Welcome to Vendetti Wellness Group (VWG). This document outlines key policies regarding our services. It serves as a binding agreement between you (the patient) and VWG. For expanded details, visit our website or discuss with your provider. Please review this document carefully.
Professional Services
Psychotherapy: Initial sessions focus on gathering information, evaluating your needs, and developing a treatment plan. The therapy process requires active effort, and while it may improve relationships and reduce distress, it can also bring up challenging emotions. The most appropriate interventions and treatment approaches to be considered will come from information the client shares, the providers theoretical framework and clinical expertise. It is important that the client and provider have open and collaborative communication during the treatment process.
Medication: The purpose of psychiatric medication management is to carefully evaluate and monitor a patient's response to prescribed medications to reduce symptoms and improve quality of life. The goal is to find the most appropriate medication, dosage, and treatment plan that best suits individual needs while minimizing side effects and maximizing the effectiveness of the treatment. It is important that the client and provider have open and collaborative communication during the treatment process. During your first appointment, the provider will discuss your needs, establish a treatment plan, and schedule follow-ups. Refills are typically provided at follow-up visits.
Medication Refills: Refill requests must be sent to your provider via the secure patient portal. Requests sent through the pharmacy or other methods may cause delays. Allow up to five (5) business days for processing. Controlled medications require stricter adherence to follow-up schedules, and early refills will not be provided.
Labs:
We partner with Quest Diagnostics and LabCorp. Lab tests may be used to monitor your treatment and medical conditions.
Missed Medication Appointments:
*A missed follow-up may result in a one-time, 30-day refill (excluding controlled medications).
*Three consecutive missed appointments may lead to discharge.
*Controlled medications: Early refills are not provided, and repeated missed appointments may lead to tapering.
Professional Services and Collaboration
We have a clinical team comprised of Licensed Mental Health Professionals, Mental Health Professionals who are working towards licensure, Psychiatric Nurse Professionals and Prescribers and at times, Master’s and doctoral interns. We place high value on keeping with the highest standards of practice, therefore, your provider may collaborate with other mental health professionals regarding the care and management of cases. Collaboration will only occur when it serves to aid in efforts to provide the highest quality of care and best practice procedures.
Contact outside of session, after hours and Emergency Procedures:
You and your provider will establish the best methods of communication and expectations around this communication. Providers make every effort to respond to communications within 24 hours, apart from weekends, holidays, and vacations. We are not a crisis facility. For emergencies, contact 911 or visit an emergency room.
Confidentiality:
Your provider has the obligation to keep sensitive information secure and private. Communications remain confidential, with limited exceptions such as required disclosures for safety or legal purposes. For more information, please visit our website.
Minors:
One legal guardian is required to consent to treatment. One legal guardian is required to be present for the initial intake meeting. Legal guardians have the right to access treatment records, but we request the legal guardian not request these records. The person in therapy needs to feel comfortable and safe sharing personal and sensitive information about their thoughts, feelings, and behavior. Therefore, the knowledge of parental or legal guardian access to these details may negatively impact the child’s therapeutic progress and can create misunderstandings and conflicts within the family. However, it is important that you receive general updates about progress. It is the duty of the provider to inform the Parent or Guardian if there is a matter relating to serious risk or harm. For more information, please visit our website.
Termination of Provider-Patient Relationship:
We reserve the right to terminate services, if necessary, due to circumstances such as, but not limited to missing multiple appointments, failing to pay for outstanding balances, threatening, harassing or otherwise creating a hostile environment, failure to adhere to your treatment plan, use of illegal drugs or abuse of prescriptions, hostile home or office environment where continuing service could do harm
VWG Cancellation Policy
24-Hour Notice Required: Please cancel or reschedule appointments 24 hours in advance to avoid fees.
Late Arrivals: Arriving 15 minutes or more late may result in a missed appointment fee. Clients arriving late will not be provided with an extension of time beyond what they were scheduled so as not to disrupt other client appointments. No reduction in fees will result from shortened sessions due to a client’s late arrival.
Cancellation Communication: Use the Patient Portal, email, or phone to cancel. Responding to appointment reminders are not valid for cancellations.
Rescheduling: The provider will assist in rescheduling when possible.
Insurance Responsibility: Insurance does not cover missed appointments or late cancellations.
Late Cancellation/Missed Appointment Fees (LCF):
*Fee is determined by service type and the credentials of your provider
Financial Responsibility and Payment:
You are responsible for providing accurate insurance details and for the payment of any fees not reimbursed by your insurance. Payment is due at the time of service. Any outstanding balance must be settled before further services. VWG files insurance claims as a courtesy, any inaccurate or delay in information provided to the practice may result in the full responsibility for payment falling to the patient.
Financial Responsibility
• Payment at the Time of Service: Payment is due at the time of service unless prior arrangements are made.
• Insurance Billing: By signing this agreement, you authorize VWG to bill your insurance for services rendered. You also consent to VWG releasing necessary medical information to process claims and obtain authorizations.
• Outstanding Balances: Patients are required to maintain a valid credit or debit card on file. This card will be charged for any outstanding balances, including co-pays, deductibles, or fees for missed appointments. Charges will be processed automatically if a balance remains unpaid within 48 hours of the service. Patients will be notified in advance for balances exceeding $450.
• Delinquent Accounts: Accounts unpaid after 30 days may incur a 5% late fee. Balances exceeding 90 days may be sent to collections, and additional fees may apply.
**Administrative services will be discussed and agreed upon prior to being charged**
+ Please note that your sessions are invoiced, and fees may vary, based on your insurance plan details. Details include service type, service duration, extent of evaluation(s), treatment strategy necessary for your care and the credentials of your provider. Based on your insurance plan details, please be advised that charges may apply for sessions conducted outside regular hours, including evenings, weekends, and holidays. If your insurance plan does not cover this charge, this may be a direct financial responsibility to the patient.
For a full list of VWG’s Professional Service Fees, please visit our website.
Good Faith Estimate:
For Health Insurance Users: We will provide details about your insurance, including deductibles and co-pays. You should verify with your insurance.
For Self-Pay/Private Pay Patients: Costs will be based on our professional fees.
Disclaimer: Estimates reflect expected costs, but additional charges may apply due to complications or changes in treatment.
Notice of Privacy Practices: By signing this form, you acknowledge your access to our full Notice of Privacy Practices, posted in our office and available on our website. By signing, you consent to the uses and disclosures of your health information described in the Practice’s Notice of Privacy Policies. For more information, please visit our website.
Acknowledgment and Informed Consent: By signing this form, you consent to treatment, understand confidentiality and privacy policies, and consent to receive communications via email and text. For more information, please visit our website.
Informed Consent to Telehealth: By signing this form, you consent to treatment via Telehealth, understanding the risks and confidentiality protections. For more information, please visit our website.
By signing below, you confirm that you have reviewed, understand, and agree to all sections outlined in this Patient Service Agreement & Informed Consent Document.