Clinic Policies

No Show Policy

We require 24-hour notice of cancellation for any missed appointment - otherwise it will be charged as a "No-Show." We understand that sickness, car trouble, etc. are spontaneous and unexpected. Your therapist will determine whether your missed appointment is a No-Show.

The first No-Show will receive a warning and a $40 charge, to be paid to the treating therapist at your next scheduled appointment and before services are continued.

The second No-Show will result in discontinuation of active therapy and a $40 charge to be paid to the treating therapist.

Cancellation Policy

Any child missing more than 5 therapy sessions during a 12 week period will be discontinued active therapy and placed back on the waiting list per therapist’s discretion. If the child's therapy is scheduled every other week he or she may not miss more than 3 sessions in a 12 week period due to the length of time between treatments. Consistent treatment is crucial to progress and positive outcomes.

Weather Policy

In the event of extreme weather, if you are not comfortable with driving conditions, please call and cancel your appointment. A twenty-four hour notice is absolutely not necessary when driving conditions are questionable. You may call the clinic for more information on local road conditions. 

Cancelled appointments due to driving conditions are exempt from the cancellation policy, however, they are still subject to the No Show Policy if no communication has been attempted. If a person is not reached at the office you must leave a message to avoid being counted as a No Show.

Payment Policy

It is our policy to try to make payments and co-payments affordable for families and we are very willing to work with you. It is ultimately your responsibility to cover payment for services if your insurance company does not cover a service, so please familiarize yourself with your child’s benefits. If you are unable however, to make a payment or co-payment as determined by your policy, please call the office as soon as you are able and make arrangements for a payment plan and subsequent co-pay amounts that will suit your family’s needs.

As a parent or caregiver the detailed benefits, co-pay amounts, deductible amounts, visit limits, authorization expiration dates, etc. are very important for you to know and communicate to our office prior to therapy. You are responsible for notifying the office when a change in insurance coverage occurs or when new cards are issued. If there is a lapse in coverage any and all charges not covered will be billed to you. All charges not covered by insurance for any reason will be your responsibility.

Co-Pays and Private Pay Rates are to be paid on the day of service before or during treatment to the Office Manager at the Administrative Office. If your child is being treated at The Annex you may also dispense payment into the lock box as it will be collected the next day. Failure to pay at the time of service will result in a $2 finance charge per date of service. Any balances over $500 or delinquent for more than 3 months will result in interruption of services.

Notice of Privacy Practices (HIPAA)

As required by the privacy regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

This notice describes how health information about you or your child may be used and disclosed and how you can get access to you "individually identifiable health information". Please review this notice carefully.

In providing therapy services to your child, records will be kept regarding the treatment and services that are provided. I am required by law to provide you with this notice of legal duties and the privacy practices that are maintained in this practice concerning your "IIHI". A copy of the current notice of privacy will be posted in the office and you may request a copy at any time. Your IIHA may be used or disclosed in the following ways:

1. Treatment: Information you provide and records kept will be used to assist in the treatment of your child. Information may be shared with family members, respite or assistant care takers when appropriate for the treatment and care of your child.

2. Payment: Information may be used and disclosed to your insurance company in order to bill and collect payment for the services that you receive. Your health insurance may be contacted to determine extent of benefits and details regarding treatment may be disclosed in order to determine if insurance benefits will cover therapy services. Information may also be used and disclosed to obtain payment from third parties that may be responsible for payment.

3. Appointment Reminders: Information may be used in order to contact you and remind you of an appointment.

4. Treatment Options: Information may be used and disclosed in order to inform you of additional options or alternatives for treatment or services.

5. Release of Information to Family/Friends/Care Providers: Information may be released to a family member, friend or care provider who is involved in your child's care.

6. Disclosures required by law: Information may be used and disclosed when it is required by federal, state or local law.

a. Information may be disclosed to public health authorities that are authorized by law to collect; information for purposes such as

i. reporting child abuse or neglect

ii. preventing or controlling disease, injury or disability

iii. notifying a person regarding potential exposure to a communicable disease or condition

iv. reporting reactions to drugs or problems with products

b. Information may be disclosed to a health oversight agency for activities authorized by law. Oversight activities can include for example: investigations, inspections, audits, licencure and disciplinary actions: civil, administrative, and criminal procedures or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.

c. Lawsuits and Similar proceedings; or in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute but only if you have been informed of the requested.

d. Law enforcement: Information may be released if asked to do so by a law enforcement official in response to a warrant, summons, court order, subpoena, or similar legal process.

Your rights regarding your IIHI:

1. Confidential communications: you have the right to request that information be communicated in a particular manner or location, for example you may ask to be contacted at home rather than at work. You do not need to give reason for your request.

2. Requesting restrictions: you have the right to request restrictions to use or disclose your information only to certain individuals involved in the care of your child or in the payment of services.

3. Inspection and copies: you have the right to obtain and inspect your child’s records, reports and notes.

4. Amendments: you may ask to have records amended if you believe they are incorrect or incomplete.

5. Right to a paper copy of this notice you are entitled to receive a paper copy of this notice of privacy practices. You may ask for a copy of this notice at any time.

6. Right to file a complaint: if you believe your privacy rights have been violated, you may file a complaint and will not be penalized for filing this complaint.

7. Right to provide an authorization for other uses and disclosures: your written authorization will be obtained for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization that you provide may also be revoked by you at any time in writing. After you revoke your authorization your information will no longer be used for the proposes described in that authorization.