Practice Policies

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Welcome to A1 integrated Wellness, LLC, where we care for your mind, body, and soul.  We are committed to providing the utmost care for your mental health and whole-body needs. Our primary focus is mental health; however, we approach this care in a holistic way by taking care of the person as a whole being.  Please read the following policies as they relate to our practice.  Please take the time to review and fully understand this document.  You will be required to sign and date at the end should you want to proceed with services at our practice.  Your signature will indicate that you agree with and understand the policies of A1 Integrated Wellness, LLC. Thank you.

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Office Hours:

• Business days are currently Tuesday, Thursday and Saturdays. There will not be any disruption of time on Saturdays.  Shall there be a proposed change in practice days and hours; A1 Integrated will attempt to make notifications in a timely manner of such changes via our website at: www.a1integratedwellness.org

• Please check our website for observations of holidays and closures.

• Please note that we do not schedule/cancel appointments or refill medications after hours, on holidays, or non-business hours/days.

Consumer Etiquette:

• Disrespectful/abusive behavior or harassment towards office staff will not be tolerated and patients will be immediately terminated from this practice should this occur.

Fraternization:

• There is never room for a romantic relationship between patients and staff of A1 Integrated Wellness, LLC.  Providers/staff are prohibited from socializing with patients outside of the therapeutic sessions.  Staff of A1 Integrated Wellness, LLC are prohibited from contacting patients via social media and staff are prohibited from accepting “friend/contact” requests from patients via social media.  It is important that your provider has a professional and therapeutic relationship with you and, therefore, not any other type of social or personal relationship.

Services:

• Services provided at A1 Integrated Wellness, LLC are provided by licensed Psychiatric Mental Health Nurse Practitioners and Board-certified Physicians.  Services will include assessment, diagnosis, medication management, collaboration with your external health care team for an integrated approach, and referral to specialist providers and therapists for total care as appropriate.

• We treat depression, mood disorders, anxiety (non-benzodiazepine therapy), obesity, tobacco dependence, schizophrenia spectrum disorders, PTSD, ADHD treatment for children ages 6-17, insomnia, and panic disorders. We treat clients starting from the ages of 6 and up. Laboratory diagnostics may be ordered as a separate expense not included in the fee of the patient evaluation/session. The patient will be solely responsible for payment of their laboratory expenses as it will not be the responsibility of A1 Integrated Wellness. Completion of necessary lab work may be required prior to initiation or continuation of medication therapeutics. Such laboratory analysis is recommended to ensure that issues of metabolic and cardiometabolic processes are not present or progressing.  Please note that several medication therapeutics needed for specific mental health conditions may cause issues with glucose metabolism, etc… In such instances, your provider at this practice will make you aware on analysis of practice ordered laboratory diagnostics.

• Services are voluntary and cash based, so a referral from your primary care provider is not required.

• A1 Integrated Wellness, LLC is not able to co-manage psychiatric conditions with other psychiatric providers who prescribe medications; therefore, it is expected that you only receive psychiatric medications with your provider at A1 Integrated Wellness, LLC. It is the right of the patient to assume psychiatric care elsewhere, but A1 Integrated Wellness, LLC will not co-manage your mental health.

• We do not perform disability determinations or fill out paperwork for short-term or long-term disability, Social security/disability, or workers compensation.

• We do not write letters in support of an Emotional support animal.

• We do not provide forensic services such as custody evaluations, assessments recommended by probation or ability to stand trial, legal matters of medical opinion, etc. 

• We do not fill out paperwork for any organization unless you have been a patient for 6 months or longer or have been seen a minimum of 7 times. In such instances of paperwork completion, a dollar fee will be proposed for completion not to exceed $75.00; complexity of the form will determine such fees.

• We do not offer neuropsychological or psychoeducational testing or evaluations for bariatric surgery.

• In some instances, A1 Integrated Wellness may not be best suited for higher levels of care; in such occurrences, A1 Integrated Wellness may give you information for referrals to specialists that are better suited for your mental health needs.

Forensic Affairs:

• If your provider at A1 Integrated Wellness is subpoenaed to appear in a court action involving the care that was delivered to you, you will be charged a fee for court appearances.  Please note the fees related to court cases (preparing for deposition, travel time, court time, etc.) are billed at a higher hourly rate than basic services.  For more detailed information, please refer to our website.

Controlled Substance Policy:

• As a policy, A1 Integrated Wellness, LLC do not prescribe habit forming medications for management of mental health.  These medications may include all medications that are identified as a controlled substance, benzodiazepines, hypnotics, Gabapentin/Pregabalin, or other medications that may be utilized which may cause tolerance, dependence, withdrawal, and potential for abuse.  In situations of ADHD, management will be provided on a case-by-case basis.  For insomnia, medications will be short-term, no more than 90 days; behavioral modification for insomnia will be advised primarily.

• A1 Integrated Wellness, LLC may not prescribe controlled substances to patients who utilize illicit substances, marijuana, and persons with alcohol dependence.

• We will not replace lost or stollen prescriptions for controlled substances without a police report.

• Stimulant medications will be withheld from patients with a history of hypertension unless the patient’s blood pressure is in good control under the management of a primary care provider.

• Persons with known cardiac disease or strong family history of cardiac disease will not be prescribed stimulant medications without the clearance from a Cardiologist at the patient’s own expense.

• Stimulant medications will be prescribed in 30-day increments only.

• Stimulant medications for the treatment of ADHD will be provided to children, ages 6-17.  We reserve the right to require random drug screens which may be obtained via urine or saliva specimens to obtain further refills and treatment.  We may also request that this population have a stimulant contract on file and abide by requests for pill counts.  If you are prescribed a controlled substance such as a stimulant and do not comply with a pill count or drug screen within 48 business hours/days; you may be terminated from this practice.

• Please note that it is a felony to divert your prescribed controlled substance medication; it is also a felony to accept a controlled substance medication from the same (or similar) class from any other prescriber without both of those prescriber’s consent and notification.  This is referred to as, “Doctor shopping”.  If you receive controlled substances from another prescriber and do not notify this clinic, you will be terminated from this practice.

Crisis Management:

• A1 Integrated Wellness, LLC does not provide crisis management or emergency psychiatric services.  If you are in crisis, are having suicidal/homicidal ideations, severe adverse medication reactions, or other emergencies that may be life threatening; please call 911 or go to the nearest emergency room.

Hospitalization:

• A1 Integrated Wellness, LLC does not have admitting privileges to any hospital.  Should you experience a crisis, safety issues, you will be advised/directed to go to the nearest hospital emergency room for evaluation and possible admission.

Forms of payment/Fees:

• A1 Integrated Wellness, LLC is a cash practice only; other acceptable forms of payment may include Zelle, and Care Credit ® for limited services.  Care Credit ® is not affiliated with A1 Integrated Wellness, LLC; Care Credit ® is a separate entity which allows consumers to pay for health and wellness.  The website for Care Credit ® may be accessed via visiting their site at: https://www.carecredit.com

• You may pay via your employment’s flexible spending account or health spending account (FSA or your HSA), however, A1 integrated Wellness, LLC will not be responsible for terms of your FSA/HSA submissions; such submissions are the responsibility of the patient. After completion of appointments, A1 Integrated Wellness, LLC will provide you with a receipt for services rendered.

• Fees may be viewed on our website for our customary charges; please note, A1 Integrated Wellness, LLC reserves the right to change the fee structure; please review our website for such changes and notifications.

• Consent for treatment/treatment issues:

• All treatment is strictly voluntary, and you may choose to stop treatment at any time you wish. If you experience any problems with medications, it is your responsibility to inform your provider of such issues.

Confidentiality:

• All information within your appointment is confidential.  Any confidential information disclosed during treatment, or any other confidential information we obtain while attending to you professionally, shall be held in confidence unless you permit us to disclose such information.  Confidentiality will be broken shall you disclose that you want to harm yourself or others; instances of court order/subpoena, as well in instances of child/elder/vulnerable person abuse.  If a mental illness prevents you from providing your own basic needs such as food, water, shelter, we will be required to disclose information to seek hospitalization.  If there is a reasonable degree of certainty that a patient can not operate a motor vehicle or heavy equipment/machinery due to epilepsy, dementia, traumatic brain injury or any other cognitive dysfunction; confidentiality will be broken.

Mental health records:

• Medical records are required by law. A1 Integrated Wellness, LLC currently uses an electronic health record to record and store patient information.  This electronic health record system is secure and abides by the HIPAA laws and regulations.  However, as with all electronic health systems, there are factors that are sometimes outside of our control.  We will strive as always to ensure that your information is secure, confidential, and compliant with HIPAA regulations.  A1 Integrated Wellness, LLC reserves the right to change the electronic health record system at any time.

Appointments:

• Currently, we will operate via a telehealth/online platform.  At a future date we may offer in-person visits.  We will notify patients via our website; please continue to view our website for practice updates and notifications.

• It is the patient’s responsibility to complete the appointment in a safe, private, and uninterrupted location that is conducive for the therapeutic evaluation. 

• All providers at A1 Integrated Wellness, LLC will respect confidentiality and patient’s privacy by conducting all appointments in private and confidential settings.

• A 25% deposit will be required at the time of booking to schedule your desired date/time.  Deposits will be in the form of cash or other acceptable means of payment as noted in our policy on fees.

• Please note that you are ultimately responsible for all charges incurred for your treatment. Full payment for services may be made prior to your scheduled appointment or at the time of the scheduled appointment.

• Services for treatment will not be provided until full payment of services are rendered by the patient before the scheduled appointment.

• Initial appointments will last approximately 45 minutes to 90 minutes.  During this appointment, interviews of history will be conducted; screenings for evaluation and review of medication will be completed.  Please bring all medication bottles with you to your first appointment or a current list via pharmacy or patient portal from all providers.  If you have received laboratory work within the past 3-6 months; please bring your results. Please bring the contact information of all your current providers and past mental health provider (s) so that we can obtain collateral information, if needed.

• Follow up appointments are shorter in duration; these may take approximately 15 to 30 minutes in length. Follow up appointments are scheduled according to monitoring and medication therapeutics evaluation.  Appointments for children or unstable patients may be more frequent due to the nature of such mental health conditions.

• Appointments are provided for the time with your specialist and do not guarantee any specific medications, treatments, and/or letters.

• Appointments are expected to start and end on time.  Please be aware if your appointment extends beyond the allotted time for any reason, you will be charged for the additional time.

• For A1 Integrated Wellness’s provider absence/cancellation/illness, we will make every effort to provide you with adequate notice if the provider is unavailable.  We will reschedule your appointment in a timely manner without any additional cost beyond your deposit.  Total payments for services rendered remains applicable at completion of appointment during rescheduled time.

• Provider vacations: A1 Integrated Wellness, LLC will notify patients at least 2 weeks prior to the provider’s scheduled leave.  Necessary medication refills will be completed prior to the provider's scheduled time of leave.  Should the provider be unavailable due to an unforeseen event, i.e. family emergency, personal health emergency, illness, or other emergent issues; A1 Integrated providers will notify patients as soon as possible.

• Please be aware that the audio or video recording of any session is not permitted.  If an unauthorized recording is made, it is grounds for immediate termination of the therapeutic relationship.

• Late arrivals, no shows, and late cancellations.

• We do not double book appointments; so, your appointment is solely dedicated to your desired time and date.  If you are not able to come to your appointment, please reschedule your appointment via the patient portal within 48 hours of your scheduled appointment, excluding weekends and holidays.  Your appointment can be rescheduled at no additional cost.  Shall you do not cancel your appointment within the 48-hour time frame without valid medical emergency i.e. hospitalization (documentation may be requested), you will forfeit your 25% deposit fee.  At A1 Integrated Wellness, we value your time and wish to provide you with respect as we strive for mutual respect.

• An appointment cancelled without at least 48-hour notice is considered a No show/late cancellation and may not be rescheduled.  Failure to show up for your first appointment may also result in an inability to schedule further appointments. Stating that you did not receive a reminder notification does not exempt you from a no-show/late cancellation occurrence.

• Shall you arrive more than 10 minutes late for any appointment, you will be asked to reschedule so that an appropriate amount of time and attention may be devoted to your care.  You will still be responsible for payment for the total amount of time of the late session.

• Failure to show at follow up appointments on 2 multiple occasions or violation of this cancellation policy may result in discharge from this practice.

• If you fail to schedule and/or you have not been seen for 90 days or more, your health file will be terminated by this clinic and A1 Integrated Wellness, LLC will no longer be your psychiatric service provider, unless plans have been made to the contrary.  Once your chart/file is closed, you will no longer be considered a patient of further care and no refills of medications will be provided.

Medication refills/disclosures:

• At your appointment, you will be provided with enough medication until your next recommended follow-up appointment.  When medications are first prescribed, patients are generally seen more frequently to assess medication efficacy and upon stabilization.  The frequency is determined at the most recent visit with the provider.  Medications are refilled only for patients who are active in treatments.  The longest interval in between visits is typically 3 months, even if you are stable on your medication.  A1 Integrated Wellness, LLC does not prescribe in states that they are not licensed and will only prescribe within the states that they are licensed.

• If the patient misses or cancels a scheduled appointment and require a medication refill before your next scheduled appointment, a charge may apply to such refill services.

• Before contacting A1 Integrated Wellness, LLC, please contact your pharmacy directly to ensure that you do not have additional refills on file.  We do not respond to pharmacy-generated automated refill requests.  If you need a refill of your medication and there is not one on file at the pharmacy, please contact the clinic.

• Should the patient relocate outside of the provider’s prescriptive/licensed state; only a 30-day supply of medication will be provided.  It will be the responsibility of the patient to locate a mental health provider in their new place of residence.

• Should a patient decline continued services from the practice within the state of the provider’s license, a 30 day only supply of medication will be provided; it is the patient’s responsibility to locate a new mental health provider.

Communication:

• The preferred method of communication is through A1 Integrated Wellness, LLC secure patient portal.  You will get the fastest and most complete response if you state your concern by sending a message through the patient portal.  Please note that all communications will be added to your medical records.  Messages received through the patient portal are checked during our business hours only as noted above.  Messages received after hours, holidays, and non-business days are reviewed during our business hours.  Please allow up to 2 business days/hours of A1 Integrated Wellness, LLC to respond to portal messages.

• Electronic communication: Portal communication is not for emergency or urgent issues.  Please do not send us a message of such nature through the portal.  Please note, if you need immediate assistance, such as you are having suicidal or homicidal thoughts, a serious medication reaction, health issues that are life threatening, or any emergency, please call 911or go to the nearest emergency room.

• A1 Integrated Wellness, LLC does not communicate health information, medication requests, or other confidential information via text or email.  These communication types are not protected and cannot be guaranteed as private.  Communication will be conducted via the portal platform; you may receive as appropriate text and email notifications of billing and appointments.

• Forms:  Through the patient portal, we may send you questionnaires/documents necessary for your evaluation.  Please complete any form/questionnaires to the best of your ability.  For initial assessments, please complete the forms at least 3 days prior to your scheduled appointment, for follow-up appointments, please complete all documentation at least 24 hours prior to your scheduled appointment.

• Phone calls:  Phone calls are accepted during our practice hours.  Should voice mail becomes available, please leave a voice message of non-emergent/urgent matter.  For issues of emergency, such as outlined in our electronic communication policy, please call 911 or go to the nearest emergency room.  Most routine calls are returned within 48 hours during the above stated business days/hours.  Brief phone calls of 5 minutes or less are not charged.  Phone calls that are greater than 5 minutes and require clinical management will incur a charge for clinical services and will be documented in the patient’s record.

Discontinuation of treatment:

• The practice may discontinue treatment with a patient which constitutes terms of termination as aforementioned in our policies.  We may also terminate services for the following reasons:

• Non-payment of your account.

• Canceling/missing appointments too often.

• Non-compliance with treatment recommendations.

• Withdrawal of treatment due to medical, geographical, financial, or legal problems.

• Lack of attendance and or motivation that prevents further progress towards goals for mental health.

• Inappropriate behavior.

• Modification of medications prescribed by A1 Integrated Wellness, LLC providers.

• Medication diversion, misuse, and abuse.

• Patient chooses to terminate treatment. Patients must advise this practice in writing, in person, or by phone of termination of treatment.  This notification will be added to the patient's chart.

• If you discontinue treatment without notifying your provider at A1 Integrated Wellness, LLC, it will be assumed that your therapeutic relationship with him/her terminated 90 days after your last visit, unless you have an appointment scheduled for a future date.  You may re-enter treatment with your provider at A1 Integrated Wellness, LLC if your treatment ended in good standing and he/she is accepting new patients.

Thank you for reading through this important information.  As previously mentioned, should you choose to begin services with A1 Integrated Wellness, LLC, your signature is required as agreement to the terms of these policies and suggests that you agree.