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Privacy Policy for Alquimedez Mental Health Counseling, PLLC

Last Updated: October 21, 2023

About Your Privacy

At Alquimedez Mental Health Counseling, PLLC (“We,” “Our,” “Us”), your privacy is of utmost importance. This Privacy Policy outlines the types of information we may collect from you, how we use it, and the steps we take to protect it. By using our services or interacting with us in any manner, you agree to collecting and using your information as outlined in this Privacy Policy.

You accept and agree to ALQUIMEDEZ MENTAL HEALTH COUNSELING, PLLC’s Privacy Policy when you use our platform. If you disagree with the Privacy Policy, please stop using the platform immediately. By accessing and using our platform, you affirm that you have read the Privacy Policy and understand, agree, and acknowledge all policy terms.

Information Collection, Use, and Disclosure

Collection

We may collect information in several ways:

To be efficient in operating our services, we may have to collect personally identifiable information (such as but not limited to your name, phone number, email address, and mailing address), billing and payment information, profile information, log data (information such as your computer, Internet Protocol address (“IP”), pages that you visit and the amount of time spent on those pages, actions you take, and other statistics), information related to telehealth/teletherapy services and/or your need for such services, and any information which is exchanged between you and your therapist. In some cases, some of the information you give to us is considered “protected health information” or “PHI.” Information can be collected from social media sites interconnecting with our digital platforms. You may decide which information, if any, you would like to share with us, but some functions of the platform may not be available to you without providing us with the requested information. By deciding to provide your personal information, you agree to ALQUIMEDEZ MENTAL HEALTH COUNSELING, PLLC’s methods of collection and use, as well as other terms and provisions of this Privacy Policy.

  • When you fill out forms, applications, or other documents
  • Through electronic communication channels like emails, text messages, and telemedicine platforms, communication between medical providers, financial institutions
  • When you interact with our Customer Relation Manager (CRM) marketing automation tool
  • When you engage with us on social media platforms
  • During consultations and medical evaluations

Use
We use your information for:

  • Providing medical consultation and healthcare services
  • Record-keeping and administrative purposes
  • Communicating updates, promotions, or important information
  • Referring you to other medical service providers as necessary

Disclosure
We may share your information with:

  1. Healthcare providers within or outside Alquimedez Mental Health Counseling, PLLC for treatment, payment, or operational reasons, debt collection;
  2. Communication service providers that facilitate our interaction with you;
  3. Electronic Communication, CRM, and Social Media Platforms.

Electronic Communication

  1. We employ secure, encrypted electronic communication methods to ensure your privacy. However, it’s crucial to understand that no electronic communication method is 100% secure.

Customer Relations Manager (CRM)

  1. Our CRM collects information in a secure, encrypted database. Only authorized personnel have access to this data.

Social Media Platforms

  1. Any information collected from social media platforms is used for service improvement and direct communication. This information is not shared with third parties unless explicitly stated.

Interchange of Information with Other Service Providers
Due to the nature of our services, we may share your information with other service providers like labs, pharmacies, and communication providers. These parties are also obligated to adhere to privacy laws and regulations.

Protecting your personal information is of utmost importance to us, and we will never sell or share your information in ways other than those detailed in our Privacy Policy. Unless you specifically request or approve such disclosure, your information will never be used or disclosed in ways not explicitly referenced in this policy.

The information you provide on our platform may be used for the following purposes:

  1. To create your account on our platform and let you log in to your account and use the platform.
  2. To manage your account, provide you with customer support, and ensure you are receiving quality service.
  3. To contact you or provide you with information, alerts, and suggestions related to the service.
  4. For billing purposes.
  5. To contact you, either ourselves or the appropriate authority, if either we or a therapist have a good reason to believe you or any other person may be in danger or may be either the cause or the victim of a criminal act.
  6. To match you with a provider.
  7. To respond to law enforcement requests as required by applicable law, court order, or governmental regulations.
  8. To comply with applicable state and federal laws, including but not limited to laws related to protecting client and public health and safety.

Text Messaging for Public Health Messages and Appointment Reminders

Purpose

It is the policy of Alquimedez Mental Health Counseling, PLLC, to permit the limited use of text messaging to communicate with the public or clients in a manner that is consistent with the HIPAA Security Rule (45 CFR Part 164, Subpart C). This policy provides for the use of two categories of text messages:

  1. Public health messages sent to members of the public who sign up to receive the messages

    2. .

  2. Appointment reminders sent to local health department clients.

Definitions

SMS or text message: A 160-character message sent over a cell phone or through a web-based interface to one or more cellphone recipients.

Short Codes: Five or six-digit unique telephone numbers used for sending SMS messages.

Protected Health Information (PHI): Individually identifiable health information in any form, whether oral, written, or electronic. Individually identifiable health information is information that:

  1. Relates to the individual’s past, present or future physical or mental health or condition; the provision of health care to the individual; or the past, present, or future payment for the provision of health care to the individual; and
  2. Identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.
  3. Electronic protected health information (ePHI): Protected health information transmitted or maintained in electronic media.
  4. Subscriber: A person who opts into a program to receive text messages with general public health content, such as educational messages.
  5. Client: A person who receives medical, dental, or other health care services from Alquimedez Mental Health Counseling, PLLC.

Policies
General Policies Applicable to Both Types of Text Messaging Programs Covered by This Policy (Public Health Messages/Appointment Reminders)

  1. Internal Notice of Text Messaging Program: Consult and inform [agency division] prior to launching a texting program. The [division] will provide logistical assistance and messaging guidance and support.
  2. Approved Devices for Sending Text Messages: Text messages must be sent from devices owned or approved by Alquimedez Mental Health Counseling, PLLC, or from an approved computer application/subscribed third-party applications.
  3. Call to Action Message Flow – We are a medical practice providing only telehealth medical care. Anyone who has visited our webpage, www.alquimedez.com, and added their phone number. They then check a box agreeing to receive text messages and emails with information about our medical practice from our electronic platforms.

Alquimedez Mental Health Counseling, PLLC Reserves the Right

  1. Withhold or offer services at our discretion.
  2. Prescribe medication based on medical evaluations.
  3. Refer you to another service provider within or outside Alquimedez Mental Health Counseling, PLLC

We also reserve the medical right to request:

  1. Medical history from your primary care doctor
  2. Urine toxicology reports
  3. Medical records
  4. Psychosocial testing for behavioral disorders

Your refusal to provide the information requested might affect the services we can offer you.

RELEASE OF RESPONSIBILITIES

I, the patient/client that has willingly signed up for services, hereby release Alquimedez Mental Health Counseling, its agents, employees, and representatives from any and all past, present, and future responsibilities, liabilities, obligations, claims, demands, actions, rights, damages, costs, expenses, and compensation of any nature whatsoever, whether based on a tort, contract, or other theory of recovery, which I have now or which may hereafter accrue or otherwise be acquired, on account of, or may in any way grow out of, any and all known and unknown, foreseen and unforeseen bodily and personal injuries and property damage and the consequences thereof. At the moment that you sign up for services, you have consented and agreed to this release of responsibility. You may refuse our care at any time.

This release extends to and includes any responsibilities that have been, or could have been, asserted by me against Alquimedez Mental Health Counseling up to the date of this release.
I acknowledge that I am releasing Alquimedez Mental Health Counseling from responsibilities willingly, knowingly, and voluntarily. I also acknowledge that I understand the content and consequences of this release and have had the opportunity to consult with the legal counsel of my choice before signing this release.

This release is binding upon me, my heirs, executors, administrators, successors, and assigns.

I have read, understand, and agree with the above policies. If desired, I have been offered a copy of these policies to take with me. This policy can be requested anytime. It has also been sent to the email provided at the time of signup. I authorize Alquimedez Mental Health Counseling, PLLC, to release any information acquired during therapy to my insurance company (if the client is a minor, parent, or guardian sign). I understand my insurance coverage is a relationship between me and my insurance company, and I agree to accept financial responsibility for payment of charges incurred. As a patient under Alquimedez Mental Health Counseling, I am responsible for my care, health, and the information I provide to the medical center. I release Alquimedez Mental Health Counseling PLLC of all past, present, and future responsibilities.

Changes to This Policy

We may update our Privacy Policy from time to time. Any changes will be posted on this page.

Contact Us

If you have questions about this Privacy Policy, please contact ALQUIMEDEZ MENTAL HEALTH COUNSELING, PLLC’s Privacy Office, at info@alquimedez.com.
Rights to Service and Information Collection

By using our services, you consent to the terms of this Privacy Policy.

Patient Agreement and Financial Responsibility

Alquimedez Mental Health Counseling PLLC provides medical services within the scope of practice behavioral health. This agreement is between Alquimedez Mental Health Counseling (hereafter referred to as “AMHC”) and the patient (hereafter referred to as “the Patient” or “Client”). By agreeing to these terms, the Patient understands and consents to the following: Although you will be assigned to a specific therapist within our group, there may be an occasion for you to see one or more members of this group.

Rights and Risks:

  1. You may ask questions about any aspect of the counseling process.
  2. AMHC policy is to conduct a first visit with a counselor, an initial assessment, and a subsequent visit consultation with a prescriber.
  3. AMHC may require your most recent physical, laboratory, and other medical documentation.
  4. If you have been referred by a court or state agency, you can divulge only what you want included in a report.
  5. Therapy is most effective when you are open and can speak honestly about your emotions and experiences.
  6. Therapy may include talking about emotionally provoking subjects and scenarios. We abide by our ethical code of standards.
  7. Our professional obligation is to report if you are in danger to yourself or others if a minor is abused, neglected, or harmed.
  8. When you sign up for clinical services, you must provide proof of identification, insurance information (back and front), sign, agree, and consent for treatment, and any payments, co-payments, deductibles, or charges you may be responsible for.
  9. AMHC will send you once you sign up “Patient Bill of Rights.”

Confidentiality:

  1. Information shared by you in the session will be kept confidential.
  2. Information will not be released without your written consent, except for professional consultation if needed and unless required by law.
  3. All therapists are legally required to disclose information about suspected child abuse, the inability to care for one’s basic needs for food, clothing, or shelter, and threatened harm to oneself or others.
  4. The court may subpoena counseling records.
  5. It is understood that information regarding treatment and diagnosis may be provided to an insurance company. You may want to discuss further limits or exceptions to confidentiality.

Appointments:

  1. All office visits are by appointment and may be scheduled directly by the office manager or counselor.
  2. Please arrive on time, as you use up your own time when you arrive late for an appointment. The usual length of an appointment is 50 minutes.
  3. 3.Hours of Operation: Monday – Friday, 7:00 a.m. to 7:00 p.m., and Saturday and Sunday, 9:00 a.m. to 5:00 p.m. EST. Late cancellations (less than 24 hours before) and no-show appointments are billed to the client for $35.00.In the case of an emergency, please notify us no later than 8:30 a.m. on the appointment day. Please leave a message if you get voice mail. If your appointment is canceled or missed, contact the office for a new appointment time; if your therapist has an opening within the same week as your usually scheduled appointment, the cancellation fee will be waived.
  4. Insurance companies will not pay for no-show cancellations. You will be charged a counseling fee for all consultations over 5 minutes.

Fees:

  1. The client portion (co-pay/co-insurance) of fees is expected at the time of service. We accept debit cards and credit cards as a form of payment.
  2. Your health insurance may help you recover some of your counseling costs. Verify with your health insurance the coverage for outpatient behavioral health services. We will assist you before your first session if your procedure requires preauthorization to receive services. Although our office will help as much as possible to ensure you are aware of your insurance benefits, it remains your primary responsibility.
  3. Insured clients are expected to pay their fees as services are rendered. Our office will bill your insurance company for the services provided. You will receive a monthly statement reflecting any balance due on your account. This office cannot accept responsibility for negotiating a settlement on a disputed claim. You are responsible for payment (and unpaid insurance claims) to your account.
  4. Clients paying on a cash basis and not billing any insurance company are expected to pay in full at the time of service unless a payment plan has been previously arranged and an agreement signed.
  5. Except for minors or when other arrangements are made, the person receiving the counseling service is financially liable.
  6. AMHC, as a medical center, holds the right to service a person, as you can seek services in the medical facility you deem fit.
  7. If our patient at the time of service cannot afford it, we may send medications because our mission is to serve the unprivileged of our community.

Telehealth Services:

  1. AMHC offers telehealth services where therapy is conducted via a secure video or phone platform.
  2. The Patient agrees to find a quiet, private space for these sessions and ensure a reliable internet connection.
  3. The same confidentiality and privacy standards apply to telehealth and in-person sessions.

Emergencies:

  1. If the Patient is experiencing a crisis or emergency, they should call 911 or seek immediate medical attention.
  2. AMHC is not equipped to handle immediate crises but can provide referrals to appropriate services.
  3. In a crisis, and your therapist cannot be reached, you may call the 24-hour 911 or go immediately to your local hospital emergency room.

Termination of Services:

  1. Therapy can be terminated at anytime by the Patient or AMHC. It is beneficial to discuss and plan termination in collaboration with the therapist.

Consent to Treatment:

By signing up for services, the patient/client acknowledges that they have read, understood, and agree to the terms outlined in this agreement. They voluntarily consent to receive mental health treatment provided by AMHC.

RELEASE OF RESPONSIBILITIES

I, the patient/client that has willingly signed up for services, hereby release Alquimedez Mental Health Counseling, its agents, employees, and representatives from any and all past, present, and future responsibilities, liabilities, obligations, claims, demands, actions, rights, damages, costs, expenses, and compensation of any nature whatsoever, whether based on a tort, contract, or other theory of recovery, which I have now or which may hereafter accrue or otherwise be acquired, on account of, or may in any way grow out of, any and all known and unknown, foreseen and unforeseen bodily and personal injuries and property damage and the consequences thereof. At the moment that you sign up for services, you have consented and agreed to this release of responsibility. You may refuse our care at any time.

This release extends to and includes any responsibilities that have been, or could have been, asserted by me against Alquimedez Mental Health Counseling up to the date of this release.

I acknowledge that I am releasing Alquimedez Mental Health Counseling from responsibilities willingly, knowingly, and voluntarily. I also acknowledge that I understand the content and consequences of this release and have had the opportunity to consult with the legal counsel of my choice before signing this release.

This release is binding upon me, my heirs, executors, administrators, successors, and assigns.

I have read, understand, and agree with the above policies. If desired, I have been offered a copy of these policies to take with me. This policy can be requested anytime. It has also been sent to the email provided at the time of signup. I authorize Alquimedez Mental Health Counseling, PLLC, to release any information acquired during therapy to my insurance company (if the client is a minor, parent, or guardian sign). I understand my insurance coverage is a relationship between me and my insurance company, and I agree to accept financial responsibility for payment of charges incurred. As a patient under Alquimedez Mental Health Counseling, I am responsible for my care, health, and the information I provide to the medical center. I release Alquimedez Mental Health Counseling PLLC of all past, present, and future responsibilities.