Office Policies

Welcome to Lake Mary Behavioral and Infusion Center! We look forward to working with you and are committed to providing high quality, compassionate care. Our office policies are designed to ensure the best possible experience for our patients and to support them in choosing the practice that best meets their needs and expectations.

Appointments Policy

• Patients are seen by appointment only. 
• Patients should bring their photo ID and insurance card to every appointment.
• Patients are allowed a 15-minute grace period for evaluations and therapy sessions. Patients arriving more than 15 minutes late will be required to reschedule.
• Patients are allowed a 10-minute grace period for psychiatric follow up appointments (30 minutes long). Patients arriving or connecting (telehealth appts) more than 10 minutes late will be required to reschedule. 
• All new patient evaluations are conducted in office. Telehealth services are not available for initial evaluations.
• All new patients must complete a psychiatric evaluation before beginning therapy.
• Scheduling a New Evaluation: When calling to schedule a new patient evaluation, please have the following information available: demographic details, insurance information, and a valid email address to set up the patient portal.
• New Patient Paperwork: All required new patient paperwork sent through the patient portal must be completed prior to scheduling a new patient appointment.
• Once new patient paperwork is completed, contact the office to schedule the new patient evaluation.
• Patients prescribed controlled substances are seen monthly and are required to have at least one in-office visit per year, or more frequently if recommended by their provider. 
• Follow-up visits: May be conducted in office or via telehealth at the provider’s discretion and patient preference.
• Patients are responsible for scheduling follow-up visits to ensure continuity of care and medication refills.
• Patients will receive enough medication and refills until the next recommended office visit.
• Missed or canceled appointments: It is the patient’s responsibility to reschedule. Medications will not be refilled based on pharmacy requests alone.
• Controlled substance prescriptions cannot be refilled without a follow-up appointment. All refill requests will be denied unless an in-office or approved telehealth visit has occurred, in accordance with Florida law.
• If an appointment must be canceled or rescheduled, at least 48 hours’ notice during normal business hours is required.
• Failure to provide adequate notice will result in a $75 no-show or late cancellation fee.

Telehealth Appointments Policy

• Eligibility: Telehealth visits are only available for established patients.
• Appointment Check-In: Office staff will contact patients on the day of the appointment to complete check-in and collect any patient’s responsibility for the visit.
• Patient Requirements: Be prepared to connect with your provider from a secure, private location with a reliable internet connection.
• The provider will send a secure link via phone or email directly to the patient.
• Telehealth visits cannot be conducted while driving or operating machinery.
• Patients must maintain appropriate attire, an uninterrupted environment, clear audio, and full camera visibility for the duration of the visit.

Treatment of Minors Policy

• A parent or legal guardian must provide express and informed consent for psychiatric treatment of a minor (under age 18) in our office. This includes evaluation, therapy, medication management, and other ongoing services.
• When parents share legal responsibility, written consent from only one parent may be accepted for treatment, unless a court order states otherwise. Providers may request documentation (e.g., custody order) to verify decision-making authority.
• If appropriate parental/legal guardian consent cannot be obtained for treatment that cannot lawfully be provided under the minor self-consent provisions, services will be declined until consent is obtained.

Treatment of Workers’ Compensation Patients Policy

• Services are covered only for work-related injuries or conditions approved under the WC claim.
• Patients are responsible for keeping and rescheduling appointments. WC patients must adhere to standard office policies regarding late arrivals, cancellations, and no-shows.
• All billing is submitted directly to the workers’ compensation insurance carrier.
• Patients are not responsible for payment of authorized services covered under WC.
• Completion of forms is subject to provider discretion and may carry a fee if not related to ongoing treatment.
• Telehealth may be used for follow-up visits if allowed by the WC insurer and applicable laws.
• All treatment is protected under HIPAA, but relevant information may be shared with the employer, insurer, or case manager as required for claim processing.
• Coordination with case managers and other providers is part of standard WC care.

Requests for Records and Documentation Policy

Medical Records

Your privacy is important to us. Psychiatric and therapy records are confidential and protected by state and federal law. 

Our practice is committed to safeguarding patient privacy while also complying with all legal obligations related to disclosure.

• Medical Records Requests: Please allow up to 5-10 business days for processing. 
• Right of Access: Patients generally have the right to request access to their medical records. However, under Florida law and HIPAA, certain mental health records may be withheld or restricted even from the patient, when specific conditions apply.
• Portal Access for medical records: You may access your records upon request at no cost through the HIPAA compliant patient portal.
• Printed Copies (non–Workers’ Compensation patients) have a cost: $1.00 for the first 25 pages, then $0.25 per page. 
• Written Authorization: Medical records may be released to any third party upon request. This requires the completion and signature of a Protected Health Information (PHI) Release Form.
• Medical records are released via secure fax to other medical providers involved in your care at no cost to you or the receiving provider.
• Psychotherapy notes are not part of the designated medical record. They are not subject to routine patient access.
• Risk of Harm: Access or release of psychiatric and therapy records may be denied if, in the professional judgement of the treating provider, disclosure is reasonably likely to: cause substantial harm to the patient’s mental and emotional health; or endanger the life or physical safety of the patient or another person.
• Requests from family members, employers, schools, attorneys or other third parties will be denied unless: the patient has provided written authorization or the requested has leagl authority recognized under Florda law.
• Exceptions Permitting Disclosure: court-ordered mental health proceedings; mandatory reporting requirements (e.g.,abuse, neglect); a credible and imminent threat of a serious harm to an identifiable person.

Billing and Payment Records

• Patients may request itemized statements or receipts.
• Billing Records are available upon request and are separate from clinical records.

FMLA Forms

• Requests for completion of Family and Medical Leave Act (FMLA) forms are subject to provider review and approval. 
• A non-refundable fee of $250 applies to FMLA form completion unless the request pertains to treatment currently being provided in our office, in which case the fee may be waived at the provider’s discretion.

• Timeline for completion: 5–7 business days.
• Patients who are unable to pay the FMLA form completion fee may request assistance from their primary care provider or another treating physician.

 Disability Forms

• Requests for completion of disability-related forms are subject to provider review and approval and are completed only at the provider’s discretion. 
• Disability forms are completed only for established patients with whom the provider has an ongoing clinical relationship of at least one year. 
• If a provider agrees to complete the requested documentation, a non-refundable fee of $250 applies. 
• Patients who are unable to pay this fee may request assistance from their primary care provider or another treating physician.

Diagnosis Letters

• Available upon request at no cost to the patient.
• Allow 5–7 business days.
• These letters confirm that you are an established patient of our practice. They state the date on which treatment commenced and, unless otherwise specified, also include diagnoses and treatment details.
• Sent to patient via the patient portal.

Other Documents

• Any documents requiring provider completion are subject to a fee. Fees start at $50 and can go up to $250.
• Please allow 5-7 business days for processing. 
• All forms are submitted to the provider for review. Completion of forms is not guaranteed and is subject to the provider’s clinical judgment, scope of practice, and determination of appropriateness.

Billing and Payments 

• Patient’s eligibility and insurance benefits are verified before every visit. Patient responsibility is determined by your insurance. Contact your insurance provider or the number at the back of your health insurance card if you have any questions about your insurance coverage.
• The portion of the visit that is the responsibility of the patient (deductible, copay, coinsurance) will be collected before the appointment.
• Accepted forms of payment include cash, credit/debit cards, HSA cards, apple pay, cash app and google pay available.
• It is the patient’s responsibility to update any new insurance information or identification number with our staff prior to any appointment.
• Unpaid billing claims are the patient’s responsibility.
• To respect the time and commitment of both our providers and other patients waiting for care, late cancellations and no shows are subject to a $75.00 fee (Can be payed in 3 installments). 
• TRICARE Prime patients: A referral from your PCP is required for in-office appointments.
• We accept most commercial insurance and Medicare. 
• Self-pay rates for uninsured patients are available upon request.

Pet & Service Animal Policy

• To ensure a safe and comfortable environment for all patients, visitors, and staff, only service animals are permitted inside our medical office.
• In accordance with the Americans with Disabilities Act (ADA), a service animal is defined as a dog that is individually trained to perform specific tasks or work for a person with a disability. These tasks must be directly related to the individual’s disability.
• The following are not allowed inside the office:

• Pets of any kind
• Emotional support animals
• Therapy animals
• Comfort or companion animals

While we understand the important role these animals may play, they are not considered service animals under the ADA and cannot be accommodated in a medical setting.

 Alternative Treatments Offered

Ketamine Infusion Therapy

We provide ketamine infusions for mental health conditions only. These treatments are not covered by insurance.

• Evaluation: A psychiatric evaluation is required and may be covered by insurance. Self-pay patients ($325) will have this fee credited to their first infusion.
• Protocol: Six infusions over two weeks, then monthly boosters as needed.
• Cost: $450 per infusion. Payment plan available. Financing not available.
• Preparation:
  • No food/drink for 4 hours prior.
  • Continue morning medications as prescribed.
  • Arrange transportation. Patients cannot drive for 8 hours after treatment.

Spravato Treatment

Spravato is indicated for the treatment of resistant depression (excludes bipolar depression).

• Coverage: Treatment is typically covered by insurance with prior authorization and is billed through pharmacy benefits. Patients are responsible for verifying coverage. Buy-and-bills are not offered.
• Administration: Medication is dispensed and administered in our office.
• Monitoring: Patients are observed for 2 hours after treatment. Transportation home is required.
• Protocol:
  • 2x per week for 4 weeks, then weekly for 4 weeks
  • Maintenance as needed based on response
• Preparation: No food/drink for 3 hours before treatment.
• Cost: Depends on insurance and deductible. Assistance may be available through Janssen Care Path patient assistance program. Visit https://www.janssencarepath.com/hcp/spravato. 

Transcranial Magnetic Stimulation Therapy

TMS is indicated for treatment-resistant depression as determined by the provider.

• • Evaluation: Complete psychiatric evaluation at our office is required for all patients referred for TMS.  

• Coverage: Most insurance plans cover TMS Therapy. Prior authorization is required by all insurances except Medicare. Patients are responsible for verifying coverage, including co-pays or deductibles.

• Administration: TMS is administered in-office using the NeuroStar device by trained staff under provider supervision.
• Monitoring: Patients are monitored during each session for tolerability.
• Protocol: 5 sessions per week for 4–6 weeks, Totaling of 36 individual treatments. Maintenance or booster sessions may be recommended based on clinical response.
• Preparation: No special preparation is required. Patients should arrive with hair free of heavy styling products.
• Patient Responsibilities: Attend scheduled sessions on time. Notify staff in advance if a session must be rescheduled. Report any discomfort, side effects, or changes in health promptly to the provider.
• Cost & Assistance: Cost depends on insurance coverage, co-pays, and deductibles. Staff can assist with insurance verification.

Emergency and Urgent Calls

Medical Emergencies
Our office does not provide emergency or crisis services.
If you are experiencing a medical or psychiatric emergency, including but not limited to:

• Suicidal thoughts with intent or plan
• Thoughts of harming others
• Severe medication reactions
• Loss of consciousness, chest pain, or other life-threatening symptoms

Call 911 immediately or go to the nearest emergency room. You may also call or text 988 Suicide & Crisis Lifeline.

Urgent (Non-Emergency) Clinical Concerns
Urgent matters are issues that require timely attention but are not life-threatening, such as:

• Worsening symptoms without immediate danger
• Medication side effects that are concerning but not emergent

Urgent calls should be made during normal business hours. Messages will be returned as soon as reasonably possible, but same-day response is not guaranteed.

After-Hours Calls
Our office does not guarantee after-hours availability. Voicemails or messages left outside of business hours will be addressed on the next business day.
After-hours messages should not be used for emergencies.

Termination of Care

The provider–patient relationship may be terminated by either party for any appropriate reason. Grounds for termination may include, but are not limited to, the following:

• Repeated no-shows or late cancellations
• Failure to comply with treatment recommendations or care plans
• Non-adherence to medication agreements or controlled substance policies
• Drug-seeking behavior, medication misuse, diversion, or falsification of records
• Verbal abuse, threats, harassment, or inappropriate behavior toward staff or providers
• Physical violence or credible threats of harm
• Providing false or misleading information to the provider or staff
• Failure to maintain required follow-up appointments
• Non-payment of fees or outstanding balances after reasonable notice
• Refusal to follow office policies, telehealth requirements, or safety guidelines
• Use of illicit substances that interferes with safe and appropriate treatment