PRACTICE POLICY & PROCEDURES

Totality Mindcare owners are licensed healthcare professionals.  The company is engaged in private practice providing medical services, medication management and/or mental health care services to clients through Totality Mindcare .

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While it may not be easy to seek help from a mental health professional, it is hoped that you will be better able to understand your situation and feelings and move toward resolving your difficulties. The mental health professional, using their knowledge of neurobiology, psychopharmacology, and human development and behavior, will make observations about situations as well as suggestions for new ways to approach them. It will be important for you to explore your own feelings and thoughts and to try new approaches for change to occur.

 

During your first appointment, the provider will complete a psychiatric assessment and provide diagnostic and treatment recommendations. This first appointment is a consultation and does not establish a patient-provider relationship. Some patients may be referred to other levels of care for treatment outside the scope of care. However, there are situations where I may be referred to outside providers for treatment. These are per the provider's clinical judgment, and may include but are not limited to: 
•  Assessment & diagnosis for ADHD, Autism, and other complex diagnostic cases .
• Unstable or severe, persistent disorders that require visits more than once per month
•  Drug and alcohol withdrawal 
• Active eating disorders

 

Initial Medication Expectations

You may or may not be started on a medication the first time you meet with your provider.  If you are already on medication, there may or may not be changes made to medication(s) at the first visit.Medications and RefillsThere are no guarantees to the outcomes of medications.  You will be involved in the choice of your prescribed medications and provided with rationale regarding treatment approaches.  You have the right to refuse recommended medications, seek a second opinion, or terminate treatment at any time.  All medications may produce side effects, and some can cause undesired outcomes.  NP will discuss the most common side-effects and you will be provided resources and a discussion concerning each medication.

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Medication Refills

• Please request medication refills at least 3 days before the medication is needed; otherwise, NP cannot guarantee your medication will be filled before you run out.

• Patients are responsible for knowing when medications will need to be refilled and the required method is to ask the provider during scheduled office visits.

• If follow-up appointments are missed or cancelled, medication(s) may not be refilled until next appointment.

• Refills may not be available when the office is closed, it is outside office hours, on weekends and/or holidays. During these hours, patients should call their PCP or go to the emergency room to avoid medication discontinuation and withdrawal effects.

• If a patient has not been evaluated in >6 months, it is our policy to discharge the patient. Letters or discharge summary will not be sent unless requested in writing due to confidentiality reasons.

• There are strict guidelines for controlled substances including medications for ADHD and anxiety. Please review Controlled Substance policy and guidelines for more details.

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Due to the recent increase in controlled substance overdose and related deaths,Totality Mindcare takes the prescribing of controlled substances very seriously. We practice holistically, caring for the whole person rather than just a diagnosis. We care deeply for our clients and want only the best in care and recovery.

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NP does not INITIATE or START patients on any controlled substance medications.  (In mental health, this primarily means stimulants (ADHD meds), hypnotics (ambien, etc.) and benzodiazepines (i.e. Klonopin, Valium, Ativan, Xanax, etc.).If you are currently taking a controlled substance, NP will continue your treatment if you have a long standing well established history and if clinically appropriate.

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Considering this, Totality Mindcare has a strict controlled substance policy that must be signed and adhered to by every client receiving a prescription for a controlled substance.

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We use the Prescription Drug Monitoring Program (PDMP) report for each client. In addition, we may require a completed drug screen test prior to the prescribing or refilling of any controlled substance. We also reserve the right to drug test any client at at any time upon the request of the servicing provider.Totality Mindcare does not diagnose ADHD or conduct ADHD assessments. To participate in Treatment for ADHD at this practice patient must meet one of the following criteria:

• Provide documentation of formal diagnosis via a neuropsychological diagnostic evaluation from a licensed psychologist.

• Patient previously treated for ADHD with stimulants, must show a long well established history.

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Meeting with a provider does not guarantee a prescription of or refill for controlled medications. You should arrange refills with your current prescriber until Totality Mindcare provider has agreed to prescribe or refill medications for you. If the provider has concerns regarding the safety of controlled medications, substance use, or the validity of the ADHD testing or diagnosis, they may not prescribe, stop prescribing, or stop refilling controlled medications and refer you for further assessment or treatment outside of Totality Mindcare .

No Show/Late Cancellation Fees

A no show is defined as a missed appointment w/o prior notification; a late cancellation is a cancellation less than 24 hours before the scheduled appointment time.

•     No shows and late cancellations will be charged a $50 no show/late cancellation fee. 

•     Insurance companies do not cover missed or canceled appointments, so it is patient responsibility for the session fee.

•     After the 3rd no show and/or late cancellation within a 12-month period, you may be terminated from the practice and provided a referral to another prescriber.

Patients who arrive late to an appointment, may not be seen and appointment may be rescheduled.

 

Scheduling

• Appointments are made on the company website at www.totalitymindcare.com or using the patient portal.

• Use patient portal to call to cancel or reschedule at least 24 hours in advance, or your account will be charged for the missed appointment.

• If your mental health professional has to cancel the appointment, you will be entitled to a refund.

• You will receive a link to join the appointment before the appointment starts. You will get a reminder email and/or text message days before the appointment.

• Totality Mindcare allows a 15 minute grace period to be late to the scheduled appointment time, before calling the appointment a no-show, at which point you will be unable to join the visit and charged the no-show fee.

 

Number of Visits

The number and frequency of sessions needed depends on many factors and will be discussed by the mental health professional. Your initial session will involve an evaluation of your needs and depending on your circumstances further evaluative sessions may be required. At the end of the evaluation process the assigned mental health professional will be able to provide you with some first impressions of what medication management and mental health services may include and a treatment plan to follow if both you and the mental health professional agree to work together. You should evaluate this information along with your own opinions of whether you feel comfortable working with the mental health professional. Medication management and mental health services involve a large commitment of time, money, and energy, so you should be very careful about the mental health professional you select. If you have questions about procedures feel free to discuss them with the mental health professional at any time. If you have doubts your mental health professional will be happy to refer you to another mental health professional for a second opinion.

 

Length of Visits

The initial intake and evaluative session is normally scheduled for sixty (60) minutes and may run longer depending on the testing or assessments a client is asked to complete. Further evaluative sessions may be scheduled as needed for the mental health professional to accurately assess your needs. Once the evaluation process is completed sessions are 30-45 minutes in length.Risks of Mental Health Services and Assumption of RiskThere are no guarantees in mental health services and medication management services and the mental health professional does not make any guarantees with this agreement.  You assume the risk of mental health services by signing this form.  The mental health professional is not liable for any adverse reactions to mental health services or medications. The mental health professional may take any reasonable action necessary during mental health services when there is a dangerous circumstance, as determined by the mental health professional. We do NOT prescribe controlled substances. The Company may discharge you at its sole discretion based on the amount of controlled substances you have been prescribed by another provider and the frequency of use.

 

Parent-Guardian Expectation

If applicable, it is expected that a parent or guardian will be present for at least a portion of the minor’s or ward’s appointment at every visit, not just at the initial appointment.  There will be a time during the appointment when we will talk one-on-one with the minor or ward, and also a time we will need to speak with the parent or guardian.

In the event of an urgent situation or an emergency necessitating immediate mental health attention. Call 911 or go to your nearest Emergency Room. If you are able to safely transport yourself, go to the nearest hospital emergency room for assistance.  If your provider is not available to return your call, please don't wait for a phone call back. 

 

You may also  contact one of the following 24-hour emergency resources:
• For emergencies, call 911 or go to the nearest emergency room immediately. 
• Call 988 or text HOME to 741741 to reach The National Suicide Prevention Hotline
•  Or call one the Local crisis resources found on our website, Mental Health Resources

 

If you are a patient who requires frequent crisis management, or has a history of requiring this, you may be better served by a more comprehensive service agency that can better address these ongoing issues. In the event that you are a patient of this practice, we will discuss the issue with you and provide some referrals so you can be better served according to your level of care.

Phone calls or correspondence , outside of appointment visits, may be billed.  Exceptions: you will not be billed for phone calls less than 5 minutes, calls to schedule appointments, or if the NP has asked you to call or scheduled the call.  

- Letter writing, form completion, care coordination, school consultations, and additional services may be billed (starting at $75). 

These fees are subject to change upon thirty (30) days' prior notice to you. If you are unable to pay, or are not willing to pay, the higher fee after receipt of notice, services may be terminated, and you may be given referrals to other competent providers. The Company will look to you for full payment of your account, and you will be responsible for payment of all charges.

 

All payments will be auto charged with a credit card authorization kept on file . 

Totality Mindcare uses a secure electronic portal to maintain your records and communicate with you. The best way to reach the Company is through the secure portal. You will receive instructions on how to access your portal. Your provider is often not immediately available.  There is no guarantee of a response time or a response at all, but we strive for a 2 to 3 business day response time.  If it has been more than 30 days since your last appointment and you have any additional treatment questions, you may need to schedule a follow up appointment. In most circumstances, the appropriate time to discuss any topic outside of rescheduling is at the next session.

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E-Mail

Totality Mindcare may use and respond to email only to arrange or modify appointments. Please do not send emails related to your treatment or mental health services as electronic communications are not completely secure and confidential.

In the case that the healthcare provider(s) are temporarily absent for any reason. The office will notify the patient and arrangements will be made in regards to any treatment or medication refills. If these arrangements require another provider to provide covering services, that provider or office staff will have access to your confidential medical or mental health information during this time.

 

Interns / Student PMHNPs

Totality Mindcare may make use of pre-licensed mental health professionals, which are individuals in the mental health field working toward their professional licensure in mental health services under an approved tract allowed by law. This means that the practitioner does not have a license. The practitioner is authorized to provide services while under supervision of a licensed professional. 

As a courtesy to our clients, Totality Mindcare will try it’s best to verify your behavioral health/mental health benefits with your insurance carrier with your permission. In order to do so, we must obtain a copy of your insurance card and obtain the name, address, and birthdate of the subscriber. Verification of coverage is not a guarantee of payment. Totality Mindcare is not responsible for any mis-quotes of benefits.

Your patient responsibility will be processed according to the explanation of benefits received from your insurance company.  It is strongly recommended that you reference your mental health benefit policy or directly consult your insurance carrier with any questions regarding benefits and participation prior to starting services.

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​All payments will be auto charged with a credit card authorization kept on file . Payment processing dates will not coincide with the date of service due to insurance processing delays, however the date of service should be listed on the invoice receipt.

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**Laboratory orders are provided to outside third parties. Please verify in network coverage with your insurance plans. Patients accept liability for charges arising from laboratory testing, which is necessary for some patients based on psychiatric and/or substance abuse history.