Mission Statement & Practice Values: Our mission is to provide the highest quality mental health care that promotes empowerment, enhances wellness and strengthens our community. At Laguna Family Health Center, we treat the whole client and strive to incorporate biological aspects, psychological factors and social components, which provides the best chance at recovery and growth. LFHC was founded out of the desire to provide mental health services in a client-centered model that focuses on wellness and prevention as much as treatment.
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: clinicians are considered mandatory reporters for child abuse and dependent adult/elder abuse. In addition, we have a duty to warn individuals in the rare case where specific and direct threats to harm are made to others. Clinicians may also have charts subpoenaed in legal cases however records may be subject to patient-therapist privilege and confidentiality is our utmost priority.
Medical Records: Both law and professional standards require that we keep appropriate treatment records. You are entitled to a copy of your records, unless the clinician believes seeing them would bring psychological harm, in which case, we can forward them to an appropriate mental health professional. We can also prepare a clinical 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 court order. You must make your request in writing. There is a fee for these copies.
Changes in Address/Phone or Insurance: Please notify us as soon as possible if you have any changes to your home or billing address, phone numbers and insurance coverage. If we do not have current information this will delay payment and possibly cause you to have unexpected expenses. California insurance laws require claims to be filed no later than 90 days after the date of service and for some companies, the timeframe is 30 days.
Emergencies: In the event of a psychiatric emergency, such as acute thoughts of harming oneself or others, a medically dangerous reaction to a medication, please call 911 or go to your local emergency room. For urgent matters, please call the office or if after hours, the emergency number listed on our office voicemail.
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 is done so on our Luminello patient portal.
Prescription Refills: Prescription refill requests will be handled within 24-48 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 send electronic refill requests to our office rather than calling and requesting refills. 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.
Psychotherapy: Psychotherapy may have benefits such as significant reduction in distress, improved social relationships, resolution of specific problems, and clearer understanding of yourself, your values, and your goals. For therapy to be most successful, you will have to be able to talk openly and honestly, address any difficulties that arise, and put forth active effort outside our sessions. Our therapists have expertise in several areas of therapy and will collaborate with clients to create individualized plans. Some therapy is brief and some requires a longer duration to address symptoms and treatment goals. If you have any questions or uncertainties, please discuss them with your therapist.
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. As many conditions have an underlying biological basis, medications can be an important component of treating certain illnesses. 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.
Laboratory Tests & Procedures: As part of your treatment plan, our NPs may recommend certain labs/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.
Referrals/Authorizations: If your insurance requires a referral or preauthorization, you are responsible for obtaining it. Failure to do so may result in payment denials from your insurance. If our clinicians refer you to another specialist, recommendations are based on their experience with the specialist but the specialist may/may not be an in-network provider with your insurance. You will need to contact the office and/or your insurance to determine if that provider is covered.
Children & Pets: Children are very special to all of us and we are always happy to see them but for their safety and the courtesy of other patients we must ask that you keep your children with you at ALL times while in our office. Pets are not allowed in the office building except animals that are registered therapy/emotional support animals.
Cell Phones & Smoking / E-Cigarettes: Please refrain from talking on your cell phone and smoking / using electronic cigarettes while in the office or waiting area. This is distracting to others around you and also to the environment that we hope to create within our office. Please be mindful that there are several professional businesses within this office building and thus respect their need for a quiet and healthy environment.
Legal Testimony: It is often unforeseen, but legal matters requiring the testimony of a mental health professional can and do arise. Legal testimony can often be damaging to the relationship between a patient and clinician. Because of this, we require that you employ independent forensic services should this type of evaluation be required. If for any reason, we are subpoenaed on your behalf and required to testify or appear in court, you will be responsible for our court fees, which our office can provide upon request.
LATE CANCEL & NO-SHOW OFFICE POLICY: 24 BUSINESS HOURS: It is our goal to provide services to you in the most comfortable and timely manner as possible. In order to achieve this we must require you to be on time for your appointments. Our clinicians will make every effort to also be on time, however due to the nature of the practice and acuity of patient issues / symptoms, clinicians may run late on occasion. 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. 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 private pay cost of the session. A list of office visit fees can be requested and is also listed on our website.
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 are beyond your control. Please discuss any concerns with our staff in these circumstances.
CREDIT CARD AUTHORIZATION & PAYMENTS POLICY: Any copays, office visit fees, or other costs must be paid at the time of service. It is our office policy to collect credit card information from all patients or their responsible parties and to maintain this information on file in a HIPAA compliant manner. Unless other arrangements are approved by us, the balance on your account is due and payable at the date it is requested in person or by billing statement, whichever is sooner. Accounts are considered past due and delinquent/subject to reporting to collections if not paid within 90 days. Any copays or deductibles are an insurance requirement and cannot be waived or reduced by our office. If a patient is not able to pay their co-payment or fees at the time of the visit with cash or check, signing this gives our office permission to process the payment for you with your card on file. Also, as noted above, if an appointment is canceled in less than 24 business hours or a patient does not show for a scheduled appointment, the full fee is due and will be charged to the card on file. No-shows and late cancels cannot be billed to insurance. Lastly, If a patient becomes 90+ days overdue, with any balance, we may process the payment using the credit card information or they may set up a monthly installment plan as agreed on by office administration. This would only occur if multiple attempts to reach the patient and/or set up a payment plan have not been returned. Laguna Family Health Center, Inc. does not accept patients without a valid credit card on file unless agreed to on a case by case basis.
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. after hours, consults, etc) but you are not responsible for all codes submitted. 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.
Good Faith Estimate / No Surprises Act: Under Section 2799B-6 of the Public Health Service Act, mental health care providers are required to provide a “Good Faith Estimate”(GFE) if requested, to patients who don’t have insurance or who are not using insurance for their appointments. This document serves as an estimate of the expected charges for medical services, including psychotherapy for these patients. Under the law, health care providers need to give these patients an estimate of the expected charges for medical services, including psychotherapy services. A GFE must be provided to the patient within three business days of the appointment, upon request. Please let our office know if you would like a GFE, otherwise please know that our office will always have our current fees posted and will communicate to you should there be any changes to your account, new billings, etc. Most clients do not need a GFE because of the small size and great communication from our office staff, but it is your right to receive one should you want. Our office has always operated under a no surprises policy per say anyways and it is also each client’s responsibility to understand his/her own medical and insurance benefits, which our office can help you navigate and translate as well. A GFE does NOT include no-shows, late cancellations, or other services related to crisis care, which by definition are unexpected and cannot be predicted for the purpose of compiling a Good Faith Estimate in advance. A GFE may also include consultations with client collateral contacts, fees related to paperwork requests, and other legal and administrative fees related to client care, when such items are scheduled in advance. You can ask your healthcare provider/office, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. For questions or more information about your right to a Good Faith Estimate, visit: www.cms.gov/nosurprises, or call 1-800-985-3059.
Medicare Opt-Out Agreement: Laguna Family Health Center, Inc.. & affiliated clinicians do NOT participate in Medicare. By law, Medicare- eligible patients are required to enter into a private contract with Laguna Family Health Center and we deliver medical care on a fee-for-service basis, which is not reimbursable by Medicare. By accepting the treatment contract with Laguna Family Health Center you agree that you shall not submit a claim for payment under Medicare for services at our office.
Patient-Provider Arbitration Agreement: Lawsuits are something that no one anticipates and everyone hopes to avoid. The method of resolving disputes by arbitration is one of the fairest systems for both patients and psychotherapists. By signing this office policy contract, you are agreeing that all disputes arising out of or in relation to this agreement to provide services shall first be referred to mediation, before, and as a precondition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement with Laguna Family Health Center and patient(s). The cost of such mediation, if any, shall be split equally, unless otherwise agreed upon. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement should be submitted to and settled by binding arbitration in Orange County, CA, in accordance with the rules of the American Arbitration Association which is in effect at the time the demand for arbitration is filed. This agreement generally helps to limit the legal costs for both patients and psychotherapists. Our goal of course is to provide care in such a way to avoid any such disputes. Most problems begin with communication and thus if you have any questions or concerns about your care, please discuss with our office / clinician.
Grievance Policy: Communication is an essential element of your healthcare and interpersonal relationships. If at any time you have concerns, please discuss with either your therapist/NP and/or our office manager. If resolve has still not been achieved, you have the right to request a meeting with the owner to discuss your concerns.