Welcome to Moving Mountains Therapy Center!

Welcome and thank you for choosing Moving Mountains Therapy Center, a partnership of Eat.Move.Grow and Stack Speech Therapy Group. We are delighted to offer speech, occupational, and physical therapy services, as well as mental health counseling to our clients. We look forward to partnering with our clients and when applicable their family units to target their needs in all areas of life and development. Here at Moving Mountains Therapy Center, we are dedicated to improving the lives of our clients. Our mission is to provide high quality, family and client-centered effective therapy that fosters an individual’s ability to perform meaningful activities and find pleasure, fulfillment, and merit in all aspects of life.

The admission packet contains forms that will provide important privacy, financial, medical, and attendance policy information. We offer a holistic approach and view the individual and when appropriate their family unit as equal partners in the therapeutic process. We value the feedback and input of our clients and when appropriate their family units to best support their needs on the path to success.

Therapy is goal-oriented and family/client-centered; we collaborate with our clients and when appropriate their family unit creates goals that are relevant and applicable to our client’s day-to-day life. Therapy sessions typically range from 30 - 90 minutes dependent on treatment needs. We seek to offer our services in the setting that best suits our client's needs whether that be in their home, at a community site, or in one of our many interactive and engaging therapy rooms at our clinic!

We ask that if there are any recent evaluations completed by other health professionals (e.g., audiologist, doctor, specialist, etc, that copies of the results are brought to the next therapy session or faxed or mailed in advance. All forms and additional information may be faxed to (406) 797-5008 or mailed to 3031 South Russell, Suite B c/o Moving Mountains Therapy Center! We look forward to working with you. Please let us know if you have any questions regarding our admission process or policies. We can be reached by email: info@mmtherapycenter.com or by phone: (406) 396 - 4130

Sincerely, 

The Moving Mountains Team

Observation Release: Here at Moving Mountains Therapy Center, PLLC, we occasionally have fieldwork students/interns and/or volunteers who benefit greatly from observing therapy sessions with one of our team members. Every one who would be observing will have completed HIPAA training and have signed confidentiality agreements as mandated by HIPAA. Any information used would be strictly for teaching purposes only.

Attendance Policy:

Clinic, Home Visits, Teletherapy

The frequency and time of treatment is especially important to the therapeutic process and growth.  Therefore, clients are given a prescribed amount of time for each therapy session and a prescribed number of sessions per week. It is important that clients arrive on time so that they can participate in the full scheduled therapy time. If a client is running late for a therapy session it is the client’s or the responsible parties’ responsibility to call and notify Moving Mountains Therapy Center. MMTC does not follow school district holiday closures. MMTC clinic has no planned closures for federal/observed federal holidays. It is left to the discretion of each clinician if they will work a designated federal/observed federal holiday. Clients and families should check with their clinician(s) to determine if their sessions will be canceled for the federal/observed federal holiday. If a client or family wishes to cancel their sessions for a federal/observed federal holiday they should inform the front desk of the cancellations. All cancellations for federal and observed federal holidays will not count against a client’s attendance record. If you have travel plans, please cancel, or reschedule your appointments with the front desk.

If you or a responsible party need to cancel an appointment for reasons aside from travel or will be running late, please first contact the main office at (406)-396-4130, not your clinician.

Tardiness

To uphold prescribed treatment plans, the following tardiness policy is enforced.

• For sessions that are scheduled for 30 minutes, if a client is 15 or more minutes late the session will be cancelled.
• For sessions that are scheduled for 45 minutes, if a client is 23 or more minutes late the session will be cancelled.
• And, for sessions that are scheduled for 60 minutes, if a client is 30 or more minutes late the session will be cancelled.

Absences

To provide quality service and foster the therapeutic process and growth, we ask that clients maintain a minimum of 75% attendance for each provided therapy discipline for a consecutive 3-month period.

• It is the clients’ or the responsible party for that clients’ responsibility to notify Moving Mountains Therapy Center if the client is going to be late or absent from a scheduled therapy session.
• For pre-planned absences, Moving Mountains Therapy Center asks that you provide at least 24-hours’ notice of the cancellations.
• For extended pre-planned absences, Moving Mountains Therapy Center requires at least 48-hours’ notice for the cancellations.
• Appointment time slots for extended pre-planned absences may be held for up to 2-weeks before the appointment time slot will be opened to other families/clients.
• For unforeseen events and illnesses, Moving Mountains Therapy Center asks for notice of the cancellation the morning of the scheduled therapy session. If a client is ill, we ask that the scheduled therapy sessions are cancelled, and a minimum of 24-hours passes with a fever of less than 99.6 F without medication to reduce the fever.

 

No Call/No Show

If a client or the responsible party for a client does not show nor call at least 30 minutes prior for a scheduled therapy appointment, it will be considered a “no-call, no-show”. If client has more than two “no-call/no-shows” with-in a 3-month period that time slot will be opened to other clients/families on our wait list. Failure to meet attendance and no-show requirements could result in loss of scheduled therapy appointments, being placed on a temporary hold, and/or being placed back on the waitlist.

 

Community Sites – Daycares & Schools

For clients that attend therapy services at Community Site locations Moving Mountains Therapy Center clinicians will have set therapy days and times that they are available to see clients attending a specific Community Site. Clients and/or their families will be informed of these treatment days and times at the initiation of therapy services. It is especially important that clients are at the Community Site during these set therapy times so that they can participate in their full scheduled therapy times to foster the therapeutic process and growth. For this reason, Moving Mountains Therapy Center enforces the following tardiness and attendance policies for Community Site Locations.

Attendance

Clients must maintain a minimum of 50% attendance for scheduled therapy sessions during the set therapy times for that Community Site in a 3-month period. If a client is unable to maintain 50% attendance or is unable to be seen during the set treatment time they will be placed on our waitlist and the time slot will be opened to another client.

 

Family and Client Centered Principles:  Moving Mountains Therapy Center is focused on family and/or client - centered services where we view our clients and when applicable their family units as equal partners. We understand that our clients and when applicable their family units are the experts and ultimate decision-makers regarding their needs. Intervention at Moving Mountains Therapy Center focuses on strengthening and supporting functioning of the individual and when applicable of the family unit. Thus, the therapy we offer is individualized, flexible and responsive to the needs you have identified for yourself and/or for your family unit. When applicable we do ask that families, including parents, caregivers, guardians, other family members, or invested individuals attend the therapy sessions and be an involved partner in therapy.

 

Communication Agreement: By checking my choice of method(s) of communication above, I understand the following: Electronic communications such as email or text messaging are not guaranteed as secure. I understand there are known and unknown risks that may affect the privacy of the client’s personal health care information when using text messaging to communicate. I understand that Moving Mountains Therapy Center will use reasonable means to protect the security and confidentiality of text information, however, text messaging is not HIPAA compliant and therefore Personal Health Information (PHI) will not be shared via text messaging and HIPAA compliant precautions will be taken to ensure the client’s PHI is protected to the best of Moving Mountains Therapy Center’s abilities. If I choose to use email or text messaging to communicate with Moving Mountains Therapy Center, I agree that if I have not received a response to time-sensitive information (i.e., rescheduling or cancelling sessions, etc.), it is my responsibility to follow up in person or via direct phone call with a Moving Mountains Therapy Center staff member. I understand that Moving Mountains Therapy Center will use reasonable means to protect the security and confidentiality of email information sent and received via a HIPAA compliant encrypted email service. I agree that if I wish to withdraw my consent to use email or text communications regarding the client’s therapy services, it is my responsibility to inform Moving Mountains Therapy Center, PLLC, in written communication.

 

Health Policy: Help and cooperation is required in order to maintain a healthy environment. An individual must be temperature-free for 24 hours, without the aid of fever reducing medicine, before returning to therapy. If the individual has vomited and/or had diarrhea, he/she should not return to therapy until 24 hours have passed since the last episode of the same.

Clients will NOT be seen if any of the following is present:

• Too ill or uncomfortable to function in the therapy setting;

• Continual runny nose;

• Thick or discolored nasal discharge;

• Excessive sneezing or coughing and mucus-producing cough;

• An elevated temperature.

 

Gun Policy: No person may carry or possess a weapon, regardless of whether the person has a permit to carry a concealed weapon, on Moving Mountians Commercial Property (3031 S. Russell St., Missoula, MT., 59801) premises except as authorized Security Personnel. 

 

Authorization for Release of Information: Moving Mountains Therapy Center, PLLC is hereby authorized to furnish and release such professional and clinical information as may be necessary for the completion of my medical claims by valid third party agents or agencies from the medical records compiled during treatment. Moving Mountains Therapy Center, PLLC, Eat.Move.Grow., S-Corp and Stack Speech Therapy Group, S-Corp  are hereby released from all legal liability that may arise from the release of said information.

 

HIPPA Release: I certify that I have received a copy of the Notice of Privacy Practices effective 4-14-13, describing the privacy regulations as outlined by HIPAA and that I understand any questions regarding this privacy notice may be directed to Moving Mountains Therapy Center, PLLC (or Eat.Move.Grow., S-Corp or Stack Speech Therapy Group, S-Corp, as appropriate).  I agree that these practices have been fully explained to me, and I am satisfied that I understand its consent and significance.

 

Financial Policy:

Assignment and Authorization to Pay Insurance Benefits:  I hereby assign and authorize payment directly to Eat.Move.Grow., S-Corp or Stack Speech Therapy Group, S-Corp as appropriate. 

 

Health Insurance: We participate with some insurance companies, but not all. In the event that we do not accept your insurance, we will be happy to provide you with the necessary paperwork to assist you in seeking reimbursement for out-of-network provider services. Please be advised that many health insurances plans have limited coverage for therapy services. We recommend you contact your insurance company to discuss the limits of your coverage.

 

Fees: To maintain your access to care we accept most insurances, in the case that you do not wish to have insurance billed for services rendered we offer private pay agreements. Payment is required at the time of service unless other arrangements are made in advance. If you have any questions or concerns regarding your or your family’s eligibility and/or co-pay, please contact our front office at (406)-396-4130. Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp.  may offer an estimate of benefits and/or authorization as a courtesy; however, this does not guarantee payment or verify eligibility. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member's contract at time of service.

 

Payment: The person who completes the Consent to Admission & Medical Treatment- Financial Agreement, is responsible for payment of all services rendered. Payment is due at the time services are rendered unless you have made other arrangements in advance. Financially Responsible Parties have the option to set up autopay on the Fusion Portal. Accounts more than 60 days overdue or have a balance of $500 or greater will be required to pay off the balance in full or sign up for a payment plan. Accounts that have not had sufficient payments made on them and are 90 days overdue will be sent to collections. For clients seeking third-party reimbursement, please be aware that you are ultimately responsible for payment of all services rendered. If your insurance carrier denies payment (including recoupment) or does not remit payment within 90 days, the client will be responsible for payment of all services rendered.

 

Collections:  Accounts that have not had sufficient payments made upon them in 90 days will be sent to a third-party collection agency. In the event any unpaid balance is placed for collections with a third-party collection agency a collections-fee will be added to the total amount due.  This amount shall be in addition to any other costs incurred directly or indirectly to collect amounts owed under this agreement such as court costs, attorney fees, late fees, and any other fees so stated elsewhere.  The authorized collections fee and the additional costs and charges listed above represent the actual costs incurred by Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp.  to collect amounts owed under this agreement and a corresponding decrease in expected revenue resulting from the signer’s failure to pay as specified in this agreement.

 

Termination of Services: In the event that financial obligations are unable to be met and maintained, services will be suspended. Services may be suspended for accounts that are greater than 90 days overdue and for accounts with a total unpaid account balance greater than $1000. Services may be terminated if it is determined that continued participation will be a detriment to you or your family.

 

 

Treatment Agreement: I understand that Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp.  provide clinical treatment services.  I hereby agree to treatment by these companies as prescribed by my physician.

 

Waiver of Liability: I give permission to participate in Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp. ’s programs and services. I hereby release Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp. ’s principal owners, therapists, employees and representatives and all other individuals or organizations acting on behalf of Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp. ’s, from any and all claims which I or my dependent may have, resulting from or in connection with participation in Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp. ’s programs This includes, but without limitation, any claim, demands or causes of action for injuries to myself (or dependent), including but not limited to injuries resulting from the use of any therapy equipment during the program where services are provided. This agreement is signed for the purpose of fully and completely releasing, discharging and indemnifying Moving Mountains Therapy Center, PLLC, Stack Speech Therapy Group, S-Corp. , and Eat.Move.Grow, S-Corp.  in connection with their programs from all liability as herein described.

 

By signing below, I (client/legal guardian) agree to the above.

The American Occupational Therapy Association (AOTA) and the American Speech and Hearing Association (ASHA) define Telehealth (the act of providing Telehealth services) as a delivery model for providing health-related services at a distance using telecommunication technology. Telehealth is a broad term that can encompass many aspects of occupational and speech therapy services. It includes “linking clinician to client, or clinician to clinician for the assessment, intervention, and/or consultation” as well as the “application of evaluation, preventative, diagnostic, and therapeutic services via two-way or multipoint interactive telecommunication technology.  For speech therapy this service delivery model is supported through the Montana licensing board, the American Speech and Hearing Association (ASHA), and is payable by most insurance carriers per the Telehealth Enhancement Act of 2013- H.R.3306, 113th Congress. For occupational therapy, this service delivery model is supported for use as a modality by Medicaid and most private insurances, due to the state of emergency with COVID-19 outbreak, through the Executive Order 2-2020. 

This means that we can provide occupational & speech therapy services through digital meetings similar to the popular communication system “Skype”. While we do not specifically utilize skype for the provision of services, the method of delivery would be similar in nature, however, would fully adhere to the Health Insurance Portability and Accountability Act (HIPAA) in order to protect patient privacy to the best of our abilities. Additionally, this use of teletherapy would be equivalent to the quality of services Moving Mountains Therapy Center provides in-person. The therapist and your child would join a computer-based session at the designated therapy time, and while using an interactive screen share, work on the same materials just as in our clinic, day-cares, or school-settings.

I hereby consent to engage in teletherapy with Moving Mountains Therapy Center, Stack Speech Therapy Group, S-Corp, and Eat.Move.Grow. I understand that “teletherapy” includes treatment using interactive audio, video, or data communications. I understand that teletherapy also involves the communication of my medical information, both orally and visually.

I understand the following with respect to teletherapy:

• I have the right to withhold or withdraw consent at any time without affecting

 my right to future care or treatment.

• The laws that protect the confidentiality of my medical information also apply to teletherapy; and

• As such, I understand that the information disclosed by me during the course of my therapy or consultation is confidential.

I understand that there are risks and consequences from teletherapy, including, but not limited to, the possibility, despite reasonable efforts on the part of Moving Mountains Therapy Center, that:

• the transmission of my information could be disrupted or distorted by technical failures. the transmission of my information could be interrupted by unauthorized persons. and/or the electronic storage of my personal health information (PHI) could be accessed by unauthorized persons.

Moving Mountains Therapy Center currently uses Zoom to provide teletherapy services. I understand that I am responsible for:

1. providing the necessary computer, telecommunications equipment, and internet access

for my teletherapy sessions;

2. the information security on my computer; and

3. arranging a location with sufficient lighting and privacy that is free from distractions or

intrusions for my teletherapy session.

Teletherapy has been determined as an appropriate service delivery model for this patient. Teletherapy will only be used if determined to be at least as effective as in-person treatment. If teletherapy is not deemed as effective, you will be notified and referred back to in-person treatment. In order to participate in teletherapy, the child must first participate in an in-person evaluation. For certain individuals, we ask that an adult facilitator be present in the room for assisting with technical difficulties or keeping a child on task. Teletherapy may be used as the primary means of service delivery or may be used in combination with in-person services.

 

I have read, understand, and agree to the information provided above.

I authorize Moving Mountains Therapy Center, PLLC, to release and/or request medical records, for the patient stated above, from the facilities listed below.

I authorize the medical records indicated above may be released and/or requested from the following facilities.

I understand that by signing this authorization:

• I authorize the use or disclosure of my individually identifiable health information as described above for the development of the above-stated patient’s treatment program.
• I have the right to withdraw permission for the release of the above-stated patient’s information. If I sign this authorization to use or disclose information, I can revoke that authorization at any time. The revocation must be made in writing and will not affect information that has already been used or disclosed.
• I have the right to receive a copy of this authorization.
• I am signing this authorization voluntarily and treatment, payment, or my eligibility for benefits will not be affected if I do not sign this authorization.
• I further understand that a person to whom records and information are disclosed pursuant to this authorization may not further use or disclose the medical information unless another authorization is obtained from me or unless such disclosure is specifically required or permitted by law.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This health care provider is required by law to maintain the privacy of health information about you or your child (as used herein, “you”) and provide you with notice of its legal duties and privacy practices with respect to your health information. If you have questions about any part of this notice or if you want more information about the privacy practices please contact the therapist at 3031 S. Russell St. Missoula, MT, 59801.

Effective Date of This Notice: January 1, 2018

I. How The Therapist May Use or Disclose Your or Your Child’s Health Information

Moving Mountains Therapy Center contracts with Eat.Move.Grow., S-Corp (occupational therapy and mental health) and Stack Speech Therapy Group., S-Corp (speech therapy and physical therapy) to provide clinical treatment services.  An Eat.Move.Grow. or Stack Speech Therapy therapist may collect and store your or your child’s clinical health or billing information in a chart and on a computer. Your or your child's clinical records are kept by Moving Mountains Therapy Center, PLLC.  Your billing records are kept by Eat.Move.Grow, S-Corp, or Stack Speech Therapy, Corp, as appropriate. However, the information in these records belong to you.  We will protect the privacy of you or your child’s health information.  However, the law permits the company to use or disclose your or your child’s health information for the following purposes:

1.       Treatment.         

Ø  Your or your child's health information may be used by or disclosed to school personnel, physician(s), and personnel from other agencies as necessary to plan, coordinate, implement and evaluate health related services provided.

Ø  Your or your child’s health information may be disclosed to Medicaid Passport provider to obtain the provider’s referral. Also, the therapist is required to share progress summaries, evaluation reports and discharge summaries with Passport providers.

2.       Payment.

Ø  Your or your child’s health information may be used or disclosed to Montana Medicaid, CHIPS, private health insurers, or  a person you identify as responsible for the payment of the account for the purpose of receiving payment for the services. In all cases, we will disclose the minimum amount of health information necessary to receive payment. This generally includes client name, social security (Medicaid) number, diagnosis code(s), and the procedure codes and fees for the services received.

3.   Regular Health Care Operations.

Ø  Portions of health information may be periodically assessed by outside health insurance/medicaid auditors to evaluate and ensure proper records are kept. For example, caseload reports showing names, social security numbers, school attended, types of services received, and source of reimbursement for services may be evaluated to ensure that we are conforming to the State guidelines.

 

4.       Information provided to you.

You have the right to request access to or amendment of your or your child’s health information. In addition, you have the right to request an account of disclosures we have made of your or your child’s health information. You also have the right to request special privacy protections and a confidential channel of communication. All requests must be in writing and must follow a formal procedure for processing. The person who has given you this notice will help you make these request.    

 

5.    Notification and communication with family. We may disclose your or your child’s health information to notify or assist in notifying you, another family member, your personal representative or another person responsible for your or your child’s care about location or general condition. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification.  If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.

 

6.    Required by law. As required by law, we may use and disclose your or your child’s health information.

 

7.    Public health. As required by law, we may disclose your or your child’s health information to public health authorities for purposes related to:  preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; and reporting disease or infection exposure.

 

8.    Health oversight activities. We may disclose your or your child’s health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.

 

9.    Judicial and administrative proceedings.  We may disclose your or your child’s health information in the course of any administrative or judicial proceeding.

 

10. Law enforcement. We may disclose your or your child’s health information to a law enforcement official for purposes such as identifying of locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.

 

11. Public safety. We may disclose your or your child's health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

 

II. When the Therapist May Not Use or Disclose Health Information

Except as described in this Notice of Privacy Practices, the therapist will not use or disclose your health information without your written authorization.  If you do authorize the therapist to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

III. Your Health Information Rights

The below listed rights are not absolute and are subject to some limitations and conditions.

1.  You have the right to request restrictions on certain uses and disclosures of your or your child’s health information.

2.  You have the right to receive your's or your child’s health information through a reasonable alternative means or at an alternative location.

3.  You have the right to inspect and copy your's or your child’s health information.

4.  You have a right to request that the therapist amend your's or yout child’s health information that is incorrect or incomplete.  We are not required to change your child’s health information and will provide you with information about the denial and how you can disagree with the denial.

5.  You have a right to receive an accounting of disclosures of your's or your child’s health information made by the therapist,

6.  You have a right to a paper copy of this Notice of Privacy Practices.             

 

IV. Changes to this Notice of Privacy Practices

The Company reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment.  Until such amendment is made, the therapist is required by law to comply with this Notice. 

 

V. Complaints

Complaints about this Notice of Privacy Practices or how the therapist handles your child’s health information should be directed to:

HIPAA Privacy Officer, Laura Olsonoski, OTD, OTR/L, ATP Eat.Move.Grow.,S-Corp. Missoula MT 952-356-6778

Shanna Stack, MS, CCC-SLP Stack Speech Therapy Group, S-Corp, Missoula MT 406-546-1103

 

If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:

Department of Health and Human Services

Office of Civil Rights

Hubert H. Humphrey Bldg.

200 Independence Avenue, S.W.

Room 509F HHH Building

Washington, DC  20201

 

You may also address your compliant to one of the regional Offices for Civil Rights.  A list of these offices can be found online at http://www.hhs.gov/ocr/regmail.html.

Caregivers can be involved in their children’s therapy in several ways and at different levels. For each of the participation manner questions listed below, please indicate how involved you see yourself according to the following scale:

 

1= Not at all

2= Rarely

3= Sometimes

4= Most of the time

5= All of the time

 

Moving Mountains Therapy Center, PLLC, now offers a patient portal through our electronic medical system, Fusion. The Fusion Patient Portal allows our clients and their families/caregivers to view all scheduled therapy sessions, access reports, and other documentation, and engage with home programming activities assigned by their clinician(s). Clients and their families/caregivers are also able to pay their bills through the Patient Portal and may set up autopayments. 

If you would be interested in signing up for the Patient Portal please complete the information below.