Notice of Practice Privacy Notices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

This notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. This Notice also describes your rights regarding health information we maintain about you and a brief description of how you may exercise these rights. This Notice further states the obligations we have to protect your health information.

“Protected health information” means health information (including identifying information about you) we have collected from you or received from your health care providers, health plans, your employer or a health care clearinghouse. It may include information about your past, present, or future physical or mental health or condition, the provision of your health care, and payment for your health care services. We are required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to your health information. We are also required to comply with the terms of our current Notice of Privacy Practices.

CONSENT TO USE AND DISCLOSE YOUR HEALTH INFORMATION

This is an agreement between you, the client, and Foundations for wellness, Inc., hereto referred to as FFW. FFW refers to Office administration and clinicians. As a client of FFW you will be ask to provide what the law calls Protected Health Information (PHI) about yourself. The clinicians at FFW require this information to plan and provide the best treatment for you. There are times when FFW may share this information with others who provide treatment to you. FFW will also use this information to arrange payment for your treatment via insurance or for other business or government functions. When you are agree to treatment, you are agreeing to let FFW use your information as noted above. The Notice of Privacy Practices/HIPPA explains in more detail your rights and how FFW can use and share your information. You can request a copy of this policy at anytime.

In the future FFW may change how we use and share your information and so may change our Notice of Privacy Practices/HIPPA. IF any changes are made, you can get an updated copy by calling 508-635-1337.

You will be asked to sign specific releases for emergency contact, as well as, others you give permission for FFW to coordinate with for continuity of care. After you have signed this consent, you have the right to revoke it (by writing a statement to inform FFW you no longer consent), FFW will comply with your wishes about using or sharing your information from that point on, however, please be aware that FFW may have already shared some of your information for care coordination.

Patient’s Rights

1. You have the right to decide to end our medication management/psychotherapy treatment at any time without prejudice. If you wish, I will provide you with names of other qualified Clinicians.

2. You have the right to ask any questions about medications discussed and interventions used during your appointments.

3. You have the right to refuse the use of any medications and/or therapeutic technique offered. FFW will inform you of intent to use any unusual procedures and will explain any risks involved.

4. You have the right to learn about alternative methods of treatment. FFW will discuss these with you as appropriate.

Confidentiality

Anything you discuss is considered privileged information and will be held in confidence by FFW. FFW will not release any information to others about you unless you give FFW explicit written permission by signing a “release of information” form. Please be aware that there are certain situations in which we are required by law to reveal information without your permission:

1. Threats to harm another person.

2. Threats to harm yourself.

3. Child or elder abuse.

4. Court-ordered psychotherapy or evaluations.

5. There is a medical emergency and 911 needs to be called

In addition, if you are requesting insurance reimbursement, please be aware that some companies require the disclosure of your symptoms, diagnosis, treatment plan and/or response to treatment. FFW will share these reports with you, as requested. There is a fee for printed medical Records or statements.

Emergency Coverage

You may leave messages for FFW during office hours at (508)635-1337 or utilize the patient portal. If there is an emergency, follow the instruction on the FFW voice mail message, directing you to call your Primary Care physician, Local Crisis Center, or to call 911 to be transported to your local emergency department. There is no on-call services at this time so please ensure you follow these instructions.

Care by a Psychiatric Mental Health Nurse practitioner

Medication management is a key aspect of our practice, as psychiatric nurse practitioners have the authority to prescribe medications to alleviate symptoms and promote mental well-being. This involves careful evaluation of a patient's medical history, ongoing monitoring of medication effectiveness, and adjustments as needed to optimize outcomes.

In addition to medication management, psychiatric nurse practitioners also excel in psychotherapy, employing various therapeutic modalities to address the psychological and emotional aspects of mental health disorders. They establish therapeutic relationships with patients, providing a safe and supportive environment for individuals to explore their thoughts, emotions, and behaviors. Through psychotherapy, psychiatric nurse practitioners help clients develop coping strategies, enhance problem-solving skills, and promote self-awareness, fostering long-term resilience and recovery.

The integration of medication management and psychotherapy by psychiatric nurse practitioners represents a holistic approach to mental health care. This dual focus allows them to address the complex interplay between biological, psychological, and social factors that contribute to mental health challenges. By combining pharmacological interventions with evidence-based psychotherapeutic techniques, psychiatric nurse practitioners contribute significantly to the overall well-being and improved quality of life for individuals facing mental health concerns. Their comprehensive and patient-centered care underscores the importance of a multidimensional approach in the field of mental health.

Helping you reach your goals through medication management and psychotherapy is the purpose of our work together. You can do your part by openly and honestly communicating your thoughts and feelings, even though this may be difficult at times. It is important to note that change takes time and you may feel worse before you feel better. There is a risk of recalling unpleasant events, and you may feel anxious, depressed, frustrated, or hopeless at times. These feelings are a normal part of the treatment process, and are usually temporary. Treatment is a collaborative endeavor and we will work together to get through the difficult times. If you are ever concerned that our work together is not helping, please feel free to discuss the matter with me.

Benefits and Emotional Risks:

The majority of people who obtain behavioral health and Substance use disorder services benefit from the process. The therapeutic process is generally useful to people, however, there are some risks. Some people experience uncomfortable feelings such as sadness, anger, guilt, or frustration. Also, Behavioral and substance use treatment can involve a discussion of unpleasant events and situations in your life. Many people experience a reduction in discomfort over time, as well as improved relationships and better problem-solving abilities. However, there are no guarantees about what your specific therapeutic experience will be. You are encouraged to ask any questions you may have about medications or interventions throughout your therapeutic treatment.

Confidentiality:

A patient’s confidentiality is a legal right and of significant importance to FFW. In most circumstances, your confidentiality is strictly maintained. However, there are certain situations in which FFW is required by law to break confidentiality. Such situations are as follows: 1) FFW believes you are a danger to yourself; 2) FFW believes you are a danger to another person; 3) A case of child abuse, elder abuse, or other disabled person being abused or has been abused in the past.

Additionally, if you are a minor (under 18 years of age) any information shared with FFW that is dangerous, or places you in risk of future danger must be discussed with your legal guardian. This will be discussed in our first session.

In the case of divorce with joint legal custody, consent forms must be completed by both parents.

For Payment:

FFW accepts many different types of insurance as a form of payment for services. As the client you are responsible for co-pays and any late.no show fees. While most insurance policies cover psychological services to some extent, coverage can vary. Please check carefully to determine the exact nature of your coverage. FFW office admin will check your insurance eligibility. If your insurance is not accepted or you do not have coverage, you will be responsible as a self-payer. The fees can be found on our website. Your provider may also wish to complete screenings that are pertinent to your care, if your insurance does not cover the fees, you will be responsible for the screening fees. You are responsible for payment regardless of insurance coverage. Signing this form gives FFW the consent to bill your insurance company for services.

Co-pays are expected at the time of the appointment. If your insurance has a deductible you are required to meet, the payment is expected either at the time of the visit or before the following visit. If you choose to not pay your deductible at your visit you will be sent a bill for the amount. If at any time financially difficulties present a problem in keeping your account current, please discuss the issue with FFW office admin as soon as possible. Failure to make timely payments for services may result in an inability to continue services or provide medication refills.

We may use or disclose your health information without your authorization so that the treatment and services you receive are billed to, and payment is collected from, your health plan or other third party payer. By way of example, we may disclose your health information to permit your health plan to take certain actions before your health plan approves or pays for your services.

These actions may include:

1. Making a determination of eligibility or coverage for health insurance

2. Reviewing your services to determine if they were medically necessary

3. Reviewing your services to determine if they were appropriately authorized or certified in advance of your care

4. Reviewing your services for purposes of utilization review, to ensure the appropriateness of your care, or to justify the charges for your care.

For example, your health plan may ask us to share your health information in order to determine if the plan will approve additional visits to your provider.

Cancellation Policy:

If you must cancel an appointment, please give a minimum of 24-hour advance notice. If you cancel an appointment without giving at least 24-hour notice, you will be charged a no show/cancellation fee of $35. The office is open unless otherwise Specified. Appointments on school and national holidays must be cancelled 24 hours in advance.

Communication Policy:

Please contact FFW through the patient portal through our electronic health record. FFW does not use e-mail as a means of communication. Someone from the office will check the portal Monday through Friday business hours only. FFW admin and clinicians are the only people with access to the portal so you may leave a detailed message and your privacy will be maintained. FFW will address messages left on the portal as soon as possible, but almost always within 24 hours. Do not wait until Friday afternoon to leave messages related to medication refills or non-emergent treatment questions, as these may not be address until Monday. In cases of life-threatening emergency or psychiatric emergency, please call 911, dial 988 for suicide crisis hotline, or go to the nearest emergency room.

Please reserve phone calls to the office for scheduling issues and short matters.

PRIVATE PRACTICE TECHNOLOGY POLICY

This document outlines the FFW office policies related to the use of electronic communication and social media. Please read it to understand how FFW uses the internet as a mental health professional and how you can expect FFW to respond to various interactions that may occur. If you have any questions about anything within this document, We encourage you to bring them up during your session. As new technology develops and the Internet changes, there may be times when FFW will need to update this policy. If we do so, we will notify you in writing of any policy changes.

EMAIL

FFW does not prefer to use email, however, may use email to transmit reports when needed. Please do not email me detailed content related to your treatment sessions as it is not completely secure or confidential. If you choose to communicate with us by email, please be aware that all emails are retained in the logs of your and FFW Internet service providers. While it is unlikely that someone will be looking at these logs, they are, in theory, available to be read by the system administrator(s) of the internet service provider. You should also know that any emails FFW receives from you and any responses that we send to you may become a part of your legal record. If there is an agreement between you and your treating clinician to communicate through email. Clinicians will read and return emails during regular business hours only, Monday through Friday. Clinicians will not communicate via email after hours, on weekends, or during vacations unless otherwise noted. There may be times you get a response during non-business hours, this is an exception and not the rule.

*****If you are experiencing a psychological emergency, call 911, dial 988 for suicide crisis hotline, or go directly to the emergency room as a FFW clinician may not be in a position to check email regularly.

INTERACTING

Please do not use text messaging or messaging on Social Networking sites such as Facebook or LinkedIn, etc. to contact anyone at FFW. These sites are not secure and FFW staff/clinicians are not expected or responsible to read messages on these sites and it cannot be guaranteed that any clinician will be able to respond in a timely fashion. If you would like to contact your provider between sessions, the best way to do so is by patient portal. Calling the office is best for quick, administrative issues such as changing appointment times. At no time should any clinician be contacted through the clinician’s personal cell phone or any other personal conact information.

FRIENDING

No one at FFW will accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc.) FFW believes that adding clients as friends or contacts on these sites can compromise your confidentiality and your respective privacy. If you and a clinician happen to have friends in common on any social media site, please do not contact the clinician via that person’s page or any other public forum. Engaging with any FFW employee this way could compromise your confidentiality. Likewise, a FFW employee will not initiate contact with you via social media or a public online platform. If there is a time, you, as the client continue to attempt to cross the boundary of the client/clinician relationship after being reminded of the policies, you may be discharged from this practice with a list of other practices you may call for follow up care.

USE OF SEARCH ENGINES

It is NOT a regular part of FFW practice to search for clients on Google or Facebook or other search engines. Rare exceptions may be made, including in times of crisis. If a clinician has a reason to suspect that you are in danger and you have not been in touch with the office via usual means (coming to appointments, phone, portal, or email), there might be an instance in which using a search engine (to find you, find someone close to you, or to check on your recent status updates) becomes necessary as part of ensuring your welfare. These are unusual situations and if FFW ever needs to resort to such means FFW will fully document the process and discuss it with you at your next appointment.