Cancellations: You will be billed for late cancellations and no-shows if you do not provide 48 business hours notice. The fee for all other no-shows or late cancellations will be $100.00; this policy applies for the outpatient clinic and Intensive Outpatient Program (IOP).  This fee will be waived if you are able to reschedule your appointment during the same week. This fee is not covered by insurance or the sliding scale policy. If you cancel your appointments frequently we will discuss this in session. If you continue to cancel or no-show frequently treatment may be ended.

Payment: Payment is expected at the time services are provided. Regardless of the custody arrangement you may have regarding payment for co-pays or mental health services, the parent that brings the child in for the appointment will be expected to pay at each appointment.  If the parent does not bring the child to the appointment, you may ask to put your credit card on file and the front desk staff will charge your credit card automatically for the co-pay and/or deductible for the visit. We will not ‘split’ the bill between two parents nor try to collect co-pays from a parent who does not come to the sessions. It will be up to the individual parent bringing the child to recover whatever is owed from the other parent without involving the Bay Area Children’s Association. If payment for services provided is not made within 30 (thirty) days after receiving a billing statement, there will be a $50.00 late fee added to the amount due.  There will continue to be a $50.00 charge for each additional 30 (thirty) days that payment is not received.

 Confidentiality: Anything you reveal in the sessions is confidential and cannot be released to another person without your consent. Exceptions to the rules of confidentiality occur when there are SAFETY issues. These include when a patient has intent to harm themselves or another person or an issue of abuse has been brought up in session. Essentially, whenever there is a safety issue this takes precedence over confidentiality. Sometimes insurance companies may request more information than what is present on the super bill. If this is the case you will be consulted before any information is released to a third party. Issues regarding confidentiality are discussed in detail for all clients before beginning formal treatment with the Bay Area Children’s Association.

Notice of Privacy Practices

HIPAA Rules: HIPAA (Health Insurance Portability & Accountability Act) privacy standards were created to protect patients’ health information when it is disclosed, but also to facilitate the flow of medical information between providers. When shared with other medical providers and for safety or security reasons, there is less protection of confidentiality than there used to be. However, in other areas, there is more privacy protection. Please read the following so that you understand your rights as a patient as well of the new rules about patient confidentiality. Feel free to ask about privacy, confidentiality, or psychiatric records.

Permission from the patient is no longer required for transfer of psychiatric and medical information between providers as long as only the necessary information is supplied. This means that if your  primary care doctor, pharmacist, or an emergency room physician calls to find out if you (or your child) are in treatment, what the diagnosis is, or what medications you (or your child) are on, we can convey this information if it is medically relevant to your (or your child’s) treatment with them. In practice, we will almost always discuss this with you personally before or after the fact, depending on the urgency and depth of the request. If you think this might present a problem for you let us know ahead of time.

Remember that if all the psychiatric records are requested, a treatment summary is usually given instead, except if the treatment consists solely of psychopharmacological treatment or brief medication visits. While brief medication visits fall under HIPAA guidelines, psychotherapy visits are specifically excluded, meaning authorization from the patient is still required for release of information in those notes and a summary is given and place of the record.

The substance abuse records from alcohol and drug programs are exempt from any disclosure with outpatient permission. If you (or your child) are admitted to a treatment program for substance abuse be sure to sign a release so that we can talk to the providers and obtain a discharge summary and lab data upon discharge. Without this we cannot obtain any information. We may have to disclose some psychiatric information when required to do so by law. This includes mandated reporting of child abuse or elder abuse. National security and public health issues. We may be required to disclose certain information to military authorities or federal health officials if it is required for lawful intelligence, public health safety, or public security.

Record Retention: (a) A licensed professional clinical counselor shall retain a client’s or patient’s health service records for a minimum of seven years from the date therapy is terminated. If the client or patient is a minor, the client’s or patient’s health service records shall be retained for a minimum of seven years from the date the client or patient reaches 18 years of age. Health service records may be retained in either a written or an electronic format. (b) This section shall apply only to the records of a client or patient whose therapy is terminated on or after January 1, 2015. (c) All records will be shredded after seven years from the date therapy was terminated.

Individual (Patient) Rights: All patients have the right to inspect and copy their own protected health information (medical record) on request, except for mental health records, which must be reviewed with a psychiatrist first. In cases where exposure to the record might be harmful to the patient, the psychiatrist may deny the request. If you request a copy of your psychiatric record, we will generally review the record with you. It is unlikely that there would be information in the chart that a patient should not or could not read, but much of the information in the chart may require explanation. Patients also have the right to amend or append their medical (or psychiatric) record.

Physicians have the right to deny such a request if it is believed that the information in the medical record is accurate, but in that case the patient request must still be attached to the medical record. Patients have the right to an accounting of all disclosures to other parties. This means that if you ask for a list of whom we have released psychiatric information to we will supply it to you. Patients have the right to have reasonable requests for confidential communications accommodated. You can give written authorization for the Bay Area Children's Association to disclose your psychiatric information to anyone you choose, and you may revoke the authorization in writing at any time. Patients maintain the right to file a complaint or grievance with the Bay Area Children's Association or the office of civil rights in the Department of Health and Human Services about any violation of the rights listed above. There will be no prejudice for filing such a complaint or grievance and can submitted verbally or in writing. Patients have the right to receive a written notice of privacy practices from providers and health plans. During the session, we may take the patient outside, on a walk or to an offsite location such as the library, cafe or grocery store. In some cases, going offsite may be helpful for treatment.

Authorization is required for uses and disclosures of (Protected Health Information) PHI for marketing purposes and disclosures that constitute a sale of PHI.  Authorization is required for most uses and disclosures of the patients psychotherapy notes not otherwise stated and agreed to in this notice. Other uses and disclosures of PHI not described in this notice will be made only with authorization from the individual or legal guardian to whom the PHI relates. Individuals who pay out-of-pocket in full for a healthcare item or service have the right to restrict disclosures of PHI to their health plan. ndividuals will be notified following a breach of unsecured PHI.

Destroying Unneeded PHI: BACA strives to be a paper-less, green clinic. All information containing PHI is scanned and inputted into a secure electronic medical records database. After PHI is scanned, it is either immediately returned to the patient (i.e. reports from other clinicians, reports/assessments/IEP from schools), or, if the information is not returned to said patient, it is immediately shredded.

Offsite Treatment: The clinician may take the patient to an offsite location (e.g. the library, cafe, mall or on a walk). In some cases, this may be important for treatment. Please advise if you do not want the provider to take your child offsite.

Research/Best Practices: The Bay Area Children’s Association is continuously developing and testing interventions to find successful treatments. As such, anonymous data may be collected and used for research purposes. The BACA staff will always get consent asking for participation in any funded, large-scale or scientifically designed, controlled study.  If you do not wish for your anonymous data to be used for any research projects, please contact our medical director.

Phone Calls/E-mail Correspondence: Due to the nature of the practice, e-mail is the preferred form for communication of non-urgent patient issues.  Any urgent issues (including safety issues or adverse reactions to treatment) should be addressed via a phone-call to the office, and not left in an e-mail.  E-mails are generally checked several times a day during the weekdays.  If you do not wish to use e-mail to communicate, it is your responsibility to inform office staff.  Phone calls will generally be checked and returned as soon as possible each day. Unless previously discussed in session, medications will not be refilled without an in-person appointment. In general, there is no charge for telephone calls.

However, if there are repeated phone calls for questions that could be addressed in session, or if lengthy (greater than 15 minutes) phone calls are made to outside sources on behalf of a patient, then a charge may apply.

After-Hour Emergencies: After-hours or when there is no one in the office you will be directed on the voicemail to dial a number to reach an answering service who can reach a physician on-call. An emergency is defined as any event in which there are immediate SAFETY concerns. Examples include: (1) The patient is threatening/actually harming themselves (2) the patient is threatening/actually harming others (3) the patient has been harmed in some way and (4) the patient is experiencing an adverse reaction to a medication. If the situation cannot wait for a phone call, then please call 911 for emergency services.

Discontinuation of Treatment: The Bay Area Children's Association will discontinue treatment with a patient only after considerable discussion and usually for one of the following reasons: (1) not paying the bill, (2) canceling too often, or (3) not doing any work in treatment. It is especially important when working with children and their families that all members involved do the necessary work in treatment in between sessions. If you foresee a problem in any of these areas, please let us know. If we see any difficulty in any of these areas, we will bring it up with you right away so we can discuss it and correct the problem. You can discontinue treatment with the Bay Area Children's Association at any time in person, by phone, or in writing. We will be happy to provide referrals to other mental health care providers. Hopefully, these policies will make our interactions easier, but sometimes there are snags or unplanned issues. Please bring these to our attention at any time. The goal of the Bay Area Children's Association is to be flexible at all times but maintain consistency, discuss this in session. If you continue to cancel or no-show frequently treatment may be ended.