OFFICE POLICIES AND PROCEDURES
Below is information about my practice, which will help you get started with an initial evaluation and, possibly, treatment. Please take a moment to read over the following information about my policies and complete the forms prior to your first appointment. If there is time, please mail or fax these forms to the address or fax number, above. Otherwise, you can bring these forms with you to the first appointment.
My office is located on 851 Fremont Avenue, Suite 108, Los Altos. There is plenty of parking available around the building.
An initial evaluation for an adult patient generally takes two hours. For children and adolescents, the evaluation can take three to four hours, and is typically divided into three or more different appointments. Please feel free to let me know if a specific format works best for your family. A common format is a one-hour initial appointment with parents, two separate hour-long appointments with your child, and a final 1-hour appointment to review findings and treatment recommendations. Please understand that the aim of these initial sessions is to provide an assessment of your/your child’s mental health needs and to determine the best available treatment options, which may include referral to another provider. The evaluation is not an agreement that I will take you/your child on as a patient.
Ongoing psychotherapy sessions are scheduled weekly and last 45 to 50 minutes. Medication management (pharmacotherapy) visits are scheduled for 25- or 45-minute appointments, depending upon your/your child’s needs. Typically, I begin with 45-minute pharmacotherapy appointments, then transition to shorter appointments when there are no significant active issues and the medication or dose has not been changed for some time. The appointment time is reserved for you/your child, so it is important that you are on time. If you are late, your appointment may still conclude at the end of your scheduled appointment time. If significantly late, you may have to reschedule your appointment and will be charged my usual fees.
48-Hour Cancellation Policy
The scheduled appointment time is reserved specifically for you/your child and this is your time. Therefore, if you are unable to keep an appointment, please be sure to cancel at least 48 hours in advance or you will be charged my usual fee for that session. Please be aware that insurance companies generally do not reimburse for a cancelled session.
Payments and Reimbursement
Payment of fees is expected at the time of service; methods of payment include cash or check. If you elect to seek reimbursement from your insurance company for my services, I will provide a monthly statement that you can submit to your insurance company. You are responsible for collecting reimbursement from your insurance company or other funding source, and for negotiating any claims. You are solely responsible for payment of your medical care, regardless of what your insurance company agrees to reimburse.
Most insurance companies require information about your child’s diagnosis, the type of service provided, the date of the session, and fees. I will include this information on your statement, at your request. In some cases, insurance companies require that the physician send information about the patient’s diagnosis and treatment plan, progress reports, and other records. Almost all insurance companies state that they will keep this information confidential, but I cannot assure this. For example, some may share the information they receive with a national medical information data bank for the purposes of deciding eligibility for future life, disability, health, and other insurance. Before I send any information to an insurance company, I will talk with you first, discuss the information to be provided, and obtain your written permission to do so. You have a choice about whether to release medical information requested by an insurance carrier, but if you refuse to have information released, most insurance programs will not reimburse for services.
I maintain a clinical chart for each patient, as required by the standards of my profession. Information in the chart includes a description of you/your child’s condition, diagnosis, treatment and progress. An entry is made for each appointment, as well as for phone communications. I keep records of any consent, information release, assessment, insurance documents, outside treatment/testing, and other records completed or collected during the course of treatment. Clinical records are kept in a locked cabinet and/or as password-protected files. Information contained in this record will not be released without your written consent except in the circumstances outlined below and as explained in the Notice of Privacy Practices.
Information shared between patient and provider is strictly confidential, with certain exceptions required by law. You hold the privilege of deciding with whom I may disclose information about evaluation and treatment. If you would like for me to share information with other providers, therapists, school officials, or other persons, please fill out an Authorization for Release of Information for each person/entity with whom you would like me to communicate.
I will release information only with your written permission with the following exceptions:
1) suspected abuse or neglect of a minor, elder or dependent individual;
2) a patient is in imminent danger of harming him or herself or another person;
3) a patient communicates a serious threat of physical violence against another person;
4) a parent or guardian is unable to adequately provide for a child’s basic needs;
5) records are ordered to be released by a judge or court; and/or
6) as otherwise required by law.
It is my policy to only write and refill prescriptions for psychotropic medications when you/your child is seen in person at a scheduled appointment. In emergency cases, I may authorize medication refills by phone or fax to your pharmacy, but generally I like to see my patients for regular, at least monthly, appointments. If you need a prescription called in before your next regular appointment, please give me at least a week to process your request. This will prevent any interruption in your medication use. It is best to contact your pharmacy directly when you need a medication refill, and they will fax me a refill request form.
If you need to reach me between appointments, please call (650) 438-7741 and leave a message with your telephone number, even if you think I have it, and some times when you may be reached. Phone consultations lasting over 5 minutes are subject to a fee. Please consider the need for a more immediate appointment if a longer conversation is necessary.
You are welcome to send non-urgent information to me by e-mail, but I cannot guarantee the confidentiality or security of e-mail correspondence (for example, from hackers) despite my use of password-protected electronic mail.
Urgent or Emergency Issues
I will do my best to respond to phone calls as soon as possible; however, I do not provide urgent, crisis or emergency services. In the event of an urgent need outside of an appointment, please contact your child’s pediatrician, the local emergency room, crisis intervention services, or call 911. On the occasion that I am away from my practice, I will inform you in advance and the message on my voicemail will direct you to the doctor providing coverage for my practice.
You may withdraw from treatment at any time. I recommend that we discuss a plan to terminate care before doing so, so that we have the opportunity to discuss further treatment recommendations, any potential risks for ending treatment at that time, and referral options if they are needed.
If you have any questions about these policies or any of the information above, I would be happy to discuss them with you in further detail. Thank you.
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