Office Policy and Procedure Statement
Welcome to Integrative Behavioral Care, the office of Dr. Violina Frenkel. This document covers the policies and procedures of my practice. Please review the following information and let me know if you have any questions or concerns.
The Initial Visit
Your initial evaluation begins with a 30-60 minute Extended Comprehensive Psychiatric Exam, depending on your specific presentation. During the visit I will take a careful history of the problems you are experiencing, including questions about your current symptoms, your past psychiatrist history, your medical history and other relevant information. I will create a highly personalized, multifaceted treatment plan which may include medications and therapy.
Treatment Philosophy
My treatment philosophy includes a broad range of approaches including psychodynamic and cognitive-behavioral psychotherapy. I believe psychopharmacological interventions are an important part of a treatment plan, but are most often efficacious in conjunction with other non-pharmacological interventions. My services include consultation and medication management. I work very closely with a number of therapists who I refer to if therapy is essential to your treatment.
Medication Management and Follow Up Appointments
Appointments can be made by calling the office at 908-522-6617 or by emailing frontdesk@ibcnj.com. Medications can be prescribed after the initial evaluation has been completed. I respect your budget and will prescribe low-cost drugs if needed. Established patients are always given enough medication and refills until the next office visit. If you have missed or cancelled an appointment, you are responsible to reschedule your appointment in a timely fashion to ensure proper treatment and medication management. If you are going to run out of medication before your next scheduled appointment, please call the office to arrange for medication refills or e-mail at refills@ibcnj.com. Although, Medication Refills are processed electronically, it requires a multi-step approval process. Please ALLOW US 48-72 HOURS to process your request. MEDICATION IS NOT REFILLED ON THE WEEKENDS OR AFTER OFFICE HOURS. Consistent follow-up appointments are necessary for safe medical care.
Telehealth (a.k.a Telepsychiatry or Virtual Appointments)
There are potential risks associated with the use of telehealth. These risks include, but may not be limited to:
· In rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate decision making by the providers and consultant(s);
· Delays in evaluation and treatment could occur due to deficiencies or failures of the equipment;
· In very rare instances, security protocols could fail, causing a breach of privacy of personal health information;
· In rare cases, a lack of access to complete health records may result in interactions or allergic reactions or other judgment errors;
Prohibited Action and Visit Expectations:
1. Not be in a moving car or operate any machinery/appliances/tools, etc.
2. Dress appropriately
3. Can be seen fully via the camera, if needed
4. Be in a secure and safe location
5. Be in a private setting and uninterrupted by surrounding environment/people/pets, etc.
6. Not be eating
Cancellation Policy for Appointments
Your appointment time is especially reserved for you. I do not double book appointments, but give each patient my full attention and time for the entire appointment. If you do not cancel your appointment or do not show up for it, I’m unable to see another patient because the time slot was allotted specifically for you. If an appointment needs to be cancelled or rescheduled, I appreciate as much notice as possible but AT LEAST TWENTY-FOUR (24) HOURS IN ADVANCE DURING NORMAL BUSINESS HOURS. A $50 Fee will be charged for No Show or Late Cancellation. Business hours are considered the weekdays between Monday and Friday, during the hours of 8 am and 5 pm. This means that if you have an appointment on Monday January 7th at 4 pm, you must cancel by 4pm Friday January 4th to avoid being charged. Our office is closed during major holidays; thus, cancelation must be received 2 days prior the appointment, if a scheduled appointment takes place the day after a holiday. Please know it is your responsibility to remember your appointment date and time. All appointment Cancelations and/or changes, must be made through our Front Desk staff and not our Providers. Our email/text system reminders are to assist you to keep track of the appointments but not to replace your own recordkeeping. Repeated late cancellation of appointments and/or failure to keep scheduled appointments by a patient may make it impossible for me to continue serving that patient.
Therapy appointments are 45-60 minutes long. If you are not able to attend full session, you could be charged for the difference in time at self-pay rate.
Insurance
I accept the following insurance: Horizon Blue Cross/Blue Shield (PPO Network plans only) and Cigna.
It may be helpful for you to call your insurance company in advance to check your mental health benefits which may be different than your regular benefits and what your mental health visit co-pay is. For those who have insurance coverage with companies that I am not contracted with, you have the option of paying out of pocket for your treatment and obtaining reimbursement from your insurance company. Please check with your carrier for out-of-network mental health service benefits or pre-approval requirements. You will be provided a bill that gives you my Tax ID Number, the date of service, the proper diagnostic and procedure codes upon each visit. It is ready to be filed with your insurance company for reimbursements according to each patient’s health plan.
Fees & Payment Information for Self-Pay clients without office’s accepted Insurance coverage
Initial consultation:
Board Certified Psychiatrist (M.D.) – $600
Advanced Psychiatric Nurse Practitioner (APN-C) – $450
Medication Management & Psychotherapy – $300
Psychotherapist (LCSW) – $250
Follow-up visits:
Medication Management/Counseling:
Board Certified Psychiatrist (M.D.) – $200
Advanced Psychiatric Nurse Practitioner (APN-C) – $200
Psychotherapist (LCSW) – $165
Medication Management & Psychotherapy – $300
All co-payments and co-insurance amounts are collected at the time of service. In addition, due to the growing trend toward high deductible plans, please be aware that we will collect an estimated payment for our services at the time of the appointment. Should your insurance pay these procedures in full, we will refund your payment upon receipt of the insurance payment.
Service invoices/bills for the balances or due payments will be sent electronically to an e-mail(s) on file unless otherwise requested in writing to billing@ibcnj.com.
At my office, I accept cash, personal check or credit card payments. Please note that any non-sufficient checks will be charged a $40.00 NSF fee.
If, after 90 days, your insurance has not paid your claim(s), payment in full is expected from you. It is your responsibility to pay the deductible amounts, coinsurance, or any other balance not paid by your insurance company. You are ultimately responsible for your bill.
Forms, disability paperwork or letters written on behalf of the patient which take greater than a ten-minutes duration will be charged a fee of $50.00. If you would like for me to complete a school/court report or any other paperwork or any type of letter, I’m happy to assist; however, the fee will be the prorated amount of her hourly fee to cover the time I spent on it.
A $75 fee will be charged to any credit card charge that is disputed for administrative time required to respond to dispute.
SuperBills will be provided free of charge but repeated requests for previously provided SuperBills may incur a $25 Administrative Fee.
Medical/Professional Records
Both the law and the standards of our profession require that I keep appropriate treatment records. You are entitled to review a copy of the records, unless I believe seeing them would be emotionally damaging, in which case, I will be happy to provide them to an appropriate mental health professional of your choice. Because these are professional records, they can be misinterpreted or upsetting, so I recommend that I review them together with you so that I can discuss what they contain. I can also prepare an appropriate summary for review. Clients will be charged an appropriate fee for any preparation time that is require to comply with any information request. Records will not be released if
there is an outstanding account balance until the balance is paid in full. It may take up to 30 days to review and prepare your or 3rd party’s records request.
N.J. Admin. Code § 8:43G-15.3 (Google this Code):
“The fee for copying records shall not exceed $ 1.00 per page or $ 100.00 per record for the first 100 pages. For records which contain more than 100 pages, a copying fee of no more than $ 0.25 per page may be charged for pages in excess of the first 100 pages, up to a maximum of $ 200.00 for the entire record; 2. In addition to per page costs, the following charges are permitted: i. A search fee of no more than $ 10.00 per patient per request. (Although the patient may have had more than one admission, and thus more than one record is provided, only one search fee shall be permitted for that request. The search fee is permitted even though no medical record is found as a result of the search.)”
Confidentiality
Confidentiality is the cornerstone of mental health treatment and is protected by the law. I can only release information about our work to others with your written permission. Some basic information about diagnosis and treatment may be required as a condition of your insurance coverage. Exceptions to confidentiality where disclosure is required by law:
· If there is a threat of serious bodily harm to others, I am required to take protective actions, which may include notifying the potential victim, notifying the police, or seeking appropriate hospitalization.
· If there is threat to harm yourself, I require to seek hospitalization for the client, or to contact family members or others who can help provide protection
· If there is an indication of abuse to a child, an elderly person, or a disabled person, even if it is about a party other than yourself, I must file a report with the appropriate state agency.
· If you are involved in judicial proceedings, you have the right to prevent me from providing information about your treatment. However, there are some circumstances in which your emotional condition is an important element, and a judge may require my testimony.
If due to mental illness, you are unable to meet your basic needs such as clothing, food, and shelter, I may disclose information in order to access services to provide for your basic needs. If I feel you are in acute danger to yourself or others, I am required to take appropriate action and to contact appropriate parties involved.
These situations have rarely arisen in my clinical practice, but should such situation occur, I will make every effort to fully discuss it with you before taking any action. I may occasionally find it helpful to consult with other professionals. In these circumstances, I will make every effort to avoid revealing the identity of you as my patient. The consultant is also legally bound to keep the information confidential. Confidentiality is waived if there are any disputes of charges if documentation is necessary to show proof of service or in situations in which we have been unable to receive payment for service and have to pursue legal measures. You also acknowledge that you allow us to contact you via text message or voice messaging to remind you of your appointments. If you do not wish to be contacted, you will need to specify this in writing and let us know directly, otherwise we will use the number you provide to contact you.
As it is our philosophy to provide a collaborative, comprehensive care model, patients may be referred to see multiple providers within the office. By signing our treatment consent, you are consenting that you understand and give permission for collaboration between providers within NJHW through verbal, electronic, or paper communication. You also acknowledge that a covering or supervising provider may also need access and if applicable, you consent to this as well. Certain supervision requirements are required at state and organizational levels and your consent also extends to the supervising party if applicable. Your signature also provides consent to allow us the right to speak to your other medical providers outside NJHW if it is regarding an issue that could urgently affect your health or well-being. This is our policy so that we can provide the safest and most comprehensive care to you. Your signature on our treatment consent acknowledges you’ve read and are in agreement with all of the above
Contacting Clinician
Some of our clinicians choose to give their personal cell phone numbers to their patients. This being said, your signature acknowledges that you have been informed and are agreeing that the personal contact of the provider is not appropriate in case of an emergency. You’re acknowledging that in an emergency you will contact 911 or go to the nearest emergency room. You also acknowledge that contacting a clinician does not take the place of an actual appointment. The abuse of this privilege will result in the loss of this privilege and is at the provider’s discretion. You are acknowledging that this is a PERSONAL cell phone and the provider has no obligation to return communication and it is not to be treated as the primary line of communication in reaching the office / provider.
Non-Payment:
If you are ninety days overdue in paying for services, I reserve the right to utilize legal resources such as collection agencies, or small claims court to collect payment. Any unpaid or uncovered services may be submitted to the patient as well as the insurance policy holder to obtain payment. Any legal and/or collection fees are the policy holder’s responsibility.
Termination of Treatment
We reserve the right to terminate treatment with a patient if there is a breakdown in rapport that makes it difficult or impossible to continue offering treatment. This could be due to threatening or abusive behavior towards office staff, sexual advances, repeated no-shows, treatment non-compliance that jeopardizes patient’s safety, refusal to follow the treatment plan or violating the terms of the treatment contract such as failure to pay bills and/or being in the collection. Payment Plan balances must be paid within 45 days. No appointments would be allowed until the Collection Balance is paid in full.
Emergency and Urgent Calls
If you are in a situation in which your physical health or safety is in danger, or someone close to you is in danger, please call 911, text to 988, or proceed to the nearest emergency room for service.
For other questions please call the office and leave a message including your name, contact number(s), best time to call, and reason for calling and I will make every effort to return your call the same day. Messages left late in the day or on weekends/holidays may not be returned until the following business day.
When I’m Away
I make coverage arrangement with local psychiatrists. Covering psychiatrist may be reached through our regular office number.
Privacy Practices
This policy explains how the office may use and disclose information about you; it also informs you of your rights as a patient/guardian. Your privacy is extremely important to me, and I will not release any identifying information about you without proper consent. There are exceptions to this rule mandated by the Health Insurance Portability and Accountability Act (HIPAA). These situations include those in which there is an immediate threat to your safety or the safety of others, child or elder abuse, and cases of domestic violence. In addition, health information may be shared with your insurance company for purposes of prior authorization for services. A full explanation of HIPAA is given to all new patients, and a copy is available upon request.