This document contains important information about our policies and professional services.  Please note that this document is divided into sections which address Psychological Services (i.e., Therapy) and Psychiatric Services (i.e., Psychiatry), as well as general Ginger.io policies regarding emergencies, communication with providers, and billing and fees. Please read it carefully. When you click “I Agree,” it will represent your agreement to the policies, procedures and informed consent contained in this document.

PRACTICE POLICIES AND PROCEDURES

IMPORTANT PATIENT INFORMATION – PLEASE READ IN ENTIRETY

PATIENT RESPONSIBILITIES

As a patient, it is your responsibility to:

  • Become actively involved in the treatment goals by having scheduled sessions with your provider and keeping your provider informed as to your progress, in order to assure each other of productivity toward desired outcomes.

  • Notify Member Support via email, phone or chat  no less than 24 hours in advance of any non­ emergency cancellations. Emergency cancellations are at the discretion of the provider, but do NOT include transportation issues, minor illnesses, vacations, ineffective appointment tracking, etc.

  • If you are being seen for Psychiatric services

    • Take medication as prescribed; do not exceed the maximum prescribed dose, and do not make changes to your dose unless doing so has been authorized by your physician. Repeated failure to take medications as prescribed/changing dosages will be grounds for termination and referral of treatment. In the event of going against medical advice and exceeding the prescribed dose, no substitute medication will be provided.

PSYCHOLOGICAL SERVICES

Psychotherapy is not easily described in general statements. It varies depending on the personalities of the psychologist and patient, and the particular problems you bring forward. There are many different methods that may be used to deal with the problems that you hope to address. Psychotherapy is not like a medical doctor visit. Instead, it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things both during your sessions and between sessions.

Psychotherapy can have benefits and risks. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, anxiety, depression and helplessness. On the other hand, psychotherapy has also been shown to have benefits for people who go through it. Therapy often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress and anxiety. Working toward these benefits requires effort on your part.

Psychotherapy requires your active involvement, honesty, and openness in order to change your thoughts, feelings, and/or behavior. You will be asked for your feedback and views on your therapy and its progress. Attempting to resolve issues that brought you into therapy may result in changes that were not originally intended. Psychotherapy may result in decisions to change behaviors, employment, substance use, schooling, housing, or relationships. Change can sometimes be quick and easy, but more often it can be gradual and even frustrating. There is no guarantee that psychotherapy will yield positive or intended results.

Your first few sessions will involve an evaluation of your needs. By the end of the evaluation, you will be offered some first impressions of what your therapy will include and a treatment plan to follow if you decide to continue with treatment. The plan will include recommendations to help you achieve your goals. You should evaluate this information along with your own opinions of whether you feel comfortable working with your therapist. If you have questions about the therapist’s procedures, you should discuss them whenever they arise. If your doubts persist, you can see another mental health professional.

If, after this evaluation period, your therapist does not think he/she can help you, he/she will refer you to others who may be a better fit for your particular issues. Within a reasonable period of time after starting treatment, your therapist will discuss his/her working understanding of your issues, a proposed treatment plan, including the type and frequency of treatment recommended, and therapeutic objectives and possible outcomes of the therapy. If you have questions about any of the procedures used in the course of your therapy, their possible risks, your therapist’s expertise, or about the treatment plan in general, please ask your therapist. You also have the right to ask about other possible treatments for your condition and their risks and benefits. If you could benefit from any treatments that your therapist does not provide, your therapist will provide assistance or referral information for obtaining those treatments.

Deciding when to stop your work with your therapist is meant to be a mutual process. Before treatment  is stopped, you and your therapist will discuss how you will know if or when to come back, or whether a regularly scheduled "check­-in" might work best for you. If it is not possible for you to phase out of therapy, it is recommended that you have closure on the therapy process with at least two termination sessions.

Noncompliance with treatment recommendations may necessitate early termination of services. Your therapist will look at your issues with you and exercise his/her educated judgment about what treatment will be in your best interest. Your responsibility is to make a good faith effort to fulfill the treatment recommendations to which you have agreed. If you have concerns or reservations about treatment recommendations, you are strongly encouraged to express them so that any possible differences or misunderstandings can be resolved.

If at some point your therapist assesses that he/she is not effective in helping you reach your therapeutic goals, your therapist is obliged to discuss this with you and, if appropriate, terminate treatment and give you referrals that may be of help to you. If you request it and authorize it in writing, your therapist may talk to the psychotherapist of your choice in order to help with the transition. If at any time you want another professional's opinion or wish to consult with another therapist, you have the option to do so. You have the right to terminate treatment at any time. If you choose to do so, your therapist may offer to provide you with names of other qualified professionals whose services you might prefer.

If you commit violence to, verbally or physically threaten or harass your therapist, the therapist’s colleagues or family, Ginger.io or anyone affiliated with Ginger.io, your therapist reserves the right to terminate your treatment unilaterally and immediately. Failure or refusal to pay for services after a reasonable time is another condition for termination of services.

PSYCHIATRY SERVICES

Psychiatry is not easily described in general statements. It varies depending on the particular problems you bring forward. There are many different methods that may be used to deal with the problems that you hope to address. Psychiatry calls for a very active effort on your part. In order for it to be most successful, you will have to work on things both during your sessions and at home, including taking your prescribed medication as directed.

Psychiatry can have benefits and risks. Since psychiatry often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, guilt, anger, frustration, loneliness, anxiety, depression and helplessness. On the other hand, psychiatry has also been shown to have benefits for people who go through it. Psychiatry often leads to better relationships, solutions to specific problems, and significant reductions in feelings of distress and anxiety. Working toward these benefits requires effort on your part.

During your first session, your psychiatrist will assess whether he/she can be of benefit to you. If your psychiatrist does not think he/she can help you, your psychiatrist will let you know and try to refer you to others who work well with your particular issues. Please note that your psychiatrist, in his/her sole discretion, may decide not to start a doctor-­patient relationship with you after reviewing your case during the initial intake process or following your first sessions; similarly your psychiatrist reserves the right to discontinue services at any time.

If you and your psychiatrist decide to continue, within a reasonable period of time after starting treatment, your psychiatrist will discuss his/her working understanding of your issues, a proposed treatment plan, and therapeutic objectives and possible outcomes of the therapy. If you have questions about any of the procedures used in the course of your treatment, their possible risks, your psychiatrist’s expertise, or about the treatment plan in general, please ask your psychiatrist. You also have the right to ask about other possible treatments for your condition and their risks and benefits. If you could benefit from any treatments that your psychiatrist does not provide, your psychiatrist will provide assistance or referral information for obtaining those treatments.

During the time it takes for your psychiatrist to evaluate you, you or your psychiatrist can decide if the assigned psychiatrist is the best person to provide the services you need in order to meet your treatment goals. If the two of you decide to continue, your psychiatrist will make a recommendation regarding session duration and frequency.

Medication management sessions typically last 15­ or 30 minutes, are more frequent in the beginning or after any changes are made, and then typically occur every 4­-8 weeks. Duration of treatment varies depending on the nature of the treatment and individual client needs. When medications are used in psychiatry, please be advised that they are frequently used “off-­label” meaning that they are used to control symptoms other than what the FDA originally approved the medication to treat. If you have questions about the procedures your psychiatrist uses, you should discuss them whenever they arise. If your doubts persist, you can see another mental health professional.

Deciding when to stop your work with your psychiatrist is meant to be a mutual process. Before treatment  is stopped, you and your psychiatrist will discuss how you will know if or when to come back, or whether a regularly scheduled "check-in" might work best for you.

Noncompliance with treatment recommendations may necessitate early termination of services. Your psychiatrist will look at your issues with you and exercise his/her educated judgment about what treatment will be in your best interest. Your responsibility is to make a good faith effort to fulfill the treatment recommendations to which you have agreed. If you have concerns or reservations about treatment recommendations, you are strongly encouraged to express them so that any possible differences or misunderstandings can be resolved.

If at some point your psychiatrist assesses that he/she is not effective in helping you reach your goals, your psychiatrist is obliged to discuss this with you and, if appropriate, terminate treatment and try to give you referrals that may be of help to you. If you request it and authorize it in writing, your psychiatrist may talk to the psychotherapist or psychiatrist of your choice in order to help with the transition. If at any time you want another professional's opinion or wish to consult with another psychiatrist, you have the option of doing so. You have the right to terminate treatment at any time. If you choose to do so, your psychiatrist may offer to provide you with names of other qualified professionals whose services you might prefer.

If you commit violence to, verbally or physically threaten or harass your psychiatrist, the psychiatrist’s colleagues or family, Ginger.io or anyone affiliated with Ginger.io, your psychiatrist reserves the right to terminate your treatment unilaterally and immediately. Failure or refusal to pay for services after a reasonable time is another condition for termination of services.

MEDICATION

If medication is prescribed, you agree to abide by your psychiatrist’s directions regarding your medication. Please discuss with your psychiatrist the effects, including any side effects, of your medication.

If your provider has prescribed medication, please contact your pharmacy and ask to have your pharmacy FAX us refill requests.

FAX NUMBER FOR MEDICATION REFILL REQUESTS: 415-­891-­0725

Refills of medication are not usually written at the time of your scheduled appointment. Instead they should be handled through your pharmacy. Prescription refills are not normally considered urgent or emergent situations, and must therefore be handled during regular business hours. Refill requests submitted on Fridays or weekends will be turned around the following week. Any controlled or scheduled substances (benzodiazepines, sleep medications, stimulants) will NOT be prescribed by your provider.

Medications will not be replaced if they are lost, damaged, or stolen without a scheduled appointment. Requests for early refill secondary to lost, damaged or stolen prescriptions will be handled on a case by case basis and an occurrence more than once within a year may be grounds for discharge from the practice. Failure to respond to a trial of medication does not guarantee further medication trials.

DUAL RELATIONSHIPS

Professional mental health services, including therapy and psychiatry, never involve sexual, business, or any other dual relationships that could impair the objectivity, clinical judgment or effectiveness of your provider, or which could be exploitative in nature. Please discuss this with your provider if you have questions or concerns.

TELEPHONE POLICY & EMERGENCY SITUATIONS

Your provider is often not immediately available by telephone. If you need to contact your provider between sessions, please contact Member Support or your Ginger.io coach, who will address your concerns or contact your provider on your behalf.

Your provider will make every effort to respond within 24 hours of your message, with the exception of weekends and holidays. Please note that cellular, computer, and voicemail technologies are not infallible. It may be more than 24 hours before your provider returns your call to set up an appointment with you. If you are difficult to reach, please inform Member Support or your coach of times when you will be available. If you are unable to reach your provider and feel that you can’t wait for your provider to return your call, contact your family physician or the nearest emergency room.

Emergency phone consultations of 5 minutes or less are normally free. However, if you and your provider spend more than 5 minutes in a week on the phone, if your provider spends more than five minutes reading and responding to messages from you during a given week, or if your provider spends more than five minutes involved in case management or coordination of care, you may be billed on a prorated basis for that time. If you feel the need for many phone calls and cannot wait for your next appointment, we may need to schedule more sessions to address your needs. If your provider will be unavailable for an extended time, your therapist will provide you with the name of a colleague to contact, if necessary; or, otherwise please contact your coach. Please note that email systems are not entirely secure, and you acknowledge this and consent to use of email if you correspond with your provider by email.

If an emergency situation arises, please indicate it clearly in your message to Member Support  or your coach. If your situation is an acute emergency and you need to talk to someone right away, dial 911 or go to your nearest Emergency Room. Ginger.io does not provide emergency or crisis services.

Urgent situations are conditions that might have severe consequences if not addressed for over a few days, and include (but are not limited to) acute, severe depression, mania, or extremely severe anxiety. In an urgent situation, please contact your coach, who will attempt to contact your provider.

Emergencies include any situations where there is a question of danger to your own life or anyone else’s, or conditions like psychosis, where patients may be incapable of making rational decisions. In emergency situations, you should go directly to the emergency room. In addition, your provider may require you to go to the nearest emergency room. If your provider has any concern of imminent danger to yourself or someone else, your provider will also be required to involve the police or medical authorities to transport you to the nearest medical facility for evaluation, sometimes for an extended time (>24 hours).

In the event of a crisis, you may contact the following or go to the nearest emergency medical facility:

Sometimes patients have questions about their medications, side effects, pharmacy problems, or their diagnosis that come up in between appointments. Please do not hesitate to contact Member Support, who will contact your provider to inform him/her of your questions. Your provider will try his/her best to answer you promptly. However, certain important clinical decisions may not be able to be made in­ between appointments. For example, you may need an appointment in order to start a new medication. If your situation is severe enough that you are unable to wait until your next appointment, we recommend that you go to the nearest health care facility/ emergency room for attention.

NO SHOW AND LATE CANCEL POLICY

Once an appointment is scheduled, you will be expected to pay for it unless you provide 24 hours advance notice of cancellation. Exceptions may be made, on a case by case basis, if your provider agrees that you were unable to attend due to circumstances beyond your control.  If you late cancel (cancel with under 24-hour notice) or no show for an appointment, we will contact you to set up another appointment. Repeated missed appointments or no shows may be grounds for termination of treatment.

DISABILITY AND MEDICAL RECORDS REQUESTS

Your provider’s primary role is to provide diagnosis and treatment for your medical condition.  However, we understand that, at times, individuals will request medical input on a variety of matters, including verification of disability status or other work-related concerns. Your provider will determine, on a case by case basis, and in accordance with legal and ethical statues, whether or not he or she is able to offer such an opinion. At times, providers will not have the training or information necessary to offer detailed assessments about ability to perform certain functions. However, providers are typically able to offer detailed information regarding diagnosis, history, type of treatment, response to treatment, and prognosis, otherwise known as a “Treatment Summary.”  Please speak with your provider in order to learn more.

PROFESSIONAL RECORDS

Legal and ethical standards require that your provider keep treatment records.You are entitled to inspect a copy of certain professional records regarding your treatment unless your provider believes that seeing them would be harmful, in which case your provider will be happy to send them to a mental health professional of your choice, or your provider can prepare a summary for you instead. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. If you wish to see your records, it is recommended that you review them in your provider’s presence so that the contents can be discussed. Patients will be charged an appropriate fee for any professional time spent in responding to information requests.

To release medical records to you or other entities, requests need to come in writing. Contact Member Support or talk with your provider for additional information. Please note that these information requests require a substantial amount of time to compose, and thus we ask for 30 days notice, when possible. We are unable to reissue parts of your treatment chart that were submitted by other agencies. You will need to request your records separately from those agencies.

PROFESSIONAL FEES

In addition to scheduled appointments, you will be charged for other professional services you may need on a pro-rated basis per hour.  Other services include report writing, telephone conversations lasting longer than 5 minutes, attendance at meetings with other professionals you have authorized, preparation of records or treatment summaries, and the time spent performing any other service you may request of your provider. If you become involved in legal proceedings that require your provider’s participation, you will be expected to pay for your provider’s professional time, including if your provider is called to testify by another party. Because of the difficulty of legal involvement, your provider may charge more per hour for preparation and attendance at any legal proceeding.

BILLING AND PAYMENTS

Except in certain circumstances in which prior arrangements have been made through your employer or health care agency, you will be expected to pay for each session at the time it is held or prior thereto. If you have questions about payment arrangements, and your particular responsibilities, please contact Member Support. Payment schedules for professional services other than direct care will be agreed to when they are requested. Unless otherwise required by your provider, billing will be provided after each session, although you may be required to pay for the service prior to your scheduled session(s). Fees may be periodically raised, and you will be provided at least 30 days notice.

If your provider is in-network with your insurance panel, or if Ginger.io has an agreement to provide clinical services as managed through your employer, this consent authorizes Ginger.io to send treatment records to your insurance company, or its designated third party administrator, in order to receive reimbursement. It is your responsibility to determine that your sessions will be covered by your insurance if your provider is a member of your insurance panel, or if you are seeking out-of-network reimbursement. You are responsible for payment of all fees that your insurance company does not cover. In addition, you will be responsible for payment of any co-pays, as stipulated by your insurance plan, directly to Ginger.io.

If services have not been paid within 30 days, you will be notified in writing that payment has not been made and that the patient make payment or contact the insurance carrier in order to request they pay for the services in a timely manner. If your account has not been paid for more than 30 days, a 3% per month fee may be added to the bill or the maximum amount allowed by law (whichever is less). If your account has not been paid for more than 90 days and arrangements for payment have not been agreed upon, your psychiatrist has the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. If such legal action is necessary, its costs will be included in the claim. In collection situations, the only information released regarding a patient’s treatment is his/her name, the nature of services provided, and the amount due.

At times, Ginger.io may provide you with information about your insurance benefits. It is your responsibility to verify all such information directly with your insurance company.  A quotation of benefits as provided by Ginger.io is not a guarantee of payment by your insurance company.

An Important Note About Credit Card Pre Authorization:

This consent gives permission to charge the patient’s credit card for any services. This consent allows for credit card processing and the charge will appear on the patient’s statement. This consent is valid unless the patient cancels the authorization in writing. The patient’s agreement to this consent constitutes preauthorization to provide payment in this manner.

INSURANCE REIMBURSEMENT

Ginger.io may be considered in-network with your insurance company, or may have a relationship with your employer or treatment provider under which you may receive health care services.  However, you are responsible for payment in full of psychiatry fees in the case in which your insurance company, employer, or treatment provider does not cover services through Ginger.io. If Ginger.io is not in-network with your insurance company, and you are interested in seeking out-of-network reimbursement, you will be provided with a billing form at your request that you may submit to your insurance company directly. Any and all dealings with your insurance company will be through you and solely your responsibility.

MINORS

Ginger.io does not provide treatment to individuals under the age of 18.

CONFIDENTIALITY

In general, the privacy of all communications between a patient and a psychiatrist is protected by law, and a psychiatrist can only release information about his/her work with a patient with the patient’s written permission. But there are a few exceptions.

In most legal proceedings, you have the right to prevent your psychiatrist from providing any information about your treatment. In some proceedings involving child custody and those in which your emotional condition is an important issue, a judge may order your psychiatrist to testify if the judge determines that the issues demand it.

There are some situations in which a psychiatrist is legally obligated to take action to protect others from harm, even if he/she has to reveal some information about a patient’s treatment. For example, if a psychiatrist believes that a child, an elderly person or disabled person has been abused or neglected, the psychiatrist must file a report with the appropriate agency.

If a psychiatrist believes that a patient is threatening serious bodily harm to another, the psychiatrist is required to take protective actions. These actions may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient. If the patient threatens to harm himself/herself, the psychiatrist may be obligated to seek hospitalization for him/her or to contact family members or others who can help provide protection.

Your psychiatrist may occasionally find it helpful to consult other professionals – either as individuals or in a consultation group  about a case. The consultant(s) is/are also legally bound to keep the information confidential. If you don’t object, your psychiatrist will not tell you about these consultations unless your psychiatrist feels that it is important to your treatment. This consent allows your psychiatrist to share information and/or records regarding your treatment with others in compliance with state and federal laws (such as HIPAA) and the Notice of Privacy Practices. Please refer to the Notice of Privacy Practices.

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that you raise with your psychiatrist any questions or concerns that you may have.

Additionally, if you are receiving services through a contractual arrangement made by Ginger.io and your employer, insurance company, or third party administrator, you agree to allow Ginger.io to share minimally necessary information with this entity in order to verify benefits and make recommendations regarding your treatment.

IN THE EVENT OF UNEXPECTED INTERRUPTION(S) OF PRACTICE

This consent verifies that you release Ginger.io or its representative to provide someone with your records and your contact information due to your provider’s death or disability or other discontinuance, unless you otherwise advise your provider in writing that you do not wish to provide such information.

MISCELLANEOUS SUBJECTS

Service Animal Requests: We recognize the importance of animals and pets for many people. That said, we are unable to complete service animal designations for psychiatric conditions because of the lack of research and co­ordination of policy guidelines for this indication.

Medical Marijuana: Due to the lack of controlled research on inhaled marijuana for psychiatric conditions and possible harms, we are unable to endorse its use from a medical perspective. However, some people report that the use of marijuana helps with certain psychiatric conditions. Regrettably, we cannot assist in obtaining a medical marijuana card due to conflicts between the state of California’s policy of medical marijuana’s legalization and our prescribing authority, which comes from Federal law.

PSYCHIATRY COMPLAINTS

If you are dissatisfied with the services you’ve received through Ginger.io, please email help@ginger.io and one of our staff will follow-up with you.

To facilitate consumers in receiving appropriate psychiatric services, all licensees and registrants are required to post the Notice below in a conspicuous location in their principal psychiatry business office. Since your psychiatrist works in multiple locations, that Notice is in this Contract:

NOTICE: The Department of Consumer Affairs receives questions and complaints regarding the practice of psychiatry. If you have any questions or complaints, you may contact this department by calling (916) 263­ 2382, or by writing to the following address:

THE MEDICAL BOARD OF CALIFORNIA

2005 EVERGREEN STREET, SUITE 1200

SACRAMENTO, CA 95815

PSYCHOTHERAPY COMPLAINTS

If you are dissatisfied with the services you’ve received through Ginger.io, please email help@ginger.io and one of our staff will follow-up with you.

To facilitate consumers in receiving appropriate psychological services, all licensees and registrants are required to post the Notice below in a conspicuous location in their principal psychological business office. Since your therapist works in multiple locations, that Notice is in this Contract:

NOTICE: the Department of Consumer Affairs receives questions and complaints regarding the practice of psychology. If you have any questions or complaints, you may contact this department by calling (916) 263­2699, or by writing to the following address:

Board of Psychology

1625 N. Market Blvd., Suite N­215

Sacramento, CA 95834