Office Policies & Procedures
Amazing Grace Mental Wellness Care Policies and Procedures Section
OFFICE POLICIES
Thank you for choosing Amazing Grace Mental Wellness Care! We realize that you have a choice in medical providers and are pleased to partner with you on your healing journey.
Consent to Treatment
You will be asked to sign a “Consent to Treatment” at your initial visit and as required by your specific treatment plan. Each step we take to assist you will be explained clearly, so you understand both the benefits and challenges of each treatment recommended.
Privacy and Confidentiality
The privacy of all medical records and other individually identifiable health information will be protected at all times. You will be offered a copy of our Notice of Privacy Practices at your initial visit.
Hours of Operation
Our office is open Monday-Saturday by appointments only. Occasionally, clinicians may schedule appointments outside of regular office hours. If you need an appointment, prescription refill or test results, feel free to leave a voice mail message for any “non-emergent” matter. We attempt to return each call no later than the following business day.
Cancellation, “No-Show” and late to appointment Policy
Our goal is to provide quality medical care in a timely manner. We have implemented an appointment/cancellation policy to enable us to efficiently deliver care to all our patients. We request a minimum 24-hour notice if you will be unable to attend your scheduled appointment. If you are 15 minutes late to your appointment you will be asked to reschedule to another time.
• All patients who fail to attend or cancel without a 24-hour’s notice will be assessed a $150 fee.
• Your card will automatically be billed 24 hours prior to your appointment if payment is not received. Please note: these fees must be paid before future appointments will be scheduled or medication refills will be prescribed. If you arrive late to your appointment, you may need to be rescheduled. The above cancellation policy enables us to better utilize available appointment time for all our patients.
Excessive no shows or late cancellations
It is important for you to keep your scheduled appointments as it allows us to maintain your mental health needs and prescribed medications. If you miss 3 scheduled appointments without notification or incur excessive late cancellations (less than 24-hour’s notice) of your appointments, you may be discharged from our practice. If it is determined that you will be discharged from the practice due to the causes listed above, you will receive a letter of notice via U.S. Postal Service Certified Mail.
Payments
You are expected to pay all co-payments, deductibles and account balances at the time of each appointment. If your account has an outstanding balance for more than 90 days, we may refer your account to a collection agency and/or discharge you as a patient from our practice.
Medical Records
Per HIPAA guidelines, copies of medical records must be requested in writing. To ensure your privacy, a form for release of medical information must be completed prior to receipt of these materials.
Prescription refills & pharmacy information
Please allow one to two business days for refill requests. If you need a medication refill prior to your next scheduled appointment, please call our office as soon as possible. There are some prescriptions we cannot refill over the phone, and we may need to see you in our office before prescribing medication for you. If you miss an appointment and run out of medication, you will need to schedule a new appointment as soon as possible.
Insurance benefits assignment and reimbursement
In order to file a claim with your insurance company, you will be asked to sign a “Consent 7 Treatment” form. By signing this form, you are giving Amazing Grace permission to bill your insurance carrier. This form does not guarantee that we will receive payment for services rendered. The patient, or guarantor, is liable for all charges. Some insurance companies require “preauthorization” prior to treatment although this preauthorization does not guarantee payment. Amazing Grace Mental Wellness Care will assist you in understanding insurance determinations per your specific plan.
CRISIS SITUATIONS
For a mental health emergency or crisis situation do one of the following based on the severity and appropriateness of the situation:
• Call the Suicide Hotline at 1-800-SUICIDE or 1-800-273 TALK
• In Franklin County, call Netcare (24-hour psychiatric emergency service) at 614-276-2273
• If you live outside Franklin County, contact your local mental health center for crisis services
• Call 911 or go to the nearest Emergency Room.