Starting 11/01/21: we are offering in-person sessions in addition to virtual sessions. Please reach out to us for more info!
(917) 740-5287

PRACTICE POLICIES

Practice Expectations

Our clinicians try to be as flexible as they can in meeting you where you are at, and we do not dictate the treatment to you. We will work with you on your goals, working within your preferences for treatment strategy and frequency, as long as the clinician you are working with also feels professionally comfortable with that plan.

Attendance in Session

If you/your child are more than 10 minutes late, it is up to the clinician’s discretion whether there is sufficient time remaining for an appointment to occur. Our clinicians are not comfortable providing subpar care (even if you say you feel okay with it), so if the clinician feels there is insufficient time for them to do their job well, they will ask you to book an additional session.

For minors, unless previously discussed and agreed upon, a parent/legal guardian is expected to be available during any scheduled sessions. If a guardian cannot be reached during the session and a discussion of treatment changes is needed,  it will be necessary to schedule a separate guardian session. 

Conversations with guardians while the child is present, or during the child’s scheduled session, are brief (for sake of privacy and to avoid speaking about the child in front of them). For this reason, periodic guardian sessions are also required. 

In addition to the above – generally, treatment discussions with guardians require more time and cannot be done within the child’s session time. There are often many topics that are better discussed without the child present.  Typically, when your child is working weekly with our clinicians, guardian sessions occur monthly on average. When sessions are less frequent than this, the clinician will let you know what frequency is clinically appropriate, and may range from monthly to every 3-6 months.

Session Frequency

Together with your provider, you will decide on what frequency of sessions would be most helpful for you. For medication, the provider might not refill medication if you are unable to make it to scheduled sessions, as these follow-ups are scheduled at a time point when the provider feels is clinically necessary. Abiding by our practice policies and remaining a client at the practice includes agreeing to come to scheduled sessions with us. We are mindful and intentional of the time and money that goes into sessions, which means we will not schedule unnecessarily with you, so all sessions that are scheduled with us are important to your care.
There may be times when you feel you are comfortable not being seen for an extended period of time, but when that period is longer than your clinician feels professionally  comfortable with, the clinician will let you know that in order to remain as a patient they are treating (and have access to ongoing appointments), you would need to schedule a session. 
Our work with patients relies on us knowing them over time at various time points and it informs the quality of care we can provide. When we are not able to do that, we often feel we are not able to provide the level of care that we are comfortable providing.  In these cases, patients often transfer to a primary care doctor for continued medication prescriptions or may work with a clinician in the community who may be comfortable with less frequent sessions. 
Alternatively, there may be times when you would like to be seen more than your clinician’s schedule can accommodate. Session frequency is an ongoing discussion that weighs factors like the clinical situation, the clinician’s availability, and your preferences.  
If you are ever unclear about your session frequency, please let either your clinician or the office know and we can help navigate the situation.
 

Cancelling/Rescheduling Appointments

If you need to cancel/reschedule a session, please let us know at least 48 hours in advance, as otherwise we would need to charge a fee equivalent to the session fee.  You are paying for reserving the time of your scheduled sessions, regardless of whether you attend or not. We understand the occasional need to cancel/reschedule, but frequent cancellations/rescheduling become disruptive to the practice and to your treatment, and could be a cause of termination from the practice.

Medications

While we encourage you to reach out with updates or concerns, any medical decision making or changes in your care/ treatment plan will not be discussed via text message or email and will require a full scheduled session. 

In rare situations when medical decision making is time sensitive and scheduling a session is not possible, we may discuss treatment plan changes in a brief phone call, but this would not replace the need for a full, scheduled session to shortly follow for adequate assessment and monitoring of the clinical situation.

Please request medication refills during scheduled sessions. If your or your child’s medication will run out before the next scheduled session, please reach out to the office directly at (917) 740-5287 or clinical@graymattersmd.com, but note that our refill policy is to give us notice of at least 2-3 business days.

When you pick up medication from your pharmacy, please ensure you are picking up the correct dose as the pharmacies sometimes will have older prescriptions from us on file and will “auto-refill” rather than giving you the most up-to-date prescription.  Also please note that we do NOT take refill requests from pharmacies (as they often send requests that are not accurate or up-to-date). Even if your pharmacy has told you they have contacted us, you still need to contact us directly to trigger a response from us.

Sometimes your insurance company may require prior authorizations for your medications, which may delay you receiving your medication. We will assist you, but we also ask that you help us by calling your insurance company or by filling out paperwork to help expedite your medication.
When medications are not available at your requested pharmacy, this may cause further delays in receiving your medication, and may require another 2-3 days for us to confirm cancelation of the original prescription and resend it to another pharmacy.

Please also note that  certain medications, classified as controlled substance (such as adderall or klonopin), are closely regulated, and we MUST be aware if you/your child are receiving any controlled meds from any other clinician, and it is your responsibility to update your clinician should you be taking controlled medications prescribed elsewhere. Medications should only be taken as prescribed, and early refills, even if medication has been lost, are not possible. Stolen medication may require a police report to show to prescriber and pharmacist to be refilled. Any deviation from this could result in discharge from the practice.

Understanding the Confidentiality Agreement 

Adolescents are legally required to have a certain level of confidentiality in therapy. Guardians should understand and respect the  provider’s guidelines on what can and cannot be disclosed to them. This encourages trust between the teen and the provider. We will not share the specifics of what your child says to us, and will update you generally about how they are doing and themes of the work together. If there is an imminent safety concern, we will break confidentiality to make you aware. However, there may be gray areas where your child is engaging in behavior that is not what you would like, but we may  not be in a position to tell you without compromising our therapeutic relationship. 
Also, please note that telephone, face-to-face, video, email, or written communication from a guardian may be shared as is clinically appropriate at the discretion of the provider, with another guardian, or with the child. 
There are certain circumstances that adolescents 16 years and older can consent to mental health treatment without guardian consent. If you have specific questions on New York State laws on minors and consent in mental health care, please let us know and we are happy to share more resources.

Streamlining Communication

Please let us know the preferred method of communication for your child and family. For example, this could be an ongoing email thread with all guardians on it or having one point person to discuss scheduling or other relevant information via text or email. We recognize that all family structures look different and there may be extenuating circumstances that require a more nuanced communication plan. We will discuss the circumstances with you to structure a communication plan that honors your situation, but also is logistically feasible for the practice/clinician while being therapeutic for the treatment. 

We definitely appreciate updates from patients or guardians between sessions. However, unless there is a specific question or issue to be addressed, clinicians might not always be able to reply to these updates, but it is still helpful to have any updates even if the clinician doesn’t respond right away.

Respectful Communication

Our practice prides itself on nurturing mutually respectful relationships. You can expect anyone on our team (clinician or admin) to treat you with respect and care. We also expect the same from you, and believe that when we achieve relationships of mutual respect, we can provide the highest quality of care to you. 

Please remember to be courteous when interacting with anyone in the graymatters community, particularly speaking kindly and assuming the other person has your best interest at heart. Please ask for assistance, rather than placing demands. Please allow a reasonable time for your call/message to be returned or for the issue to be resolved. Remember that our admin team is here to work in collaboration with you, and deserve to be treated respectfully.

 

Some examples of the types of behavior that are not acceptable in our practice include:

  • Making excessive demands, expecting immediate responses, and making repetitive calls or sending multiple messages within a short period of time.
  • Using offensive language, threats, or abusive behavior.
  • Repeated disregard for someone’s time by not responding to communication in a timely manner, being late to appointments or calls, or multitasking while engaged with others.

Since we are a mental health practice, we obviously understand that things you may be feeling or going through may make it difficult to communicate respectfully at times. That being said – although we are understanding and empathetic, we also appreciate our clients doing their best to collaborate with us in a way that ensures our relationship is respectful and reciprocal so that we are able to provide the highest quality care possible to you and our entire community.

Termination Guidelines

Your work with us can range from time limited or short-term to long-term work. You are always free to conclude your treatment at any point and for any reason. There may also be times when our practice chooses to conclude treatment, with some of the reasons being:

  • A client having met goals as indicated by the client’s treatment plan and not actively working on any other goals with their clinician.
  • The initial treatment plan decided upon by the clinician and client was time limited and has concluded.
  • A client failing to communicate with staff about an overdue balance even after attempts from the practice to open a dialogue about it.
  • A client not responding to the clinician and/or the practice and not scheduling sessions.
  • Even though your treatment plan is collaborative, a client not being able or willing to work with clinician in recommended treatment options in a way that we believe could be potentially harmful.
  • The clinician feeling that the client and clinician are not a good fit.
  • The client being unable, for any reason, to meet the expectations outlined in our practice policies.

Financial Responsibility

Our session fees vary depending on the type of service and clinician whom you are seeing. Although we will be discussing session fees over the initial phone call, please see our website for a summary of our different rates.
 
Our session fees cover your scheduled session, clinician preparation and post-session documentation of visits, and brief communications with you or other members of your treatment team.
 
For other time spent outside of your session, you are charged ADDITIONAL fees (billed rounded to 15-minute increments proportionate to your session time and fee). This typically includes, but isn’t limited to: extended phone calls, special document work, intensive record review, and medication refills (requested outside of sessions/due to missed session).
For any accommodations letters for school or any other kind of documentation/paperwork – we require a notice of at least two weeks. It may also require a full scheduled session dedicated to completing the documentation, or may be billed for time spent outside of sessions.

Billing Procedures

We require a credit card or debit card to be on file that will be used to charge appointments, including missed appointments and late cancellations, or when additional services are provided.

The card on file will be charged on the day of your scheduled session, typically prior to your session. If your credit/debit card on file does not go through, we will reach out to you directly to get different card information. All sessions must be paid for on the day of the session.

If you have an outstanding balance, you may not schedule/attend sessions, unless you have spoken to our office about any financial accommodations.

By putting down the person that you note as the billing contact on this form, you and the billing contact are acknowledging that they are financially responsible for session fees. You are also acknowledging that the billing contact is aware in advance of any charges made to the billing contact’s credit/debit card.


To change your card information, please reach out to our office at (917) 740-5287 or office@graymattersmd.com.

Out-of-Network Benefits

We are typically an out-of-network provider, which means we don’t take health insurance and you are responsible for paying your fees upfront and in full before your sessions. We don’t work with insurance directly as it would entail red tape and bureaucracy that would limit our ability to meet our standards of care.
However, you could still receive reimbursements and/or other benefits because some insurance plans still include out-of-network benefits. We encourage you to find out what your out-of-network benefits are so that we can help you make informed decisions about your treatment plan.
After you have paid your fee in full for a session, you can expect a statement/superbill from us within 7 days after your scheduled session..
Please keep in mind that you are responsible for submitting your claims to insurance so that you can be reimbursed directly. It can be a little confusing at first so if you need any help with how to submit claims, please let our office know.

Emergency Services

Our clinicians are not able to be available 24/7. If you are in crisis and need immediate assistance, please call 988 or go to your nearest emergency room. After you have done this, please also contact our main office AND your clinician so that we can get back to you as soon as we are able.
 
On the Resources page of our website, we have included some outside crisis resources and hotlines that may be available 24/7.
On occasion, our clinicians may be able to reply to texts/emails/phone calls outside of typical office hours (Monday-Friday 10:00am-5:00pm ET) or their individual specific hours (ask your clinician or the office for these hours), but this is not always the case.  Their response outside of or during  these hours cannot be relied upon, even in the event of emergencies, and should not be used for crisis care services. We will do our best to respond as promptly as possible to support you and coordinate emergent services if available between scheduled appointments.

Opt-in Communication

You will get emails that are automatically sent to you through our scheduling system as appointment confirmations, appointment reminders, and rescheduling/cancellation confirmations. You can opt out of these emails, but please note that if you choose to opt out of these emails, you will no longer receive emails that can be helpful in keeping track of your appointments.
 
You will also receive email newsletters and updates for the express purpose of facilitating communication of information that may be of interest. If you would not like your information to be used for email newsletters and updates, please let the office know by calling (917) 740-5287. You can choose to unsubscribe at any point, but you will no longer receive emails that will keep you informed about what’s going on at the practice.

Secure Communication

The most secure ways to communicate electronically with your clinician and the office is through the following secure platforms:
 
•Spruce messaging app (upon request, you can receive an invite for this platform once you have been accepted into the practice as a client);
•Video chat using Google Meet;
•Shared cloud folder (for sending/sharing documents – please request).
 
You may choose to communicate electronically with graymatters through the following non-secure platforms:
 
•Texting;
•Email;
•Fax;
•Video chat using Skype, FaceTime, WhatsApp, and other platforms that are not Google Meet.
 
Please note that while texting, email, and faxes are secure and/or encrypted on our end, these forms of communication may not be secure on your end. Skype and FaceTime are not secure methods of video chat for both the sender and receiver, which is why the practice prefers to use Google Meet. Please understand the risks that come with choosing to communicate via text, email, fax, or non-secure video chat.
Communication via the above non-secure platforms may be used for administrative reasons, such as scheduling or billing. If you have personal topics you would like to discuss with your clinician, this should be done so via email or in your next session with them.
 
For any form of electronic communication that you choose, you are consenting to electronic communication with the understanding that the security of information delivered using technology carries risks to confidentiality, privacy, and security. During the course of your treatment, you may choose to communicate through these methods for your convenience; however, the only forms of communication that would be encrypted for both the sender and the receiver would be via Spruce, Google Meet, and a shared cloud folder.
If you need to send documents to your clinician, you may do so via secure fax or secure email. Our fax number is (888) 396-3996. If you wish to use secure email, please let your clinician know so that they can initiate a secure email thread.
If you do not wish to receive/send communication via the above non-secure methods, you can fill out the rest of this form but you must call (917) 740-5287 to notify us that you are choosing to opt-out of the above non-secure methods. If you do not call us to notify us, we may not be aware of your request. If you opt-in to non-secure methods now but decide at a later point that you no longer wish to receive/send communication via the above non-secure methods, please call (917) 740-5287.

HIPAA Compliance Privacy Notice

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Your Rights

You have the right to:
•Get a copy of your paper or electronic medical record.
•Correct your paper or electronic medical record.
•Request confidential communication.
•Ask us to limit the information we share.
•Get a list of those with whom we have shared your information.
•Get a copy of this Privacy Notice.
•Choose someone to act on your behalf.
•File a complaint if you believe your privacy rights have been violated.

Your Choices
You have some choices in the way we use and share information, if we:
•Tell family and friends about your condition.
•Share information in a disaster relief situation.
•Share information for marketing, sales, or fundraising purposes.

Our Uses and Disclosures
We may use and share your information as we:
•Treat you.
•Run our organization.
•Bill for your services.
•Help with public health and safety issues.
•Perform research.
•Comply with the law.
•Address workers’ compensation, law enforcement, and other government requests.
•Respond to lawsuits and legal actions.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of your paper or electronic medical record.
•You can ask to see or receive a paper or electronic copy of your medical record and other health information we have about you. Ask us how to do this.
•We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Correct your paper or electronic medical record.
•You can ask us to correct your health information that you think is correct or incomplete. Ask us how to do this.
•We may deny your request, but we will tell you why in writing within 60 days.

Request confidential communication.
•You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
•We will agree to all reasonable requests.

Ask us to limit the information we share.
•You can ask us not to use or share certain parts of your health information for treatment, payment, or our operations.
•We are not required to agree to your request, and we may deny it if it would affect your care.
•If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will agree to your request, unless a law requires us to share that information.

Get a list of those with whom we have shared your information.
•You can ask for a list (”accounting”) of the times we have shared your health information for six years prior to the date you ask, with whom we shared this information, and why.
•We will include all the disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you requested us to make). We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you request another within 12 months.

Get a copy of this Privacy Notice.
•You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act on your behalf.
•If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
•We will make sure the person has this authority and can act on your behalf before we take any action.

File a complaint if you believe your privacy rights have been violated.
•You can complain if you feel we have violated your rights by contacting us.
•You can file a complaint with the US Department of Health and Human Services Office for Civil Rights by sending a letter 200 Independence Avenue SW, Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
•We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:
•Share information with your family, close friends, or others involved in your care.
•Share information in a disaster relief situation.

In these cases, we never share your information unless you give us written permission:
•Marketing purposes.
•Sale of your information.
•Most sharing of psychotherapy notes.

Our Uses and Disclosures

How do we typically use or share your health information?

To treat you.
•We can use and share your health information with other professionals who are treating you.

To run our organization.
•We can use and share your health information to run our practice or improve your care, and contact you when necessary.

To bill for services.
•We can use and share your health information to bill and get payment from health plans or other entities.

How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually to contribute to the public good, such as public health and research. We have to meet many legal conditions before we can share your information for these purposes. For more information, visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

To help with public health and safety issues.
•Preventing disease.
•Helping with product recalls.
•Reporting adverse reactions to medications.
•Reporting or suspecting abuse, neglect, or domestic violence.
•Preventing or reducing a serious threat to anyone’s health or safety.

To perform research.
•We can use your share your information for health records.

To comply with the law.
•We will share information about you if state or federal laws require it, including the Department of Health and Human Services, if it needs to confirm that we are complying with federal privacy law.

To address workers’ compensation, law enforcement, and other government requests.
•For workers’ compensation claims.
•For law enforcement purposes or with a law enforcement official.
•With health oversight agencies for activities authorized by law.
•For special government functions, such as military, national security, and presidential protective services.

To respond to lawsuits and legal actions.
•We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

•We are required by law to maintain the privacy and security of your protected health information.
•We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
•We must follow the duties and privacy practices detailed in this notice and give you a copy of it.
•We will not use or share your information other than as describd here, unless you give us written permission. If you give us permission, you may change your mind at any time. Let us know in writing if you change your mind. For more information, visit www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request and on our website.