Question 1

Patient Policy Agreement

Accepted Answer

Our goal at Renew Psychiatric Group is to use modern treatment modalities along with technology to efficiently and effectively deliver the best possible mental health care to our patients. This page describes the conditions of services provided and will answer questions you may have about our practice. Patients are required to confirm their consent to these conditions when booking an appointment and when starting a telepsychiatry video session with our providers.

Question 2

Confidentiality

Accepted Answer

Renew Psychiatric Group will maintain the privacy of patients' protected health information within the practice. Protected health information will only be accessible to providers within the practice, our billing providers who process insurance claims, and any ancillary persons whose administrative services may be utilized by the practice. Unless instructed by the patient, Renew Psychiatric Group will not share information with third parties outside the practice, except in exceptional circumstances whereby a provider reasonably believes that the patient is in imminent danger of harm to themselves or others or a vulnerable person is being abused or neglected, or the law requires certain information to be disclosed. In addition, to ensure effective patient care, limited information may be disclosed to pharmacies, laboratories and other providers of ancillary health care services. Due to the nature of billing, the name "Renew Psychiatric Group" or similar may appear on a statement from the payment card issuer.

Question 3

Establishing Care-Therapeutic Relationship

Accepted Answer

All new patients to our practice undergo an initial psychiatric evaluation so that the provider may make a diagnostic assessment and offer treatment recommendations relevant to that individual patient.  After the evaluation, the provider will determine whether it would be appropriate to establish a therapeutic relationship and start care, and the patient may decide whether to seek treatment as discussed with the provider. In certain cases, the provider may determine that tele-medicine is not an appropriate mode of treatment or that the practice may not be a good clinical fit for the patient’s needs. While the provider may offer advice on alternative treatment options that may be sought, they are not responsible for the patient's decision on whether to seek such treatment or from who or where they should seek it. Contacting your insurance carrier or local primary care provider may be a good alternative source for a referral to another mental health provider.

Question 4

Security of Records

Accepted Answer

Renew Psychiatric Group will maintain the security of patients' protected health information within the practice. To maintain patient records securely, Renew Psychiatric Group may utilize the services of electronic medical records companies. Renew Psychiatric Group may also utilize the services of telecommunications companies to facilitate virtual interactions between providers and patients. Where such services are employed, Renew Psychiatric Group will maintain a business associate agreement with the relevant vendors. In the unlikely event that a vendor experiences a security breach, Renew Psychiatric Group will make reasonable efforts to notify patients.

Question 5

Request for Medical Records

Accepted Answer

The patient may request a copy of their medical record held by Renew Psychiatric Group. Records will be shared unless a provider determines that it would be emotionally damaging to the patient. In this case, the provider may discuss the situation with the patient prior to their release. Patients may also access their treatment plans, labs and some other portions of their medical record through our secure patient portal. The patient may request a correction of any information that they believe is incorrect in the chart and it will be discussed and reviewed by the provider. Addendums can be added to the chart if there is information that is incorrect or needs to be changed for a variety of reasons upon approval and by the provider who completed the documentation initially.

Question 6

Emergency or Urgent Needs

Accepted Answer

If a patient faces an emergency (including a threat of physical harm to themselves or others, or a severe drug reaction), they should seek help from the relevant emergency services provider in their local area by going to the closest emergency room or calling 911 if needed. We don't offer after hours care or emergency coverage. Our practice focuses on an outpatient private practice general psychiatry model.

Question 7

Clinical Services

Accepted Answer

All services rendered by Renew Psychiatric Group are provided on an outpatient basis via advance appointments using secure HIPPA compliant telecommunication software. To ensure continuity of care and appropriate treatment, patients with whom Renew Psychiatric Group and its providers has an established therapeutic relationship with should have a follow-up appointment at least every three months. All established patients must be seen for a follow up visit at least one time every 3 months. If a follow up visit is not made and attended within the 3 month period, you will no longer be considered an active patient of Renew Psychiatric Group or it’s providers and we will no longer accept responsibility for your care, including medication refills.

Question 8

Written Communication via Patient Portal

Accepted Answer

Patients may use the online patient portal to securely message their provider. This option is provided as a complimentary service to support patient care. While responses are usually prompt and we try to respond to portal messages as quickly as possible, there is no guarantee of immediacy. Messages should not be sent by patients experiencing an emergency; instead, the assistance of relevant emergency services should be sought for a psychiatric emergency. Secure messaging through the patient portal may not be appropriate in other contexts, including when patients seek to change or substantially alter their prescribed medication due to side effects or efficacy concerns. In such cases, patients should schedule an appointment to discuss treatment options with their provider as medication changes are not made without seeing and fully assessing the patient.

Question 9

Payment and Fees

Accepted Answer

When you make an initial appointment, you must provide a credit card to secure the appointment. The credit card information is known only to the payment processor, and will be used for any future "no-show" fees if indicated, as well as for appointment fees if we do not participate as an in-network provider with your insurance company.
Renew Psychiatric Group is in-network with select insurance panels through one of our billing partners, Headway or Alma. You will be required to provide your insurance information, along with a credit card that is filed with the billing partner. Co-pays, co-insurance, deductibles, and any other fees due and will be charged at the time of service to the credit card on file with the billing partner. The billing partner will handle filing the claim with your insurance company, though ultimately you are responsible for payment if the insurance company denies the claim.
For patients without insurance coverage or coverage through insurance companies where Renew Psychiatric Group is not an in-network provider, the published cash rate is due at time of service, and will be charged to the credit card on file with Renew Psychiatric Group's payment processor. Upon request, patients will be provided with documentation with which they may seek reimbursement from their insurance carrier for out-of-network benefits. We can provide a "superbill" to patients on request. Signed by the provider, this document contains details regarding the diagnosis and treatment received with the appropriate billing codes. Certain insurance plans (usually PPOs) will accept such documentation in support of claims for out-of-network benefits. To check that your plan provides such benefits, you may contact them and use the following CPT codes to discuss with your insurance carrier:
- initial evaluations: 99204 & 90836 or 99205 & 90833
- follow-ups: 99214 & 90833
Renew Psychiatric Group does not bear responsibility for the success or reimbursement of such insurance claims.
To ensure efficiency of services, patients are requested to provide payment details when booking their first appointment. Payment details are securely stored by a third-party payment processor. We accept major cards, including Visa, MasterCard, Discover and American Express as well as HSA/FSA cards. By providing these details, the patient consents for Renew Psychiatric Services to pre-authorize the payment for services on the card in advance of each appointment and to subsequently bill for services per the current listed fee schedule below. 
Payment is due at the time of your or your child’s appointment. The person signing below is the account guarantor and is accepting responsibility to pay for any services rendered. This includes those provided to a child - regardless of custodial or legal agreements between parents. We assume 50/50 custody for the purposes of treatment.
Your payment method will be pre-authorized in advance of each appointment and charged afterwards as follows:

For an Adult initial evaluation, we charge $350.
For a Child/Adolescent initial evaluation, we charge $400.
Follow-up appointments with established patients we charge $175

Question 10

Late Cancellations / No Shows

Accepted Answer

If you arrive more than 10 minutes late to an appointment, it will be considered a late cancellation / missed appointment and you will be charged for the scheduled appointment per our late cancellation / missed appointment policy, and then rescheduled for another time. Cancellations must be made 48 business hours in advance, not including weekends or Holidays. (A 9am Monday appointment must be cancelled by Thursday 9am). Except in emergencies, there will be a fee for appointments missed, or cancelled without 48 hours’ notice. This fee is $150, regardless of scheduled visit type, and will be billed by the payment processor to the card on file. This fee is regardless if the appointment were to be paid self-pay or billed through insurance, and it is not covered by insurance.  Please note that repeated late cancellations or more than three missed appointments in a year may result in being discharged from care with our practice and its providers, resulting in the need for the patient to find an alternate provider for their care.
If you fail to show up to a scheduled appointment and do not call within 30 days to reschedule, you will be considered to have self-terminated care with our practice.

Question 11

Medication Refills

Accepted Answer

Medication refills are done during scheduled appointments only so that your response to the medication(s) can be accurately assessed. Prescriptions will be written and sent with enough refills to last until your next scheduled appointment. We recommend scheduling your next appointment at the end of each appointment so that we can be sure you are following your treatment plan and so you do not run out of medication, as our schedule can fill up quickly.
These strict policies primarily reflect our concern for our patient’s well-being, as self-assessment of psychiatric symptoms is difficult, and seeing patients at regular intervals is best practice. In most cases an appointment will be required for any prescription refills.
If something unexpected occurs and you will run out of medication before your next scheduled follow-up, please call or message our office through the patient portal to request a refill. Do not contact the pharmacy directly as they can take days in some cases to contact us, and this could result in delays in getting your medication refilled.  Please allow up to 5 business days for refills to be processed. Controlled substances cannot be refilled without being seen for an appointment and no early refills will be provided.
Controlled substances such as benzodiazepines and stimulants are tightly regulated by the DEA. These medications can be useful when indicated but require more monitoring and must be part of a comprehensive treatment plan. Patients who are on controlled substances must sign a controlled substance agreement and be seen at minimum once every 3 months, or more frequently at your provider's discretion. If you do not adhere to the agreed upon treatment plan, then we will be unable to continue to provide care to you. There will be no early refills of controlled substances for any reason. If you no show or late cancel for your scheduled appointment and request a refill of these medications, you will not receive a refill until you are seen for an appointment.

Question 12

Forms Completion Requests

Accepted Answer

We require an appointment to be scheduled for any forms that may be requested to be completed by our providers. We do not certify patients for disability, service animals, or medical marijuana. Examples of forms we do sometimes complete are FMLA, short term disability, and other miscellaneous forms, on a case-by-case basis. We require an appointment to assess the patient and review the requested form to decide if it is something we can assist with. In the case of long-term disability, we do complete these in some cases, but only after the patient has been being seen actively as a patient with our practice for a minimum of 6 months.

Question 13

Court Evaluations and Legal Matters

Accepted Answer

Renew Psychiatric Group and its providers do not provide court ordered evaluations including forensic evaluations, parental fitness evaluations, psychosexual evaluations, or any other services outside of general outpatient psychiatric care. These other areas are specialty areas that require additional training and expertise and would be provided by psychiatric/psychologic providers who specialize in those areas of treatment.
We accept patients for care with the specific agreement that they will not involve our practice or its providers in any legal matters, including but not limited to child custody, court-ordered treatment, worker’s compensation claims, and criminal cases. We do not provide legal opinions, evaluation, nor testify for disability or child custody cases.
If we are ordered to testify in any legal proceedings, it is very disruptive to the office routine, and is unfair to our other patients whose care may be affected by the inability to be seen. Please inform us immediately if you are involved in any legal situations or plan to go to court. If legal issues result in our providers having to attend any court related matters on your behalf, this will result in a charge of $400 per hour billed to the patient directly. A deposit will need to be prepaid to the practice after discussion of an agreed upon estimated time requirement proposed by the patient or their legal counsel for those services.

Question 14

Minors and Patients with Legal Guardians

Accepted Answer

All minors and adults with appointed legal guardians must be accompanied by their parent or legal guardian to all appointments. If there is no parent or legal guardian present, the appointment may be canceled by the provider and this would result in a late cancelation fee being charged per policy for the scheduled service. We assume 50/50 custody for the purposes of treatment.

Question 15

Termination of patient-provider relationship

Accepted Answer

Renew Psychiatric Group reserves the right to terminate the provider-patient relationship under the following conditions/circumstances:
 • When Renew Psychiatric Group's services may no longer be beneficial to the patient.
 • When payment is not received for services.
 • When a patient misses two consecutive appointments without 48 business hours’ notice or frequently misses scheduled appointments.
 • When a patient does not participate or follow along with the agreed upon treatment plan.
 • If a patient or family member/significant-other of the patient are hostile, aggressive, belligerent, threatening, or in any way disruptive to the professional environment.

Patient Rights and Responsibilities

Policies