Mindful Urgent Care Policies and Informed Consent
Please review the following information on Mindful Urgent Care’s policies and procedures.
Patient Expectations and Responsibilities
Participation: Patients must be active participants in their treatment at Mindful. This includes attending scheduled sessions, disclosing any information necessary to inform treatment decisions, and actively collaborating with your treatment team by exploring and setting treatment goals. It is expected that you will be following your treatment plan both during sessions and at home. This also means participating in treatment even when difficult or distressing feelings come up as a result of discussing sensitive topics. We always encourage you to process these feelings with your providers, as an open therapeutic relationship is essential to treatment and recovery.
Cancellation: Patients must notify providers of a cancellation no less than 48 hours in advance. We recognize that emergency situations occur, and ask that you notify us as soon as possible. The following are not considered excused absences: transportation issues, minor illnesses, vacations, or forgetting about the appointment. If you cancel with less than 48 hours notice or do not show up for an appointment, you will be charged the rate of the session, and we will contact you to set up another appointment. Repeated missed appointments or no shows may be grounds for termination of treatment.
Medication: Patients must agree to take medications as prescribed. This includes not taking a dosage higher than prescribed, not altering the dose without consulting with your provider first, medication non-compliance, abruptly stopping medications or skipping doses. If medication non-compliance is demonstrated, the provider reserves the right to withdraw treatment.
Psychiatry Services and Policies
What to Expect
Your first session at Mindful will include an assessment by a provider to determine the best treatment plan for your individual needs. Our psychiatrists reserve the right to refer you to a more appropriate provider if they feel it is clinically necessary after the assessment. Your psychiatrist also reserves the right to discontinue services at any time.
Following the assessment process, if you and your provider decide to move forward with treatment, you will discuss and create an individualized treatment plan based on your treatment needs and goals. This may include a variety of treatment modalities including medication management, group, individual, family therapy, etc. It is important that your input is considered when creating this plan. If you have any questions about your treatment plan, please consult with your psychiatrist.
Treatment with your provider will typically consist of regular sessions in agreed upon increments i.e. once per week, once per month, etc. for a set period of time i.e. 15-30 minutes. Once an appointment is scheduled, you will be expected to provide payment at the time of service unless you provide 48 hours advance notice of cancellation, or unless your psychiatrist agrees that your absence was excused.
At some point you may want to change the frequency of treatment, or even terminate services. This should be a mutually agreed upon decision between your doctor and you, with reasonable notice on both parts. Patients will always be made aware of any change in service that occurs outside of the therapeutic relationship (i.e office closures, staff changes, etc).
Termination without consultation may occur if the patient is noncompliant with treatment recommendations, or if the client fails to pay for sessions within a reasonable time. If you find that you do not agree with the treatment plan or doctor recommendations, please discuss this with your provider to come up with a reasonable solution. If you are unable to afford the services, please discuss this with your provider to determine if there is an alternative payment plan available. Termination may also occur or be proposed if progress is not being made or if the provider feels their treatment is not effective. In this case, referrals will be provided. Additionally, your provider may want to speak with your other providers, such as a psychotherapist or medical doctor, to better inform treatment. In this case, your written consent is required. You as the patient also have a right to terminate services if you feel you are not benefitting from treatment.
If you have not scheduled any upcoming appointments for 60 days without contacting the center, we will assume that you are no longer interested in services. If you regularly do not show up to an appointment without calling or cancel at the last minute, this is also grounds for termination.
Code of Conduct
We do not tolerate any type of physical violence, threats, or harassment to our providers and staff at Mindful, or their families. If this occurs, it will lead to immediate termination and if necessary, legal action.
Your relationship with your provider may be professional in nature, only. There will be no sexual, business, or any other dual relationships permitted that could impair the objectivity, clinical judgment or therapeutic effectiveness of your provider. If you have any questions, please discuss this with your provider.
Length of Treatment Sessions
Medication management sessions typically last 15-30 minutes. Visits will be more frequent at the beginning or after a change is made to your medications, and then typically occur once per month or once every three months. Frequency of visits and duration of treatment is something you will be discussing with your provider on an ongoing basis.
Telephone Policy and Emergency Situations
Your psychiatrist will not always be available by telephone; however, you are always welcome to leave a message, which will be returned within 24 hours, with the exception of weekends and holidays. If there is a true emergency or you are unable to wait for a return call, please contact your primary care physician, 911, mobile crisis unit, or go to your nearest emergency room. Emergencies or crises that may not be able to wait until the next visit include, but are not limited to: acute, severe symptoms of depression, mania, anxiety, or suicidal ideation; intense side effects of medications; urges to harm yourself or someone else.
If your question or concern is something that can be addressed via phone or email, we will do our best to do so. Otherwise, your concern may have to wait until your next office visit. If you are finding you need more time with your psychiatrist and that your needs are unable to wait until the next session, we recommend speaking with him or her about increasing the frequency of visits.
Your medication regimen is part of an agreement between you and your provider to treat your symptoms. Please always take your medications as prescribed, and do not make any changes without consulting your doctor first. If you are concerned about a medication refill, please contact your pharmacy and ask to have your pharmacy FAX us refill requests. All prescriptions are now done electronically, and no paper prescriptions will be written.
Prescription refills are not considered an emergency, and must be handled during regularly scheduled appointments. Refill requests submitted on Fridays or weekends will be processed the following week. Additionally, medications that were lost, damaged, or stolen will not be replaced without a scheduled appointment.
We are unable to make a determination about any pending disability cases. Your providers’ role is to assess and diagnose your mental health needs, therefore, we are only able to provide documentation that speaks to the following: mental health diagnosis, presentation, symptoms, medication, history, response to treatment, and treatment plan. If a lawyer requests additional information regarding your ability to perform certain work duties, we will be unable to provide or complete this. Please consult a disability expert for further assistance.
At this time, Mindful will not be able to provide determination for the following: Child Protective Services (CPS) cases, service animals or emotional support dogs, bariatric surgery, or medical marijuana.
Your psychiatrist is mandated to keep records pertaining to your psychiatric treatment. You are entitled to a copy of these records unless your psychiatrist believes that seeing them would be harmful, in which case he or she may be willing to forward a copy to a mental health professional or physician as necessary. If you or another provider would like a copy of your records, this request must be made in writing, with at least 14 days notice.
You will be expected to pay the fee agreed upon by your provider for any clinical/professional services being offered. Billable services include (but are not limited to): telephone consultations lasting longer than 5 minutes, meetings or sessions with family or other treatment providers, and written records or treatment summaries to be sent elsewhere. If you require your psychiatrist participate in any legal proceedings, you will be responsible to cover the cost of any professional time used.
Billing and Payments
Assignment of Insurance Benefits:
Medical treatment has or will be provided to the patient and as such, the patient agrees to transfer and convey to Mindful Urgent Care all of my/our rights, title and interest to all of the medical insurance benefits to which I/we may be entitled according to my/our insurance policies with the companies noted to the extent necessary to provide for payment of the patient’s bill.
Payment for Services
Mindful Urgent Care will bill your insurance company following your service. Your co-payment and any deductibles and balances will be collected when you check in. Mindful Urgent Care is authorized to release any medical information needed to process applications for financial coverage for services rendered during the visits.
In accordance with the Office of the Professions of New York State Education Department, we must advise you in writing that the treatment may not be covered by the patient’s health care plan or insurer without a referral from a physician. It is the patient’s responsibility to determine if a referral is required per their insurance plan and obtain this referral prior to the office visit.
If the patient’s insurance benefit is insufficient to pay all of the medical care rendered, I understand that I am fully responsible for the balance due within 30 days of receipt of invoice. Balances in excess of 90 days are subject to a monthly finance charge of 1.5%.
Should any issues arise with your insurance company or should your coverage change, you are still responsible for payment and making arrangements with your insurance company.
If payment is not made within 30 days, you will be notified in writing as a courtesy to complete the payment. If payment is still not made after this time, you may accrue a late fee of up to 3%. After 90 days if payment is still not received, legal action may need to be taken such as hiring a collection agency or small claims court.
All patients have a right to patient-doctor confidentiality by law, meaning all communications are confidential unless the patient provides written consent to release protected health information, or due to certain exceptions, such as billing your insurance or subpoena. Your provider is required to break confidentiality under the following circumstances: if subpoenaed by a court of law, if there is a belief that you are a danger to yourself or someone else, or that abuse is occurring. In these cases, confidential information may be necessary to report in order to protect others from harm, and the provider may need to initiate a hospitalization or contact local law enforcement.
Your provider at Mindful works closely with an interdisciplinary team made up of other professionals who may provide consultation on various matters. If your provider consults with other professionals, they will not use identifying information without your consent. Your personal information will not be shared with any health professionals that you may personally be working with, without your written consent. If you have any further questions regarding confidentiality rules and regulations, please discuss them with your psychiatrist.
Patient Contact Policy
Mindful Urgent Care may contact the patient via email or phone call in regards to coordinating appointments, appointment reminders/confirmations/changes, or to discuss your treatment. Mindful Urgent Care may occasionally send out a newsletter with relative mental health information. Your information will never be disclosed or shared with third parties.
At the time of receiving medical services Mindful Urgent Care has incurred expense and has provided a high level of care. As there are no guaranteed outcomes of any medical visit, patient agrees not contest credit card charges that were approved, after the fact.
It may be medically necessary for your physician to request lab tests in order to provide the best treatment possible. It is your responsibility to obtain the requested examinations. Our office will assist you as much as possible, but testing will require you to visit another facility or lab. If you do not obtain these tests within a reasonable time, your physician reserves the right to refuse to refill or prescribe further medications until tests are completed.
Urine drug screens are performed on patients when necessary. All patients who are prescribed controlled medication will have an initial urine drug screen and will be subject to monthly UDS after. Any charges that may incur from the UDS will be the responsibility of the patient if not covered by the insurance company.
MINORS: If you are under 18 years of age, please be aware that the law may provide your parents the right to examine your treatment records.