Billing

Co-pays will be collected at the beginning of visit.  Patients with high deductible plans or coinsurance the fee will be collected at the end of the visit as the cost of the visit depends on the service provided during the visit.  Patient’s will not be allowed to carry a balance, on their account.  All co-pay’s and co-insurances must be met at the time of service.  If a patient has a high deductible plan or coinsurance and is not aware of their portion the full fee will be collected and a credit or refund will be issued once the insurance claim has been approved and paid.  As an example, if you had a 30 min appointment and your insurance company has a contract rate of $115 for the code being submitted, you will have to pay the $115. If the insurance company pays us $115 we will issue you a refund of $115.   This does not apply to people who have a standard office co-pays, if this is the case than just the co-pay will be collected.  As a courtesy, patients who have met their out of pocket expenses for the year and have their visits covered at 100% will not be required to pay up front for their visit.  Patients are responsible for paying the bill if their insurance does not cover the service provided.  

All Patients are Required to Keep an Active Credit Card on File for practice charges.  

Late Cancel and No Shows

A No Show is not showing up for your appointment, a late cancel is not providing 48 hours business notice to change an appointment. 

First No Show/Late Cancel $25

After the first one the fee is $60.

Refills will not be provided if patient is not showing up for appointments and has balances due on their account. 

Why are no shows and late cancels such a big deal?  

One of the biggest barriers to treatment is not being able to get in to see a provider in a timely manner.  However there is a lot of time wasted when people don’t show up for their appointments and don’t call to cancel.  Unlike a busy medical practice, a specialty field such as Mental Health sees far fewer patients in a day. We allocate that time specifically to the patient. As a provider I do not overbook  as a way to buffer the income lost from no shows and late cancels as it can lead to long waits in the waiting room.  Unfortunately I usually can not fill a last minute cancellation. No show/late cancel fees are used as a deterrent and to help keep the practice financially solvent so we can continue to provide much needed services.  With that said, everybody gets sick and has last minute complications, I’ll make a judgement on a case by case basis to waive the no show fee.

Arriving Late

I do not have grace period for being late.  If you are late for your appointment even a few minutes and I don’t feel there is adequate time to see you than I’ll ask you to reschedule and charge a no show fee.  If based on  my medical judgement we can accomplish what we need to in the time we have left then I will go ahead and see you.  Please try to be on time or a few minutes early for you appointment. Please do not misinterpret this to mean that I never run behind schedule. Sometimes there is a medical necessity that requires extra time, as a rule though I make every effort to stay on time not leave patients waiting for their appointments. 

Refill Requests

Please do not ask your pharmacy to put your medication on automatic request.  I do not fill medications that are requested from the pharmacy, only the patient.  I will not respond to fax requests from the pharmacy either. Please call personally before you run out of medication.  And adhere to the following policy.

Refill Requests Require 5 business days notice otherwise a $25 fee will be charged for urgent requests and $50 if it’s the weekend.  

Keep in mind refills are for active patients who keep their appointments.  

Reasons for Discharge

The foundation of providing mental health services lies in the relationship with the patient.  As a human being I have my own style and expertise, so I always feel that if the patient doesn’t clique with my style of providing medical care they should find another provider.  Sometimes after evaluation I find that I can not provide the services that the patient needs, in that case I will do my best to make a referral to another provider or organization better suited to assist the patient. If I feel discharge is necessary I’ll provide a letter in writing explaining why.  Immediate discharge happens when the patient has blatantly lied to the provider such as getting controlled medication from more than one provider and not disclosing such information or withholding information about symptoms or issues that effect your treatment plan.  But most commonly people are discharged because they do not want to follow the treatment plan or the don’t show up for their appointments or are constantly late.  In this case after the third time, I reserve the right to discharge. Now if I have seen you past the initial evaluation I will make sure that you have medication and a referral to other providers if you choose to continue care.  

Communication

Text and Email are available for the convenience of the patient and will only be used if the patient initiates communication in this manner.  It is important for the patient to understand that these methods of communication are not HIPPA compliant, privacy and security of information can not be guaranteed.

Release of Information and Collaboration

General

Patient’s do not need to sign a release of information for other active providers to share basic medical information that effects the treatment plan of the patient.  For more in depth sharing of patient treatment information such as treatment notes and evaluations, the patient must sign a release.  If a patient is seeing a therapist, I will require a release to collaborate on the treatment plan.  

Young Adults

Once a patient reaches the age of 18 they no longer require a parent to make medical decisions. but since many young adults are still financially dependent on their family and still live at home I require the Young Adult to sign a release of information so that I may coordinate care for the patient with the family if necessary.  Patients who are unwilling to provide this release will be asked to find another provider.  Concerns about this policy should be raised as soon as possible.  

Divorced Parents

The decision to treat a mental health illness is often a difficult one for parents, and often times the parents feel differently about the treatment options for their child.  The most effective way to provide treatment is to have both parents present at the time of the initial appointment.  If only one parent can attend the appointment and the parents have joint custody then I require a notarized letter stating that the parent that is present has the authority to approve the treatment plan.  For parents that have medical decision making authority I ask that you sign the letter included in your new patient packet attesting that you have the legal authority to consent to treatment and a copy of the divorce decree or legal paperwork supporting this claim.   

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008301/

Including a Support Person

When deemed medically necessary I will request that the patient include a support person in their plan of care.  This may be a spouse, a parent or even a close friend.  The purpose of this person is varied and the necessity will be explained during the development of the treatment plan.  A release of information will be required for this person.  

Inquiries

As a rule if we do not have a release of information we will not return a phone call for somebody making an inquiry unless it is another health care provider calling to collaborate care.  As an example, a spouse calls wanting to ask questions about the treatment or has concerns.  Without a release we will not call the spouse back, we will call the patient and let them know their spouse is concerned but that we can’t speak with them without a release. Families are always welcome to participate in the patients care at the patients discretion, we just need to have a release to share information.  

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