Policies

Office Hours and emergencies:

• Our office hours are Mon through Fri, 9 AM to 3 PM. We do not provide emergency services, crisis services, weekend and after-hours coverage. If you have a life-threatening emergency, please go to the nearest emergency room or call 911

Insurance:

• Medical expenses are patient’s responsibility regardless of insurance coverage. While we verify your benefits with your insurance company as a courtesy, a copay or coinsurance info provided by us is not a guarantee of insurance coverage or payment. Patients are responsible for knowing the stipulations of their insurance policy. If for some reason your insurance company fails to pay for services rendered and/or you are not eligible at the time the services are rendered, the patient is still responsible for payment. You also agree to take full responsibility for the entire amount due for any and all services rendered that are not covered by your insurance carrier. You are responsible to timely notify our office for any changes of insurance or demographics information. You authorize your insurance plans to pay directly to Allen Psychiatry for the services provided.

Medication refill policy:

• Maya Health Care & Behavioral Health Clinic request you to schedule a follow up before your prescription refill runs out. All refills and changes in medications are done during an office visit. We only provide treatment and medication management during an appointment. Missing appointments can disrupt your care and lead to a relapse.

Cancellations and missed appointments:

• If you miss or cancel an appointment, a 24 business hour notice is required. If you miss or cancel an appointment without a 24 business hour notice, you will be charged $75 for the missed appointment. Missed appointments CANNOT be filed with insurance. Therefore you are solely responsible for the this fee. After 3 missed appointments, we will no longer provide services unless all missed appointments are paid in full.

Scope of Services:

• At Maya Health Care & Behavioral Health Clinic we do not provide Forensic or Occupational Psychiatry. We do not involve in worker’s compensation cases, divorce/child custody cases, fit or duty, disability evaluations or forms or other legal matters including testimony or reports in civil matters.

Returned checks:

• There is a $50 charge for any returned checks.

Testifying in court:

• If legal actions occur in which your Healthcare provider is subpoenaed to provide testimony (such as in custody cases) you will be responsible to provide the following even if the subpoena is sent from the opposing side of the case: a.) travel expenses b.) hourly or per diem fees based on our existing fees from the time the Healthcare provider leaves the office until she returns. At least 50% of the anticipated cost will be expected prior to the court appearance.

Communications:

• We routinely use phone, email and text to communicate on scheduling, billing, refills and other matters related to our services. While we exercise caution, and encrypt electronic communication on our end, we expect the electronic communication is protected on your end (such as PIN for voicemail or password for email). If you do not feel comfortable with electronic communication, or if it isn’t protected on your end, please do not schedule an appointment with us.

Confidentiality:

• Maya Health Care & Behavioral Health Clinic is committed to confidentiality to the fullest extent allowed by Texas law. There are several exceptions. The following are common: a.) any evidence of child abuse (past or present) must be reported. b.) If any individual intends to take harmful, dangerous, or criminal actions against another human being or against him/herself. It is our duty to report such actions or intent to the authorities. c.) Sexual improprieties by a former therapist or psychiatrist are a criminal offense and must be reported. You have certain rights in such reporting which your physician can explain to you. d.) Certain court order / action such as custody cases, malpractice actions and criminal cases. e.) Collection of fees. If you have questions about this area, please feel free to discuss with your provider.

Danger:

• In the event that your provider, in her clinical judgment believes you to be dangerous to yourself or to someone else, by signing this consent you authorize her to contact either the person listed as your emergency contact or someone else to provide assistance through a crisis situation.

Right to withdraw:

• If a conflict arises for the client or the physician/provider, either has the right to withdraw from the treatment. If the provider feels the need to withdraw from providing treatment, she will inform client and will try to provide appropriate referrals and 30-day emergency care.