Policies

PAYMENT 

Jeremy operates out of network with health insurance. 

An initial appointment requires 50-60 minutes and is $250.00. Follow ups can be done in 30 ($125) or 60-minute ($250) slots depending on patient preference. These rates may increase 5% at each year end on the basis of inflation. Credit cards are accepted with a 3.99% transaction fee. Cash, Checks, Electronic payments, Debit, HSA, HRA, FSA are not subject to any fees. 

Upon request, Jeremy can provide documentation for a patient to submit to their health plan should they have an OUT of network benefit.

Lina operates in network with several of the major health plans:

CANCELATIONS

For appointment changes please contact us 24 hours the business day prior to your appointment time. For Monday appointments this means the previous Friday. Noncompliance may result in a charge for the entire cost of the visit. Thank you for your understanding.

COVID PROTOCOL

I hope that you and your loved ones have remained well through the pandemic. Now that the City of Boston and the State of MA are in the “living with Covid” stage:

  1. Face coverings are optional. Your provider will however be happy to put one on at your request.
  2. Waiting room chairs have recently been replaced with chairs that are more easily sanitized. 
  3. Please wash or sanitize your hands regularly. This is never a bad idea and could save you and others a massive inconvenience.
  4. Contact surfaces always have and always will be sanitized regularly. 
  5. HEPA filters that circulate the air every couple minutes are used.
  6. Please arrive at the agreed time and minimize time spent in the waiting area. 
  7. Please stay home if you have a fever or signs of a fever. Those that are sick or told to stay home will not be charged cancellation fees
  8. Appointments with me are always 100% 1 on 1 and in a private treatment room.

Feel free to email with questions or for appointment requests. 

PATIENT RIGHTS

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. 

Get an electronic or paper copy of your medical record: 

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee. Ask us to correct your medical record. 
  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. 
  • We may say “no” to your request, but we’ll tell you why in writing within 60 days. 

Request confidential communications:

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say “yes” to all reasonable requests. 

Your Rights Notice of Privacy Practices

Your Information: Your Rights. Our Responsibilities. 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. 

  • You can ask us not to use or share certain health information for treatment, payment, or our operations.
  • We are not required to agree to your request, and we may say “no” if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. 
  • We will say “yes” unless a law requires us to share that information. Get a list of those with whom we’ve shared information. 
  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. 

Get a copy of this privacy notice:

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. Choose someone to act for you.
  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated. 
  • You can complain if you feel we have violated your rights by contacting us.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint. 

Your Rights Continued. Your Choices for certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: 

  • Share information with your family, close friends, or others involved in your care. 
  • Share information in a disaster relief situation.
  • Include your information in a hospital directory.
  • Contact you for fundraising efforts.
  • If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. 
  • We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases we never share your information unless you give us written permission:
    • Marketing purposes 
    • Sale of your information 
    • Most sharing of psychotherapy notes In the case of fundraising: 
    • We may contact you for fundraising efforts, but you can tell us not to contact you again. 

PATIENT BILL OF RIGHTS

You have the right:

  1. To safe, considerate and respectful care, provided in a manner consistent with your beliefs;
  2. To expect that all communications and records pertaining to your care will be treated as confidential to the extent permitted by law;
  3. To know the physician responsible for coordinating your care at the Clinical Center;
  4. To receive complete information about diagnosis, treatment, and prognosis from the physician, in terms that are easily understood. If it is medically inadvisable to give such information to you, it will be given to a legally authorized representative;
  5. To receive information necessary for you to give informed consent prior to any procedure or treatment, including a description of the procedure or treatment, any potential risks or benefits, the probable duration of any incapacitation, and any alternatives. Exceptions will be made in the case of an emergency;
  6. To receive routine services when hospitalized at the Clinical Center in connection with your protocol. Complicating chronic conditions will be noted, reported to you, and treated as necessary without the assumption of long-term responsibility for their management;
  7. To know in advance what appointment times and physicians are available and where to go for continuity of care provided by the Clinical Center;
  8. To receive appropriate assessment of, and treatment for, pain;
  9. To refuse to participate in research, to refuse treatment to the extent permitted by law, and to be informed of the medical consequences of these actions, including possible dismissal from the study and discharge from the Clinical Center. If discharge would jeopardize your health, you have the right to remain under Clinical Center care until discharge or transfer is medically advisable;
  10. To be transferred to another facility when your participation in the Clinical Center study is terminated;
  11. To expect that a medical summary from the Clinical Center will be sent to your referring physician;

To designate additional physicians or organizations at any time to receive medical updates.

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