Patients have the right:

1. To be treated humanely, with dignity, and respect.

2. To not be discriminated against due to race, religion, ethnicity, gender, sexual orientation, or disability.

3. To receive treatment appropriate to their mental health condition.

4. To have diagnosis and treatment explained in understandable terms.

5. To participate in the formulation and revision of the treatment plan.

6. To refuse treatment, request another provider, or seek a referral outside of the practice.

7. To receive services that adhere to the principles of confidentiality and privacy except for the following specialized circumstances:

a. When circumstances place the patient’s welfare or that of others in immediate danger.

b. When disclosures made by the patient raises the suspicion of child physical, mental, or sexual abuse or neglect, or if an adult discloses an allegation of abuse in their childhood. In this situation, the law requires a report be made to the appropriate agency, usually Social Services.

c. When a court order requires testimony or release of patient’s records.

d. In a circumstance where the provider determines that consultation within the practice is needed in order to provide optimal treatment, in which case the utmost discretion will be used to insure privacy.

8. To access your medical record as deemed appropriate by the provider.

Patients have the responsibility:

1. To know the benefits and exclusions of your insurance coverage and to provide us with current insurance information.

2. To make regular and prompt payments for services rendered.

3. To keep scheduled appointments. Patients will be charged for missed appointments or cancellations for which 24 hour notice has not been given.

4. To follow the mutually agreed upon treatment plan.

5. To be open and honest in sessions.

6. To report any safety concerns or abuse allegations to your provider.

7. To discuss with your provider any concerns about treatment, including the desire to terminate treatment.

8. To discuss with your provider any concerns about treatment, including the desire to terminate treatment.

Office Hours
Evening, weekend and other hours are available at the discretion of your clinician.  The business office is open Monday through Friday from 8:30am until 4:30pm.

Appointments
All appointments are scheduled.  Psychiatrist’s appointments are scheduled by the administrative staff.  All other appointments are scheduled by your clinician.  Twenty-four hours notice is required to cancel an appointment.  Payment for missed appointments are the responsibility of the patient.  Missed appointment charges are as follows: Psychiatrist = $180; Psychologist = $175; Counselors or Social Workers = $160.

Telephone Service
The office uses a voice mail system.  Please listen carefully to all options.  During business hours, you can direct your call to the receptionist at any time by selecting “0”.  If you know the extension of your clinician, you may enter it at any time. If you do not know your clinician’s extension, you can press “4” for a directory.  The prescription line is monitored daily until 4:00 p.m. The following services can be reached directly by entering the appropriate extensions:

New patients – 1       Prescription refills – 2       Physician scheduling – 3       Billing – 5

Emergencies
If you have an emergency outside of normal business hours, contact our answering service at 301-712-9183.  If your clinician is unavailable, the answering service will direct you to the on-call clinician.  Please do not call for non-emergency problems after regular business hours.

Prescription Refills
There are 2 ways to request prescriptions. 

1.      Website request form- Under the prescription request tab (www.blueridgebehavioralhealth.com)

2.      Leave a message on the prescription voicemail- Ext. 112 or option 2 (301-695-8390)

ALLOW A MINIMUM OF 48 HOURS FOR PRESCRIPTIONS TO BE PROCESSED.

Managed Care
Managed care plans have various rules about how to begin treatment.  If your plan requires a referral from your primary care physician, we must receive the referral prior to the first visit.  Some plans require phone authorization before beginning treatment.  If the required referral or authorization is not presented at the first visit, you agree to waive your insurance benefits and you will be responsible for payment in full at time of service.

Other Fees
Psychiatrists charge $300 per hour, rounded to the nearest 15-minute interval, for school or team conferences, consultations conducted by telephone, and time spent reviewing, preparing, and/or writing reports.  The charge for court-related services is $600 per hour rounded to the nearest 15-minute interval.

Psychologists charge $175 per hour, rounded to the nearest 15-minute interval, for school or team conferences, consultations conducted by telephone, and time spent reviewing, preparing, and/or writing reports.  The charge for court-related services is $360 per hour rounded to the nearest 15-minute interval.

Social Workers charge $160 per hour, rounded to the nearest 15-minute interval, for school or team conferences, consultations conducted by telephone, and time spent reviewing, preparing, and/or writing reports.  The charge for court-related services is $300 per hour rounded to the nearest 15-minute interval.

The minimum charge for copies of patient records is $15 plus 50 cents per page.  The maximum copying charge per patient chart is $75.  There is an additional fee of $15 if the chart is archived off-site (typically older than 2 years).

These charges are not subject to insurance reimbursement and are the responsibility of the patient.

CRISP NOTICE

We have chosen to participate in the Chesapeake Regional Information System for our Patients (“CRISP”), a regional health information exchange (“HIEs”) serving Maryland. CRISP is also affiliated with and shares data with other HIEs, including those, in Alaska, Connecticut, D.C., Maryland, and West Virginia. As permitted by law, your health information will be shared with this exchange in order to provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions. You may “opt-out” and disable access to your health information available through CRISP by calling 1-877-952-7477 or completing and submitting an Opt Out form to CRISP by mail, fax or through their website at www.crisphealth.org. Public health reporting and Controlled Dangerous Substances information, as part of the Maryland Prescription Drug Monitoring Program (“PDMP”), will still be available to providers