Confidentiality & Reporting: While one of the clinician’s primary duties is to protect the patient’s privacy and confidentiality, this duty is not absolute or without exceptions. Communications are confidential and generally no information will be released without your consent, except for the following: Laguna Family Health Center clinicians are considered mandatory reporters for child abuse and dependent adult / elder abuse. Clinicians may also have charts subpoenaed in legal cases however records may be subject to patient-therapist privilege and patient confidentiality/safety are utmost priority. Confidentiality is primary, however in the case of a threat to self or other harm, we must report.
Financial Policies: Once your appointment is scheduled, you will be expected to pay for it unless you provide at least 24 business hours advance notice of cancellation. Business hours are considered the weekdays between Monday and Friday. This means that if you have an appointment on Monday at 4 pm, you must cancel by Friday at 4 pm to avoid being charged. Please note, insurance companies will not reimburse for missed or late cancel sessions nor can they be billed. As a reminder, credit card(s) on file will be charged for any of these fees, as consented in the intake paperwork.
If you do not provide at least 24 business hours notice, or fail to show for a scheduled appointment, you will be responsible for the FULL cost of the session. Fees range from $175-$195 for medication follow-ups to $150-$375 for 60 min therapy sessions. A list of office visit fees can be requested. Many practices overbook on purpose so that no-shows and cancellations won’t limit access for other patients as well as cause a financial hardship for the practice. Our practice chooses not to do this common practice as we prefer to focus on individualized care that is not rushed or expedited. We pride ourselves on offering care that is outside of the norm of managed health care and that allows each client the time needed to address their specific needs. Because of the focus of our practice and shortage of mental health providers, many of our clinicians have waiting lists and thus, no-shows or late cancels can take away from other clients seeking treatment. We understand that certain emergencies can arise that is beyond your control. Please discuss any concerns with our staff in these circumstances.
Payments: Unless other arrangements are approved by us in writing, the balance on your account is due and payable at the date it is requested in person or in wring by billing statement, whichever is sooner. Accounts are considered past due and delinquent/subject to reporting to collections if not paid within 60 days. Any copays, office visit fees, or other costs must be paid at the time of service. Any copays or deductibles are an insurance requirement and cannot be waived or reduced by our office. Please note there is also a $35 fee for any returned check.
Medical Records: Both law and the professional standards require that we keep appropriate treatment records. You are entitled to review a copy of the records, unless the clinician believes seeing them would be emotionally damaging, in which case, we will be happy to provide them to an appropriate mental health professional of your choice. We can also prepare an appropriate summary for review. Clinicians may have charts subpoenaed in legal cases however records are usually subject to patient-therapist privilege and will only be released with your consent or a court order. You must make your request in writing. There is a fee for these copies.
Emergencies: In the event of a psychiatric emergency, such as acute thoughts of harming oneself or others or a medically dangerous reaction to a medication, our clinicians can be reached through the urgent numbers specified on our office voicemail. If you are facing a true clinical emergency such as imminent danger to self or others, please call 911 or go to your local emergency room.
Insurance Policies: You are responsible for any amount that is not covered through insurance and charges rendered at times when your insurance is inactive. It is the responsibility of the patient to fully check your benefits and coverage before your visit(s), although our office will assist patients in navigating benefits. If we are contracted with your insurance (in-network provider), we must follow our contract and their requirements. We will bill your insurance as a courtesy and after claims are received, the patient and office will receive an Explanation of Benefits (EOB) that reviews the charges and coverage. Due to the complexity of coding, you may see charges on your EOB for services or additional costs (ie. patient education, consults, etc). The amount due to the office is based only on the primary code billed. Please note as well that if you are choosing to use insurance for your visits, the insurance carrier may request information such as diagnosis and copies of progress notes. Many clients chose to not use their insurance for office visits because of this element. Please notify our office if you have any questions regarding this.
Telephone Calls & Emails: We must screen all calls to the clinicians during office hours while they are seeing patients. Calls deemed “non emergent” will be handled by the staff in the order received. If it is necessary to leave a message for the clinicians directly, calls will be returned within 24-48 hours by either the clinician or staff, as appropriate. Most of our clinicians have preference for email in terms of communication if it is a question or concern on a specific issue that falls beyond the role of the office staff to address. Emails will be answered by clinicians directly and are confidential, but please keep in mind the limits of technology security. Emails may also be used to communicate with office staff and all email addresses can be found on our website: www.lagunafamily.com
Prescription Refills: Prescription refill request will be handled within 24 hours of receipt during regular business office hours. Prescription refills will not be handled after regular office hours or on the weekend. Please have your pharmacy fax refill requests to our office rather than calling and requesting refills. Certain medications that are controlled substances require monthly scripts that need to be taken into the pharmacy in person and thus cannot be called in or faxed. Our clinicians reserve the right to deny refills or reduce quantity/doses.
Patient refills may also be denied if patients have not returned for follow-ups within the time frame agreed at the previous appt and thus a follow-up appt must be made before refills are authorized. Furthermore, if accounts are past due and payments are not received or a payment plan initiated, clinicians’ refills will not be granted.
Laboratory Tests & Procedures: As part of your treatment plan, our NPs may recommend certain lab tests/blood work to be ordered to assist in diagnosis and rule out medical causes to symptoms. Our NPs are all dual-licensed in both primary care and psychiatry due to our practice focus on comprehensive care.
Certain medications also require routine and periodic blood work. Please make sure to discuss any physical symptoms, past medical history, etc. that may be important in your current situation. If labs are ordered, it is your responsibility to make sure that lab services are an included benefit in your insurance.
Pharmacology/Medications: Medications are often used as adjuncts to psychotherapy. If you are seeing clinicians at Laguna Family Health Center for medication management, we will work together to find the optimal combination of medication (if warranted) and therapy that help to fulfill your personal goals. If a medication is indicated, we will discuss with you the reason for the medication, the likelihood of improving with and without medication, and any reasonable alternative treatments. Further, you will understand the type(s) of medication being recommended; dosage and frequency and any possible side effects. As many conditions have an underlying biological basis, medications can be an important component of treating certain illnesses. A common concern in psychiatry of prescribers seeing patients for quick visits, focusing almost entirely on medications, over-prescribing, not being open to working with therapists, and not educating patients about their condition or needs is not what occurs in our practice. Medications are used in conjunction with therapy as the catalyst for growth, with a focus on prescribing only when needed, reducing the use of substances that can increase addiction, and customizing a pharmacological plan specific to the unique needs and symptoms of the individual.