Patient Accounts:
All prospective and current patients are required to sign up and create their own free individual patient account with my practice’s HIPAA compliant, cloud based electronic medical record vendor Therapy Notes. All patients are required to maintain their own patient account in order to retrieve, complete, sign, and return all patient consent and intake forms. All patient intake and consent forms need to be reviewed before an initial appointment may be scheduled.
Appointment Reminders:
You will be sent an email appointment reminder 24 to 72 hours before your scheduled appointment.
Appointment Cancelations:
Please give at least 24 hours notice if you need to cancel your appointment. If less than 24 hours notice is given, you will be charged a Non-Refundable Late Cancelation Fee of $50. Any late cancelations due to unexpected illness or emergency will be evaluated on an individual basis. If you Do Not Show for a scheduled appointment, you will be charged a Non-Refundable No Show Fee of $100.
Payment Policies:
My practice accepts private pay patients, and accepts:
Blue Cross Blue Shield of Massachusetts (HMO Blue Managed Care, Preferred Provider Organization(PPO), and Indemnity plan).
My practice does not accept cash or checks. My practice only accepts online credit card payments. Visa, Mastercard, Discover, American Express Credit Cards, and Health Care Allowance Credit Cards are accepted.
All credit card payments are made online through Therapy Notes’ PCI compliant third-party billing, and credit card processing company “Card Pointe” that is owned and operated by Card Connect. You will be required to enter your preferred credit card information and number onto a Therapy Notes’ payment authorization form. This form will encrypt your credit card information, and this form gives my practice permission to charge your credit card for all copays, appointment fees, and coaching fees. My practice does not have access to your credit card information, and your credit card information is not stored within your patient record.
If required payment is not received before the start of your appointment, or if your credit card payment is declined, and cannot be processed, then your appointment will be canceled. You will need to reschedule your appointment for another time.
Private pay patients: All private pay patients are required to remit full credit card payment for all appointments prior to the start of all appointments.
All patients may request a Good Faith Estimate before requesting an appointment.
For patients who would like to request out-of-network care services, my practice can provide you with a Superbill that you may submit to your health insurer to request reimbursement for any out-of-network care. All patients are responsible for submitting their own Superbills.
My practice does not submit, and is not responsible for submitting any Superbills.
Video Telehealth Appointments:
All Telehealth appointments are conducted over a secure HIPAA compliant video platform through Therapy Notes. Appointments are not conducted over the phone.
You must be physically located in the state of Massachusetts at the time of your scheduled appointment. Appointments will not be conducted if you are driving.
Telehealth Prescribing:
My practice follows and complies with all United States Federal and State of Massachusetts Drug Enforcement Agency (DEA) Laws and Regulations for telehealth care and prescribing. The DEA had announced a temporary rule that extended the allowance for practitioners to continue Telehealth prescribing of medications, including controlled class medications (i.e., stimulant medications, sleep medications, anxiety medications) to new and/or existing patients who had established care and treatment through telehealth until December 31, 2025.
Please note, that either on or before December 31, 2025, the DEA may change these laws and regulations, and may require that all patients will need to be seen in-person via an in-office appointment(s) with their prescriber in order to be eligible to be prescribed a new and/or ongoing medication refill.
Therefore, All Patients of A Compassionate Mind and Wellness, LLC Must Agree To Comply and Must Attend Any In-Office Appointments Mandated By All DEA Laws and Regulations. You understand and agree that continuation of your care, and your eligibility for ongoing prescriptions are contingent upon your compliance and attendance to all appointment requirements mandated by all Federal and Massachusetts DEA Laws and Regulations.
My practice reserves the right to clinically assess and determine whether or not a prescription(s) may or may not be clinically indicated for you. My practice reserves the right to decline prescribing any new medication(s) and/or may decline continuing prescribing any medication(s) that may have been prescribed to you by another provider outside of my practice.
Follow-Up Appointment Requirements:
Upon starting a new prescribed medication, you will be required to return for a medication follow-up appointment, biweekly or monthly depending on the type of medication. This will allow my practice to accurately assess medication efficacy, to help monitor any potential side effects, and answer any questions. After a therapeutic dose is achieved, follow up appointments may extend out to 30 days, 45 days, 60 days but may not extend more than 90 days per DEA rules and regulations. If you do not return for a follow-up appointment within 90 days, you will need to schedule a follow-up appointment before another medication refill may be sent.
No Refunds Policy:
You understand and agree that No Refunds will be given for any copays, appointments, evaluations, psychotherapy, and for any ADHD coaching sessions.
Unpaid Patient Balances:
You understand and agree that you are responsible for remitting full payment for all outstanding patient balances to A Compassionate Mind and Wellness, LLC. You understand and agree that your outstanding patient balance may not exceed $125. In the event your patient balance exceeds $125, you authorize the practice to charge your credit card for the full amount of your outstanding patient balance “prior to the start of your next appointment”. Any outstanding patient balance that is Sixty (60) Days Past Due, will be transferred to a collection agency. All unpaid patient balances will be charged an additional interest of 1.5% per month until all outstanding balances are paid in full and will be charged an additional interest of 18% per year until the balance is paid in full.
A Compassionate Mind and Wellness, LLC Privacy Policies:
The practice adheres to Federal and Massachusetts Laws to protect the privacy, confidentiality, and security of all its clients. The practice implements and maintain policies and procedures in compliance with the Federal law Health Insurance Portability and Accountability Act (HIPAA).
A Compassionate Mind and Wellness, LLC’s Non-Discrimination Policies:
A Compassionate Mind and Wellness, LLC comply with applicable federal civil rights laws and Massachusetts Civil Rights Act. Our practice is committed to provide compassionate and respectful care to all. Our practice does not discriminate or exclude any person, or treat any person differently based on a person’s race, color, creed, national of origin, citizenship or immigration status, religion, age, sex or sexual orientation, gender identity or expression, marital status or civil partnership, family or parental status, mental disability, intellectual or cognitive disability, physical disability, genetic information including family medical or psychiatric history, veteran or active military status, political beliefs or affiliation, and any other class of individuals protected from discrimination under federal and state laws.
A Compassionate Mind and Wellness, LLC’s Discharge and Termination of Care Policies:
You understand and agree that your care may be discontinued at any time by you or by the practice. You understand and agree that our practice reserves the right to terminate care with you at any time as defined in our practice’s Terms and Conditions and with your agreement and signed consent to our practice’s Terms and Conditions. Please refer to my practice’s Terms and Conditions for full explanation of all Discharge and Termination of Care Policies.
Updated: 11/27/2024.