysfunctions in joints, fascia, and viscera.
• Soft tissue, HVLA, and myofascial release techniques restore normal alignment and improve proprioception.