Notifications
In compliance with the No Surprises Act that went into effect January 1, 2022, all healthcare providers are required to notify patients of their federal rights and protections against “surprise billing.”
This Act requires that we notify patients of their federally protected rights to receive a notification when services are rendered by an out-of-network provider, if a patient is uninsured, or if a patient elects not to use their insurance.
Additionally, if you become a patient of Peninsula Mental Health, we are required to provide you with a Good Faith Estimate of the cost of services. It is a federal requirement that we have each patient sign the Good Faith Estimate to begin/resume treatment.
It is difficult to determine the true length of treatment for mental health care, and each patient has a right to decide how long they would like to participate in treatment. We will collaborate with you on a regular basis to determine how many sessions you may need.
GOOD FAITH ESTIMATE
What is a Good Faith Estimate?
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for health care items and services before those items and services are provided.
You have the right to receive a “Good Faith Estimate” explaining how much your pharmacotherapy and/or therapy services could cost. It is not possible for a provider to know in advance how many sessions may be necessary or appropriate for a given person; therefore, the Good Faith Estimate will provide an estimated cost of services provided.
Total cost of services depends on the number of sessions scheduled and/or attended, your individual circumstances, and the type and amount of services provided to you.
How can I receive one, and what are my rights?
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service, and you can expect to receive it in a timely fashion.
If you schedule an appointment in advance, you can expect to receive a Good Faith Estimate in a timely fashion before your appointment.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
How can I learn more?
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.
OPEN PAYMENTS DATABASE NOTICE
Dr. Reed does not accept any payments from manufacturers of medical devices, drugs, or biologics. However, by law, you are entitled to learn about the Open Payments Database and receive the following message:
“The Open Payments Database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at
https://openpaymentsdata.cms.gov
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here.
The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices and biologics to physicians and teaching hospitals be made available to the public.”
Notice of Privacy Practices
This document explains how your medical information may be used and shared, and how you can access it. Please read it carefully. This practice policy is currently effective and was last updated on November 8, 2024.
Use of My Health Information
I understand that my healthcare provider, Catherine Reed, MD, is authorized to use and disclose my health information for treatment, payment, and healthcare operations. This includes my symptoms, test results, diagnoses, treatments, and billing documents.
If I use my insurance to get reimbursement for services, Dr. Reed may share information such as my diagnoses and treatment dates with my insurance carrier. She may also disclose my information to business associates who support her practice, like malpractice insurance carriers, or for auditing purposes. Dr. Reed is also permitted to disclose my health information to public health agencies to prevent disease, report abuse or neglect, or protect me or others in emergency situations. In some cases, she may be required by law to disclose my information for administrative or legal proceedings, with my authorization or as directed by a court order. Dr. Reed may speak to other providers on my care team to benefit my current care. Unless I object, Dr. Reed may release health information about me to a friend or family member who is involved in my medical care. In general, this will only be done in an emergency.
Dr. Reed makes every effort to protect patient confidentiality in all communications. Although Dr. Reed provides HIPAA-compliant avenues of communication with patients, electronic communication can never be one hundred percent secure, and may be retrievable by unintended third parties. Dr. Reed cannot guarantee full protection against potential unknown/illegal/unauthorized privacy violations. If I initiate or request an email or phone message that includes sensitive information, I will be responsible for any privacy-related outcome of this communication.
My Health Information Rights
I have certain rights regarding my health information. I can request restrictions on how it is shared and used, inspect and copy my records, appeal a denial of access, amend incomplete or incorrect information, and request alternative means of communication. I can also request an accounting of disclosures or revoke previous authorizations. I can tell Dr. Reed my preference in situations where she would typically share my information with family or friends, for disaster relief, or in a hospital directory. If I am unable to communicate my preference, Dr. Reed may share my information if she believes it is in my best interest. Dr. Reed will not share my information for marketing purposes, the sale of my information, or most sharing of psychotherapy notes without my written permission. If I think my rights are being denied, I have the right to file a complaint with the U.S. Department of Health and Human Services or my insurer.
Dr. Reed will maintain the confidentiality of my health information, except when required by law or when it is necessary to protect my health or safety. Dr. Reed may eliminate or change some provisions of this notice but will notify me if she does so. If I have questions, I can ask Dr. Reed.
By utilizing the medical services of Peninsula Mental Health, you acknowledge that you have reviewed and understand our privacy policy and consent to the terms as outlined above.