We may occasionally update our policies. Use of our services after an update constitutes consent to the updated policies to the extent permitted by law. This policy is valid for NeuroScience & TMS Treatment Center (NSTMS). It is very important that you read and understand all the policies.
INITIAL APPOINTMENT DEPOSIT PAYMENT
A deposit payment* for the initial appointment is due prior to scheduling the appointment ($175). This payment reserves the appointment. This deposit will be applied to the cost of the initial appointment and it ensures that the clinician is paid a portion of the total fee, if the patient does not show for the appointment or cancels less than 72 hours prior to the New Patient appointment. If the clinician you see is in-network with your insurance, your deposit will be applied to the amounts you owe (deductible, co-pays, and co-insurance). If we are in-network, you will be responsible for your specific deductible, co-payment, and co-insurance. If you do not show up for your new patient visit, you will be responsible for the Full charge of the visit; for a new patient appointment = $395; for a TMS or Spravato Consultation = $350); the deposit only covers part of this charge, regardless if we are in-network.
*If your insurance payment covers your charges, your deposit can be refunded, or credited to your account.
We have a 72-hour (Three business-day) cancellation policy for all appointments. If you do not show or do not cancel within the notice period, you will be obligated to pay the full fee of the service. This cancellation policy includes virtual visits. Notification must be received by 4:00 pm to be counted on that business day. The Cancellation fee is NOT billable to insurance.
As a courtesy, our electronic medical record provides appointment reminders via email or text as approved by the patient (or parent/guardian), in addition, staff may call to remind of an upcoming appointment. These reminders (electronic or phone) are not guaranteed and not receiving a reminder is NOT a reason not to avoid paying for missed or canceled appointments. These reminders may be incorrect as we are unable to edit the reminders from our Electronic Medical Record, for instance, if you know that your appointment is scheduled as virtual and the reminder says the appointment is at the office, your appointment will still be virtual.
NSTMS office staff employees typically answer telephones from 9 am to 4 pm, Monday through Friday. If we are assisting other patients OR if you are calling after hours, your call will go directly to voicemail. We check and respond to voicemails regularly during office hours. If you need to speak with a clinician urgently or emergently during or after office hours, you will be billed accordingly. If considered medically appropriate by the clinician, calls can be scheduled with clinicians and will be billed at their prorated hourly rate.
USE OF VIRTUAL APPOINTMENTS/VIDEO APPOINTMENTS FOR CLINICAL COMMUNICATION
Our clinicians may communicate via a video chat format like Doxy.me, Zoom, Skype or Google Video. A patient, who uses this form of communication, agrees and understands that this form of communication has substantial and inherent security risks and hereby allows such communication. These video calls will be billed at the clinicians prorated hourly rate or if covered by in-network insurance at the agreed upon rate. If a patient does not approve of this form of communication, then the patient must refuse such forms of communication and give us notification as such in writing. Face-to-face visits, and direct phone calls offer the only, more secure alternative.
Virtual visits with clinician must comply with state and local laws, and with the clinician malpractice coverage. You will be required to be within TN in order to be seen by a Prescribing Clinician at NSTMS. In addition, your insurance coverage may not cover charges for virtual visits in the same way that they do for face-to-face visits.
For virtual visits, please be prepared and be ready for the virtual visits before the scheduled time; sit with your telephone, and make sure that you can receive calls from unidentified numbers. If you are doing a video call, prepare your room, your computer, phone, or ipad before your scheduled appointment.
HIPAA COMPLIANT TEXT LINE – 615-551-5853
We have a secure, HIPAA Compliant Text Line which patients, and potential patients can use to communicate with staff during office hours, 9-4pm (Monday thru Friday, except federal or observed federal holidays). Clinicians & Therapists may send you information from an appointment, links for virtual visits, or confirmation of refills via this Secure text line. The Clinicians & Therapists can access the test line, but these clinicians and therapists do not monitor the text line; monitoring of the text line is by staff. The text line is not meant to be used as immediate access to a clinician or therapist; the text line can not take the place of a visit with your Clinician or Therapist. Important private information shared via this text line is shared with all staff and clinicians in the office. Urgent or Emergent issues should be handled with a phone call or emergent page to the clinician on call. As a potential patient or patient, you should consider text messages, like emails to our office. This is another (perhaps more efficient way) to communicate with staff to reschedule appointments, schedule appointments, ask a non-clinical question, etc. All clinicians can see these communications and these communications can be included as part of your electronic medical record.
We provide an on-call service for our current patients. Calls after hours will be managed and charged by a clinician on-call. Note: our clinicians rotate call coverage, so your primary clinician may not be the clinician on-call.
HOURS: Regular office hours are by appointment only.
USE OF EMAIL:
If you provide us your email or originate an email to us, then you agree with the use of email with our office. Please note that your email system may be insecure and with continued emails, you are accepting the inherent privacy risks.
EMAIL IS NOT FOR MEDICAL EMERGENCIES OR URGENT QUESTIONS:
Please do not use email for urgent or complicated issues that should be properly addressed via a consultation or at minimum a scheduled phone call to the office staff and provider. We use email for administrative purposes, like billing, receipts, scheduling, and patient feedback. We only use email from the domain name healnashville.com or nashvilletmsdoctor.com or hopeforyourbrain.com or TMSworkbook.com.
Please DO NOT accept any emails from other domains regarding care from our clinic. Patients, family members, and patients understand that using email has some inherent security risks. If you do not want us to use email to communicate, then give our office notification in writing and do not supply your email to us. If a patient originates an email to us, then they, therefore, give us permission to communicate with them via email. Clinicians responding to email may charge for their time, at a prorated hourly rate. Email communication with a clinician is a NON-COVERED charge which cannot be billed to insurance.
PRESCRIPTION & REFILLS:
We prefer face to face or virtual appointments, and generally do not prescribe medication outside office visits. Medication refills will only be handled during office hours, during scheduled appointments, and only if as a Patient are CURRENTLY under our care. If a patient is prescribed medication, a Patient will be given enough medication to last until a Patient’s next scheduled appointment. If a Patient’s appointment is rescheduled because of unforeseen circumstances, contact the office staff to arrange for medication refills. The best way to get a refill, if it is approved, is to contact the office directly. Allow at least THREE business days (72 hours) for refills. Please Do NOT wait until you are out of medicine to request a refill. Prescription Refills Outside of an office visit, if allowed, cost $50 (fifty dollars). This prescription refill fee is a non-covered charge and is NOT billable to the Patient’s insurance.
Clinicians in the office make efforts to see a patient at their scheduled time for their scheduled time. Situations do arise where additional time is medically needed to address a specific need. If the appointment goes beyond the originally booked time, the Clinician will bill for the additional time in session; additional time may not be billable to your insurance company and would be considered a non-covered charge. We ask prior to scheduling, for you to keep a credit card on file with our office, and to sign a billing agreement in the office to permit the collection of outstanding balances incurred from refills, phone calls, non-covered charges, copays, coinsurance, deductibles etc. Please refer to the separate payment policy for our office.
Phone calls, letters, reviews of medical records, form completion, etc. will be billed based on the complexity of the job. Please be prepared to pay before your request. The basic fee schedule is noted in this Patient Pack and discussed in the Non-Covered Services/Charges section of Policies on Insurance & Payment.
CONFIDENTIALITY & PRIVACY:
Patient confidentiality will be respected at all levels of communication and is protected by the Federal and State Laws. There are, however, situations in which confidentiality may be compromised and the provider’s professional and legal duty to protect may override the dictates of confidentiality. Briefly, these situations may include a strong indication of imminent danger to self or others or indication of abuse or neglect of another. Patients under the age of 18 require consent from a parent or legal guardians to receive medical services. Please discuss your concerns about the limits of confidentiality with your clinician and read the Privacy (HIPAA) statement on our website, or on file at the office.
Staff and professionals are encouraged to avoid personal virtual relationships via social media (e.g. Facebook, Snapchat, Instagram, LinkedIn) with patients. Requests to friend a clinician will not be honored in order to respect professional boundaries.
RELEASE OF INFORMATION
Following the execution of a valid Patient Authorization Form (Release of Information), patient records, or a treatment summary will be forwarded to licensed professionals at no charge as a professional courtesy. Requests to release records to any other entity (including attorneys, underwriting companies, etc.) will be billed at the actual cost of supplying the records, to include cost of reviewing, copying, mailing, and additional professional time. Any request for release of records must allow at least three weeks preparation time as a Summary of Care (SOC) may be prepared by the treating clinician. It is the policy of our clinic to not release records directly to patients because medical & therapy records can include medical & psychiatric jargon and abbreviations. A patient may request a SOC of their treatments in our office. The typical charge for this SOC is $50. Should the patient want to review their entire medical record, this can be done together, in person, in an office appointment; charges for the office appointment apply.
If a patient receives a charge which they believe to be invalid, our office will accept a written notice concerning the disputed charge. We will review the dispute with supporting evidence and respond in a timely manner.
When we partner with select Laboratories that provide testing and testing results, the lab will bill the patient’s insurance directly. Some labs we use may not work with Medicare, Medicaid, or TennCare. If we collect the specimen for the laboratory test, our office may charge a collection fee which is payable at your next session or in a monthly statement, whichever comes first. This collection fee may not be covered by your insurance.
FOR LABS – WHAT YOU MIGHT SEE ON YOUR INSURANCE EOB:
You may see lab/laboratory analysis with fees to a patient. In most cases, the lab will bill you directly for the costs of the tests minus the amounts contracted or paid for by your insurance. Although we cannot guarantee this process, we believe this means that the amount your insurance pays will be the amount collected by the lab for your test.
SPECIAL TESTS OR PROCEDURES, RESULTS (Labs, Urine Drug Screening, COVID Testing, Genetic Testing):
Most lab results will be reviewed with the patient at the next scheduled visit, (unless there is a more pressing need prior to the visit). A small clinical charge may be charged to review the laboratory values when the results arrive in our office. In most cases, clinicians will attempt to wait and review the information during your appointment. In some cases, because your appointment may not be scheduled for weeks to months, clinicians may decide to handwrite a note on the laboratory results and send the copy to you to convey the message before your next appointment. These results can be sent via email (if you have agreed), secure text, and mail.
With all minors, or wards, we must legally have at least one (1) parent/guardian present in the office during the first appointment, and subsequent appointments unless otherwise discussed with the clinician. The interview will include the parent for a portion of the time, but we will also take some time to see the patient alone. If parents are divorced, both can attend if they choose. It is expected that parents will maintain calm conversation focused on the patient. If it is a volatile situation between parents, it is better for one (1) parent to attend and the other to write a letter describing their observations and concerns for the child. If divorced parents do not communicate well, we alternatively suggest that the non-attending parent schedule a meeting with providers either in-person or by phone after the initial evaluation is complete. This encounter will be billed as either a consultation with a family member or as a regular session depending on the time required and whether it is in-person or virtual. It is acceptable for the child to attend that meeting, or not. Any testing or available I.E.P. should be brought to the session or provided prior to the session for review.
VIRTUAL VISITS IN STATE
During the past year during the SARS-COVID-19 pandemic, the clinicians at the NeuroScience & TMS Treatment Centers (NSTMS) have accommodated patients with virtual visits even when patients have traveled out of Tennessee (TN).
Because of expected upcoming changes in many state laws and malpractice coverage changes, the prescribing clinicians at the NSTMS will only be able to offer virtual care (with prescribing medications) if the patient is located in TN at the time of the visit. THIS DOES NOT APPLY TO THERAPISTS. Because therapists are covered by different licensing boards and malpractice coverage, they are allowed to see patients who are not in TN.
If you have chosen to travel outside of TN, you will need to make sure that you will be in TN for your virtual or face to face appointment if you are being prescribed medication.
If you have traveled or moved outside of TN during the pandemic you will need to travel back to TN to have your virtual or face-to-face appointment with your prescribing clinician.
If you do not plan to return to TN, you will need to make arrangements to get prescriptions in the state where you are presently living.
If you fail to honor the New Virtual appointment policy, your visit could be terminated by the prescribing clinician. In this case, you will be responsible for the full cost of the appointment; insurance will not cover these costs.
We have implemented a COVID 19 policy in the office to keep you, your family, our families, and all employees and patients in our clinic free of illness. Please notify us at email@example.com before you come in if you have Covid, or have a fever, cough any shortness of breath. If you have these symptoms or have been around anyone who has had COVID 19 in the last seven days, you should quarantine and be tested.
We offer virtual visits for your care if you can not attend your appointment in person.