Policies

  • Two full business days (48 hours prior not counting weekends) notice is required when canceling an appointment. Appointments that are canceled or missed without two full days' notice will be charged to you at the full fee. No future appointments will be scheduled until your fee is paid. All new evaluations scheduled on a Monday will have their credit card charged for the full appointment fee the Thursday prior to their appointment. Your appointment time is reserved for you. We do not double-book appointments. If you do not cancel your appointment in advance or do not show up for it, we are unable to see another patient because the time slot was allotted specifically for you.

    • In the case of an emergency, please dial 911 or go to the nearest emergency room.

  • PHONE CALLS:


    At times, we are not available to receive calls during the day as we are seeing patients and managing administrative duties. Please leave a detailed message as to the nature of your call. We will respond to any messages as soon as possible. If we notice that calls from a patient are increasing in duration and frequency, this may be a sign that you need to be seen sooner. You will be asked to schedule an earlier follow up appointment. After-hour non-emergency calls or extended telephone consultations during office hours that otherwise would have necessitated an office may be charged. Please note that if you have an emergency, please call 911 or go to the nearest emergency room.

    E-MAIL:

    E-mail is not a secure method of communication and should not be used to discuss private health information. Please call the office or make an appointment if you have private health information that you would like to discuss.

    • Payment is due prior to services being rendered. Credit cards will be kept on file to bill for no shows and cancellations. Please contact your insurance company to verify/confirm benefits, especially out of network benefits for outpatient mental health services.

  • Please contact your pharmacy first to check whether they have a refill on file for you. It is our policy that medication refills must be requested through our office (not the pharmacy), a minimum of 3 (three) BUSINESS days prior to your next refill (not counting weekends or holidays). We cannot guarantee same-day refills or any refills requested with less than a 3 business day request. Additionally, patients must have a follow-up appointment on file in order for refill requests to be processed.

GOOD FAITH ESTIMATE

Under the No Surprises Act (H.R. 133 - which went into effect on January 1, 2022), health care providers need to give clients or patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes (under the law/when applicable) related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

    • You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

    • You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

    • There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

  • Make sure your health care provider gives you a Good Faith Estimate within the following timeframes:

    • If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;

    • If the service is scheduled at least 10 business days before the appointment date, no later than three business days after the date of scheduling; or

    • If the uninsured or self-pay patient requests a good faith estimate (without scheduling the service), no later than three business days after the date of the request. A new good faith estimate must be provided, within the specified timeframes if the patient reschedules the requested item or service.

  • This is the public disclosure of the “Good Faith Estimate”

Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment.

To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount. Please contact our office if you have any questions or concerns.