PRIVACY POLICIES

Privacy Policies

Financial Policy


To reduce confusion and misunderstanding between our patients and practice, we have adopted the following financial policies. If you have any questions regarding these policies, please discuss them with our Office Manager. We are dedicated to providing the best possible care and services to you and regarding your complete understanding of your financial responsibilities as an essential element of your care and treatment.

  1. A fee applies for all patients who no show, reschedule, or cancel appointments without a 24 hour notice.
  2. Patients with new insurance(s) or changes to existing insurance(s) should notify us 48 hours prior to appointment. Patients who fail to notify us will have to reschedule their appointment.
  3. We have made prior arrangements with many insurers health plans to accept assignment of benefits. This means that we will bill those plans for which we have an agreement and will only require you to pay the authorized co-payment/coinsurance or deductible amount at the time of appointment.
  4. In the event that your health plan determines a service to be “non-covered”, you will be responsible for the complete charge, any balance due will be collected at the time of service or upon receipt of a statement from our office.
  5. After our office has sent three statements for the balance or the balance is past due more than 120 days the person who is financially responsible for the patient will be turned over to R&R Collection Agency.
  6. You will have 15 days to provide your insurance company information they request (Ex. Coordination of benefits, Pre- Existing condition, etc.). If you fail to do so, you will be responsible for the balance on your account.
  7. For all services rendered to minor patients, we will bill the parent or guardian with custody for payment.
  8. Minors - An adult must accompany any patient under the age of 18 or the appointment will be rescheduled.
  9. Prescriptions - *Triplicate prescriptions (ADD/ADHD Medicines) expire in 21 days and cannot be called in. There will be a $10.00 charge for all lost, expired, or stolen prescriptions.

    *Changes in prescription dosage or medication cannot be made over the phone. You will need to make an appointment if you need refills. * If you need a partial refill before your next appointment, call the pharmacy to request a refill first. After making the request, notify our office as to why you need the refill. *Prescription refill requests made after 3 p.m. are processed the next business day. *Prior authorization for medications takes 2-3 days. Please do not call the office repeatedly. We understand you need your prescriptions and we will contact you once we receive a response from the insurance company.

Confidentiality and Privacy


Permian Psychiatry’s privacy policy addresses the collection, use, and disclosure of information about clients to the extent necessary to provide services while maintaining reasonable safeguards to protect the integrity and confidentiality of the information consistent with the requirements of the Health Insurance Portability and Accountability Act of 1996 and the federal regulations implementing the Act ("collectively referred to as “HIPAA”), as well as other applicable federal and state laws and regulations.

Dr. Medi may obtain, collect, maintain, use, transmit, share and/or disclose information about clients in the administration of its programs, services and activities, and as necessary, to assist clients in accessing and receiving services. Permian Psychiatry will safeguard confidential information about clients, inform clients about the agency’s privacy practices and respect client privacy rights.

Staff will provide a copy of the Notice of Privacy Practices to all clients at the time of their intake assessment or first service and to any person who requests information on Permian Psychiatry’s privacy practices. The client will acknowledge receipt in writing by signing the Consents Form signature sheet. The Permian Psychiatry Notice of Privacy Practices shall contain all information required under federal regulations. The HIPAA Privacy Rules, as well as other federal and state laws and regulations, describe specific actions that a client can take or request to be taken with regard to the uses and disclosures of their information.

*Some Exclusions Apply, Client Privacy Rights
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