INITIAL INTAKE APPOINTMENT:
Our first meeting is a consultation and does not constitute an agreement on the doctor’s part to ongoing treatment. After coming to understand your case, we can proceed to treatment planning if appropriate. If it does not seem that our services and treatment expertise match your needs, you will not be charged for the intake session.
IN OFFICE FOLLOW-UP SESSIONS:
In order to manage your treatment, follow-up sessions generally occur every 30 to 60 days until your condition improves. The first two follow-up sessions will be 30-50 minutes unless otherwise arranged. Over the long-term, we see patients at least every six months, although occasional exceptions are made. Phone sessions or video sessions for medication management and/or psychotherapy may be arranged as appropriate. The length of time for follow-up sessions is determined by the complexity of your case. If you, the patient, do not schedule and/or keep a follow-up appointment within a month of the time specified by the clinician, you accept that the clinic may no longer consider you a Choose Hope patient. This is for reasons related to safety, as your clinician will specify follow-up appointment timing based upon clinical need, and our information will be incomplete if such timing specification is not met. It is your responsibility to schedule and keep your follow-up appointment, or to reschedule as soon as possible if cancellation is necessary. If you do not follow through with this responsibility, your care may be terminated without formal notice.
At Choose Hope we keep records of our meetings and the content of our sessions. They are documented within our electronic medical record (EMR) and any information you disclose will be held in strict confidentiality unless you specifically authorize its release or unless the law or professional standards of practice requires disclosure. Specifically, your right to confidentiality may not be maintained if there is reasonable concern of: 1) abuse or neglect of a child, dependent or elder adult, 2) danger of harm to yourself or to others, 3) grave disability (i.e., inability to care for yourself), or 4) pursuant to legal proceedings. If other health professionals are involved in your care, we may ask you to sign a release to coordinate.
Details regarding your case might be included in research reporting through case reports, letters and/or discussions with colleagues. Only pertinent details regarding your medical history, presenting circumstances and range of response is used in these cases. Under no circumstances would specific identifying information be included in such communication. Your signature on this form acknowledges your understanding of this policy and your consent to our use of information related to your case in research.
If a Choose Hope physician is prescribing you medications, our goal is to refill prescriptions at your regularly scheduled follow-up visit. If the timing of a needed refill does not coincide with your next scheduled visit, please inform your prescribing physician of your request at least 72 hours in advance and make sure that you have received an acknowledgment of your request from the physician. We will do our best to manage prescription requests in a timely manner.
For all contact, please phone or message within the patient portal. We will return messages in a timely fashion, usually within 24 hours with exceptions on Fridays from noon through weekends and holidays. The Patient Portal is the best way to protect patient privacy and preserve HIPAA provisions.
TEXTING and eMAIL (eComm):
As per a patient’s preferences and appropriateness of these modes we can communicate by email and text. However, transmitting confidential health information by email and text has a number of risks, both general and specific including but not limited to: eComm can be immediately broadcast worldwide to unintended recipients; recipients can forward eComm without the sender’s permission or knowledge; users can easily misaddress eComm; eComm is easy to falsify; backup copies of email may exist even after the sender or the recipient has deleted a copy; eComm may contain information pertaining to diagnosis and/or treatment; individuals with access to your chart will have access to the eComm; patients who send or receive eComm from their place of employment risk having their employer read their eComm. We use reasonable means to protect the security and confidentiality of eComm but because of the risks outlined above, we cannot guarantee the security and confidentiality of eComm or internet communication and are not liable for improper disclosure of confidential information not caused by gross negligence or wanton misconduct, or breaches of confidentiality caused by the patient. While we endeavor to read eComm promptly, we can provide no assurance that a particular eComm is read. Therefore, eComm must not be used in a medical emergency, nor should it be used for communications of particularly sensitive information regarding diagnosis or treatment. Your signature below signifies your acceptance of these terms.
Please call 911 or go to the nearest emergency room in the event of a life-threatening medical or psychiatric emergency. Call the Choose Hope main number to inform your physician of your status as soon as possible, but do not wait for a return call in life-threatening emergencies. We are occasionally out of contact for approximately 2-4 hours, so please attempt to contact Choose Hope again if your call is not returned within 3 hours.
At Choose Hope we understand that life is busy and promise to do our best to accommodate your scheduling needs. We do request that any change in scheduling be made at least 24 hours in advance of your originally agreed upon appointment time. “No Shows” or “Cancellations” within 24 hours of a scheduled appointment will be charged in full. If you have scheduling conflicts, please contact us as soon as possible.
PAYMENT and BILLING:
Payment is expected at the time of service with check, cash or credit. You will be asked to have a credit card on file with our office however, you may pay for your sessions by check or cash if you wish. At your request, we will attempt to charge a Health Savings Account (HSA) credit card first. However, we require a secondary card to be on file given the potential complications of HSA funding. While we do not bill insurance companies directly, we will provide a receipt or “Super-Bill” that may be submitted to your insurance provider for potential reimbursement. Reimbursement rates differ substantially between different insurance companies, and between the different illness and CPT codes used to signify your condition and the treatments provided. You are responsible for payment regardless of the status of your claim. Additionally, labs are also reimbursed by insurance at variable rates. If this is a concern, please contact your insurance carrier to get an estimate of costs before proceeding. Billing a third party for treatment can be arranged as is appropriate. If a check is returned for non-sufficient funds your credit card will be charged for the session as well as a $35 charge for returned checks.