Frequently Asked Questions

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.I. MY PLEDGE REGARDING HEALTH INFORMATION:I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:·       Make sure that protected health information (“PHI”) that identifies you is kept private and secure.·       Let you know promptly if a breach occurs that may have compromised the privacy or security of your information.·       Give you this notice of my legal duties and privacy practices with respect to health information.·       Follow the terms of the notice that is currently in effect.·       I am also required by law to provide you with adequate notice of your rights and my legal duties if I create or maintain records protected by 42 C.F.R. Part 2.·       I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.For Treatment, Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if I were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist in diagnosis and treatment of your mental health condition.If your records are protected under 42 C.F.R. Part 2, certain uses and disclosures permitted by HIPAA for treatment, payment, and health care operations are materially limited by the stricter standards of those regulations. Furthermore, information disclosed pursuant to these rules may be subject to redisclosure by the recipient and may no longer be protected by federal privacy standards. Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.Lawsuits and Disputes: If you are involved in a lawsuit, I may be required to disclose health information in response to a court or administrative order. However, for records protected by 42 C.F.R. Part 2, such records or testimony relaying their content shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide specific written consent or a court order is issued in accordance with 42 C.F.R. Part 2.III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:1.      Psychotherapy Notes. If at any point, I maintain “psychotherapy notes” as that term is defined in 45 CFR § 164.501, any use or disclosure of such notes requires your Authorization unless the use or disclosure is:·       For my use in treating you.·       For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.·       For my use in defending myself in legal proceedings instituted by you.·       For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.·       Required by law and the use or disclosure is limited to the requirements of such law.·       Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.·       Required by a coroner who is performing duties authorized by law.·       Required to help avert a serious threat to the health and safety of others.2.      Substance Use Disorder (SUD) Counseling Notes. I may also maintain “SUD counseling notes,” which are notes recorded by a substance use disorder provider documenting the contents of a counseling session. Any use or disclosure of these notes requires your separate written authorization, which cannot be combined with a consent for other types of records. You can revoke your consent at any time except to the extent that I have already acted upon it to disclose these notes in accordance with your initial authorization.3.      Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.4.      Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:1.      When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.2.      For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.3.      For health oversight activities, including audits and investigations.4.      For judicial and administrative proceedings when required by law.5.      For law enforcement purposes, including reporting crimes occurring on my premises.6.      To coroners or medical examiners, when such individuals are performing duties authorized by law.7.      For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.8.      For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.9.      Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:1.      Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:1.      The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.2.      The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.3.      The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone), or to send mail to a different address, and I will agree to all reasonable requests.4.      The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes” and “SUD counseling notes” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.5.      The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request. You also have the right to request an accounting of disclosures specifically for your substance use disorder records protected under 42 C.F.R. Part 2. 6.      The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.7.      The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.8.      File a complaint if you feel your rights are violated. You can complain if you feel I have violated your rights by contacting me. Alternatively, you can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html. I will not retaliate against you for filing a complaint.

ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By signing below, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.BY SIGNING BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD, AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.                 

General Practice Policies

Welcome to Salt and Light Psychiatry, PLLC. We are committed to providing evidence-based, integrative, and patient-centered psychiatric care supported by secure, HIPAA-compliant technology.The purpose of this document is to outline our practice policies and expectations. These policies are designed to promote clarity, safety, consistency, and a therapeutic environment grounded in mutual respect.If you have any questions regarding these policies, please contact our office.

CLINICAL SERVICES

Patients must be at least eighteen (18) years old, and not actively receiving medical care from the Department of Veterans Affairs. Patients must also be physically located in the state of Florida at the time of the appointment.

Physician and prospective patient must be in agreement with proceeding to schedule the initial evaluation which is determined during a brief introductory phone call for which there is no fee.

Following the initial psychiatric evaluation, if it is determined that Salt + Light Psychiatry can provide the services you need, a treatment plan and appointment frequency will be established based on medical necessity. This is when the doctor-patient relationship will be established.

Patients receiving medication management must be seen at least every three (3) months in order to remain active in the practice and continue receiving prescription refills. More frequent visits may be required depending on clinical complexity, medication changes, or symptom severity.

Salt + Light Psychiatry requires patients to attend at least one in-person appointment annually. This policy ensures a thorough clinical evaluation and supports a strong therapeutic relationship. Depending on treatment needs, additional in-person visits may be recommended.

Telehealth services are available throughout the state of Florida.

If there is an immediate risk of harm to yourself or others, call 911 or go to the nearest emergency room. You may also call or text 988 to reach the Suicide & Crisis Lifeline.

Salt + Light Psychiatry does not have admitting privileges at any hospital and is not affiliated with any hospital system. If a higher level of care is needed, appropriate referrals will be provided; however, we cannot guarantee availability or quality of outside services. If an emergency arises, the practice will call 911 and give hand-off to emergency personnel.

SERVICES NOT PROVIDED

This practice does not provide:

·       Forensic evaluations

·       Child custody evaluations

·       Court-ordered evaluations

·       Disability determinations

·       Evaluations solely for medical marijuana cards

·       Care to patients located outside of Florida at the time of the appointment

APPOINTMENT POLICY

Appointments are required and scheduled in advance.

Every effort is made to keep appointments running on schedule. Please be aware that

emergencies occasionally arise which may cause unexpected delays. If this occurs, we will

make an effort to notify the patient prior to the appointment.

Please arrive on time to make the most of your session. If you are running late, notify the office as soon as possible. If you arrive more than 15 minutes late, the appointment may be considered a no-show.

Appointments must be canceled or rescheduled at least 24 hours in advance. Late cancellations or missed appointments will incur a fee (see Fee Policy).

We understand that life can be unpredictable. However, repeated no-shows or late cancellations impact our ability to provide timely care to you and other patients. If these occurrences become frequent, we may need to consider termination of the doctor–patient relationship.

Our goal is always to work collaboratively and compassionately. If you are experiencing barriers to attending appointments, please communicate with us so we can explore possible solutions.

Patients must complete required questionnaires and forms at least 24 hours prior to their appointment. Failure to do so may result in rescheduling.

TELEHEALTH POLICY

Telehealth appointments require:

·       A private, secure location

·       A reliable internet connection

·       A compatible device with audio and video capability

Patients must be physically located within the state of Florida at the time of the session.

MEDICATION POLICY

Medication management is provided as part of your individualized treatment plan.

Patients must:

·       Inform the provider of all medications and supplements currently being taken

·       Attend follow-up appointments at least every 3 months for prescription renewals

·       Schedule additional visits if medication changes or symptom instability require closer monitoring

Regular follow-up appointments are necessary to monitor for side effects, assess treatment effectiveness, and ensure safety.

Refills are provided during scheduled appointments. Early refill requests may not be granted. The patient must be seen for an appointment at a minimum every 3 months to receive refills on medications.

Controlled substances are prescribed in accordance with Florida and federal regulations.

Salt + Light Psychiatry does not prescribe medical marijuana.

CONFIDENTIALITY

All patient information is kept confidential in accordance with HIPAA regulations.

Information will only be shared with your written authorization or as required by law (for example, in cases involving risk of harm, abuse reporting, or court order).  See notice of privacy practices for other applicable exceptions.

FEE SCHEDULE & PAYMENT POLICY

Salt + Light Psychiatry is currently in network with HealthSmart, Mutliplan, and NPPN insurance, and an out-of-network practice with all other insurance companies.

Healthsmart Preferred Care Inc (HSPC)

Multiplan/ PHCS

Coalition America (formerly NPPN- National Preferred Provider Network (Plan Vista/MedAdvant)

In-network fees will be billed as per insurance contracts.

We do not accept Medicare, Medicaid, or Tricare.  Out-of-network patients pay out-of-pocket for all appointments. Most private insurance companies reimburse 50-80% of the out-of-network cost to the patient. However, as each insurance plan is different, it is not guaranteed that an insurance company will reimburse the patient for the mental health services they received. Please contact your insurance company to find out exactly what will be covered. Please note, patients cannot request reimbursement from Medicaid, Medicare, or Tricare for our services. Medicaid, Medicare, or Tricare do no reimburse patients for out-of-network mental health services.

We will provide a superbill to our patients after each appointment. A "Superbill" is a medical billing receipt for an appointment with an out-of-network provider. It includes diagnoses, CPT billing codes, fees, and date of service. Patients can choose to submit the superbill to their insurance company directly to request reimbursement. As each insurance plan is different, submitting a superbill does not guarantee that an insurance company will reimburse the patient for the mental health services they received.

Patients are required to save a credit or debit card on file when scheduling their first appointment. If you are an out-of-network patient, full payment will be charged to the card on file at the time of appointment even if you plan to request reimbursement from your insurance, FSA, or HSA. Payment is charged at the time of the appointment through our secure payment gateway. For in-network patients, co-pays will be collected and the insurance company will be billed accordingly.

A credit or debit card must be kept securely on file. Booking new evaluation appointments requires a nonrefundable fifty percent (50%) deposit of the total fee.

Out-of-Network/ Self-Pay Current Fees:

·       New Patient Psychiatric Evaluation: $375

·       Follow-Up Appointment: $175

·       Extended Follow-up Appointment: $325

·       Reproductive Psychiatry One-Time Consultation: $450

·       After Hours Paging: $50 flat fee

·       Urgent Phone Calls / After-Hours Appointments: $7 per minute (billed in 10 minute increments)

·       Late Cancellation/No-Show Fee: 100% of scheduled appointment cost

NO SHOW & LATE CANCELLATION POLICY

Appointments canceled with less than 24 hours’ notice or missed appointments will incur a fee of of the scheduled appointment cost.

Three (3) separate no-shows or late cancellations may result in termination from the practice.

If two consecutive no-shows occur, the treatment relationship may be terminated.

RECORDS & TRANSFERS

Requests for medical records or transfer of care must be submitted in writing and require a signed release form.

Please allow adequate time for processing to ensure accuracy and confidentiality.

NO RECORDING POLICY

To protect patient privacy, maintain confidentiality, preserve the integrity of the therapeutic relationship, and comply with applicable privacy and healthcare laws, Salt + Light Psychiatry prohibits the recording of any clinical interactions without prior written authorization from the practice.

Patients, family members, support persons, and any other participants are strictly prohibited from:

·       Audio recording

·       Video recording

·       Photographing

·       Livestreaming

·       Screen recording

·       Otherwise capturing any portion of:

·       Telehealth appointments

·       In-person appointments

·       Telephone calls with providers or staff

·       Clinical discussions or encounters within the practice

This prohibition applies whether the recording is overt or concealed and includes recordings made through phones, computers, tablets, wearable devices, or any other electronic equipment.

Patients participating in telehealth services must attend appointments from a private setting and may not use any software or device to record, screenshot, screen capture, or transmit the session without express written consent from the provider and practice administration.

Unauthorized recordings may compromise:

·       Patient and staff privacy

·       HIPAA compliance

·       Clinical candor and therapeutic trust

·       The safety and comfort of providers and staff

If a patient is found to have recorded, attempted to record, or distributed any recording of a session or clinical interaction without authorization, this may result in:

·       Immediate termination of the appointment

·       Discontinuation of care from the practice

·       Referral options for alternative psychiatric care, when appropriate

·       Additional legal action if privacy laws or confidentiality protections are violated

Unauthorized recording constitutes grounds for immediate termination from Salt + Light Psychiatry.

SINGLE PSYCHIATRIC PRESCRIBER POLICY

Salt + Light Psychiatry requires that psychiatric medications be managed by a single psychiatric prescriber while a patient is actively enrolled in the practice.

Patient Termination Policy

Patients who establish care with, receive ongoing psychiatric medication management from, or obtain psychiatric prescriptions from another psychiatric prescriber during active treatment with Salt + Light Psychiatry may be dismissed from the practice.

This policy applies to:

·       Psychiatrists

·       Psychiatric nurse practitioners

·       Physician assistants providing psychiatric medication management

·       Telepsychiatry services

·       Online psychiatric prescription services

Exceptions may be considered at the sole discretion of Salt + Light Psychiatry in circumstances including, but not limited to:

·       Temporary coverage arrangements approved in advance

·       Higher levels of care (hospitalization, intensive outpatient, residential treatment)

·       Specialty consultations coordinated with the practice

·       Geographic relocation or emergency situations

Patients must notify Salt + Light Psychiatry of any outside psychiatric treatment or prescribing.

If another psychiatric prescriber becomes involved in a patient’s care, Salt + Light Psychiatry may:

·       Request records and medication lists

·       Require signed releases of information

·       Pause prescription management until care is clarified

·       Determine whether continued treatment within the practice is appropriate

Failure to disclose outside psychiatric prescribing or failure to comply with this policy may result in dismissal from Salt + Light Psychiatry.

When appropriate, dismissal will follow applicable state and federal regulations regarding patient notification, emergency coverage, and continuity of care.

TERMINATION POLICY

Salt + Light Psychiatry is committed to consistent and effective care. The following policies apply:

Inactivity

If a patient has not been seen for three (3) months and has not scheduled follow-up care, the patient will be considered inactive and termination initiation will begin. The practice will attempt to contact the patient via termination letter. If no response occurs within 30 days, care may be formally closed.

Repeated No-Shows or Late Cancellations

Three (3) missed or late-canceled appointments may result in termination initiation. The practice will attempt to contact the patient via termination letter.

Non-Payment

Failure to resolve outstanding balances after reasonable collection attempts may result in termination. Written notice will be provided prior to termination.

Zero-Tolerance Policy

Salt + Light Psychiatry maintains a zero-tolerance policy for:

·       Threats of violence

·       Aggressive behavior

·       Harassment

·       Inappropriate sexual behavior toward providers or staff

·       Unauthorized recording

Any such behavior may result in immediate initiation of termination of services to protect the safety and integrity of the therapeutic environment.

COMMUNICATION POLICY

For non-urgent matters, please contact the office during business hours.

Clinical questions must be submitted through the secure patient portal to protect privacy and ensure appropriate documentation. Non-urgent requests will be responded to based on clinical triage within 1–3 business days.

If you find that you have frequent questions or require ongoing communication between appointments, this may indicate the need for more frequent follow-up visits. Additional appointments may be scheduled and billed according to the fee schedule.

Phone calls outside scheduled appointments may incur additional fees.

There is an option through our phone provider, Spruce, for patients to mark their message as urgent. Urgent phone calls or urgent appointments may be scheduled by using this feature.

After-Hours & Fees

·       After-hours paging: $50 flat fee per occurrence

·       or after-hours appointments: $7 per minute, billed in 10-minute increments

Email, text messaging, social media platforms, or other informal communication channels should not be used for clinical matters. These platforms are not monitored for patient care and do not provide appropriate privacy protections. Emails regarding clinical matters will not receive a response.

Emergency Resources

If there is any immediate concern that you may harm yourself or others:

·       Call 911

·       Go to the nearest emergency room

·       Call or text 988 to reach the Suicide & Crisis Lifeline

·       Call 1-800-273-TALK (8255) - This confidential hotline is available 24 hours a day, 7 days a week.

Salt + Light Psychiatry, PLLC is an outpatient practice and is not equipped to provide emergency or crisis intervention services. Non-urgent requests will be responded to based on clinical triage within 1–3 business days. Resources and a safety plan are provided for emergency services in the area.

SCHEDULING APPOINTMENTS

New Patients

Prospective patients may request an appointment by:

·       Submitting an appointment request form through the website via SimplePractice

·       Calling the office directly during business hours

Submitting a request does not establish a provider–patient relationship. After review, Salt + Light Psychiatry will determine whether the practice is an appropriate clinical fit and confirm the appointment accordingly.  Only after the initial consultation will a treatment relationship be established if appropriate.

Established Patients

Established patients may schedule follow-up appointments through the secure patient portal or by calling the office.

Urgent Concerns & Paging the Psychiatrist

When calling the clinic line, patients will hear options to:

·       Leave a voicemail for non-urgent questions

·       Page the psychiatrist for urgent clinical concerns

Voicemail messages are triaged and responded to based on clinical urgency.

If you choose to page the psychiatrist using the urgent access code function:

·       Your concern will be assessed promptly

·       You may be advised to schedule an urgent same-day or next-day telehealth appointment or phone consultation

·       Urgent appointments or extended phone calls may incur additional fees and may be billed to insurance (if applicable) or according to the current fee schedule

Paging should be reserved for time-sensitive clinical concerns that cannot safely wait until the next business day. his code will be given to you when you establish care with the clinic. This code may be updated, and you will be notified of any changes.

Non-urgent requests will be responded to based on clinical triage within 1–3 business days.

If your situation involves immediate safety risk, call 911 or go to the nearest emergency room rather than waiting for a callback.

Between-Appointment Communication & Clinical Needs

At Salt + Light Psychiatry, your well-being is our priority. If you find that you have frequent clinical questions or require ongoing communication between appointments, this may indicate that more frequent follow-up visits are clinically appropriate.

Please discuss this during your sessions so your care plan can be adjusted accordingly.

Please note:

·       Extended phone calls or clinical communication outside scheduled appointments may incur additional fees

·       Additional appointments will be billed to insurance (if applicable) or according to the current fee schedule

This structure helps ensure that care remains thoughtful, intentional, and appropriately supported.

LETTER POLICY

Patients may request clinical documentation or letters for purposes including:

·       Workplace accommodations

·       School accommodations

·       Short Term Disability claims

·       FMLA or medical leave

To ensure appropriate clinical evaluation and accurate documentation, all requests must be reviewed directly with the treating provider.

Appointment Requirement

Patients requesting any form of clinical letter, documentation, certification, or paperwork completion are required to schedule and attend an appointment specifically to discuss the request.

Requests submitted through phone calls, portal messages, email, or staff alone may not be sufficient for completion of documentation.

No Guarantee of Completion

Attendance at an appointment does not guarantee that a letter, form, or documentation request will be completed.

Requests are evaluated based on:

·       Clinical appropriateness

·       Medical necessity

·       Available treatment history and records

·       Provider assessment and professional judgment

·       Ethical and legal standards

Completion of documentation is solely at the clinical discretion of the treating provider.

Accuracy & Professional Standards

Salt + Light Psychiatry will only provide documentation that the provider believes is accurate, clinically supported, and medically appropriate.

The practice will not complete forms or issue statements that are:

·       Misleading

·       Unsupported

·       Fraudulent

·       Outside the scope of the provider’s professional opinion

Additional Information

Patients may be required to:

·       Provide supporting records or collateral information

·       Sign release forms

·       Allow adequate processing time for paperwork completion

·       Pay applicable administrative fees, if permitted and applicable

Right to Decline

The provider reserves the right to decline any request for documentation or forms that are not clinically indicated or cannot be supported by the patient’s medical record or evaluation.

Changes to This Notice

Salt + Light Psychiatry, PLLC reserves the right to change this Notice at any time. Revisions may apply to health information already obtained as well as information obtained in the future.

If changes are made:

·       The revised Notice will be available upon request

·       The updated document will be available on the practice website

·       The effective date will be updated below

Effective Date: July 30, 2026