Welcome to Choices of Alabama LLC! This information is provided to inform you how the Choices of Alabama LLC operates and the procedures we use to coordinate counseling and other services. If you have any questions about this document, we will be happy to discuss them! We sincerely want you to understand and feel comfortable with our policies.
Services We Provide:
Choices of Alabama LLC (COA) offers comprehensive behavioral health services to include intake assessment, counseling, psychiatric consultation and treatment, crisis intervention, and referral. Sessions length varies on the needs of the client but is typically no longer than 50 minutes. During the initial intake, you will meet with your counselor for the purpose of evaluating the nature of personal needs and difficulties, discovering the desirability of counseling or referral, and recommending the type(s) of counseling. You WILL NOT receive a prescription at initial intake. Throughout the course of treatment, you are expected to follow the treatment plan, attend scheduled sessions, and abstain from all non-prescription mood-altering substances. You have the right and the obligation to participate in treatment decisions and in the development and periodic review/revision of your treatment plan. You also have the right to refuse any recommended treatment or to withdraw consent to treat.
Risks and Benefits of Counseling:
There may be both risks and benefits associated with participation in counseling. Counseling may improve your ability to relate with others, provide a clearer understanding of yourself, your values, and your goals, and an ability to deal with everyday stress. Please understand that counseling may also lead to discomfort or other negative feelings. If this should happen, you are encouraged to discuss these feelings with the counselor so that you can work through these feelings together.
COA reserves the right to terminate patient care upon written notice. Upon termination if desired by the patient, the patient will be provided with urgent care and refills on recommended medications only for a period of 30 days, allowing time for you to seek establishment with another psychiatrist. Reasons for termination include but are not limited to: misrepresentation, misuse/abuse of medications, repeated noncompliance with doctor’s recommendations, threatening behavior, change in insurance status, repeated No shows or missed/cancelled appointments, conflicts of interests, changes in insurance, and violation of the doctor-patient relationship.
Cancellation: Once you schedule an appointment at Choices of Alabama LLC, that time is reserved for you! Therefore, failure to give 24 hour notice is considered a No Show and will be documented in your record. Two or more No Shows or repeated Reschedules and Cancellations is considered grounds for terminating services.
We ask that you confirm appointments when we call the day before to remind. Even if you leave a voicemail after hours saying you are coming, that is great! Please note, if we DO NOT receive confirmation, your appointment might be given to someone else with emergent needs.
You are responsible for attending on time any appointment. While we make every effort to remind you the day before your appointment, patients arriving more than 15 minutes late for an appointment will be rescheduled at the next available time slot. It is your responsibility to make note of and attend any appointment scheduled.
If you wish to be evaluated for medication during the course of your care at Choices of Alabama LLC, please indicate this to your therapist. They will assist you in setting an appointment to discuss this with a psychiatrist in our office. Please note it is our belief and policy that unless otherwise noted in your treatment plan, that when prescribed medications, clients respond best to a combination of counseling AND medications. We have some additional guidelines noted below:
1) Prescriptions will not be refilled after normal business hours, on holidays or weekends when the clinic is not open. An early refill on your medicine will NOT be granted if you take more than the prescribed amount.
2) Prescription refills should be called into your pharmacy. Your pharmacy will then contact the office. It may take up to two working office days to refill a prescription.
3) Prescriptions will not be refilled if you have cancelled your last appointment, did not show for your last appointment, if you do not follow through with recommended treatment/testing, you have been discharged from the practice, or if you were to return only as needed (PRN). WE DO NOT PRACTICE PAIN MANAGEMENT.
4) Prescriptions that have been lost, misplaced or discarded will not be refilled until they are due.
5) It is the doctor’s privilege to refill or not refill prescriptions that have been stolen, even if there is a police report, but as a general rule, we do not refill.
6) We reserve the right to terminate the doctor-patient relationship in the event of any breach in this policy by the patient.
7) Due to its potentially addictive nature and the availability of alternate treatment options, the doctor does not routinely prescribe Xanax or other benzodiazepines. The physician also reserves the right to alternate prescribing methods such as prescribing in shorter 10 day supplies, to prevent misuse.
8) The doctor does not prescribe pain medications and that all patients requiring such medications will be referred to a pain specialist or their primary care physician.
COA maintains your information in an electronic medical record which are maintained in a secure and safe location. Your records are not shared with anyone without your permission. Records are retained 7 years. At the end of 7 years, the records are destroyed in a confidential manner. COA will then maintain a record of your name and demographics, diagnosis at the time of last service, and dates you attended treatment. You do have a right to a copy of your chart which we must provide within 30 days. Choices will send your records with a signed release as a courtesy. Or if you wish to get a copy of your records yourself, you will need to sign a release of information. Requests for medical records may take up to 30 days to process. The cost is $1 per page for pages 1-25, and 50 cents per page thereafter. Any postage costs is the actual cost of postage. If you find an error in your medical records, you can request in writing that it be corrected or add information to your file if it is incomplete. For example, if you and your doctor agree that there's an error such as what medication was prescribed, he must change it. Even if your doctor doesn't agree that there's an error, you have the right to have your disagreement noted in your records. In most cases the file should be changed within 60 days, but it can take an additional 30 days if you're given a reason.
Mandatory Reporter of Child Abuse:
Under Alabama law, the staff at COA are mandatory reporters of child abuse or neglect. If such should come up it must be reported to the state and/or law enforcement for investigation.
Any person or agency who applies for or receives any service from Choices of Alabama LLC may file a complaint/grievance. However, you are encouraged to first approach your counselor with any concerns. Informal complaints may be verbally given to any staff member or supervisory personnel. Those staff members may resolve the complaint quickly, in an informal manner. In the event you are not satisfied with the resolution of the complaint, you may file a formal written complaint/grievance with the Clinical Director of Choices of Alabama LLC who has 7 days to resolve the grievance. If the grievance is still not resolved, you may present it to either Managing Member (owners) of Choices of Alabama LLC, who have 7 days to resolve the grievance. You may also call any of the following agencies at any time
Choices of Alabama LLC 205-639-1334
Dept. of Human Resources 205-945-3700
Alabama Department of Mental Health 1-800-367-0955
AL Disabilities Advocacy Program (ADAP) 1-800-826-1675
We value your personal privacy! This means that, without your written permission, no information about your contact with COA is available to anyone outside of COA without your written permission. However, there are certain exceptions which are noted below.
Effective counseling sometimes requires that your counselor participate in a clinical supervision and treatment team review process, in which your case is discussed and reviewed by your counselor and supervisor. Further, in some cases your counselor may consult with other professional colleagues to facilitate continued professional growth and to give you benefit of professional review. In these cases, the dynamics of the problems and the people are discussed along with the treatment approaches and methods.
If you pose a clear and imminent threat of harm to yourself or another person, we will take whatever steps are required to help prevent the potential harm from happening. This could include involuntary commitment, or contacting the Emergency contact you have provided.
In the event of a psychiatric hospitalization;
If you report information indicating that a child, disabled, or elderly person is suffering abuse or neglect;
A court order, issued by a judge, could require us to release information contained in your records, or could require a therapist to testify;
If you have a disease commonly known to be both communicable and fatal, COA is justified in disclosing information to an identifiable third party, who by his or her relationship with the client is at a high risk of contracting the disease.
Your insurance company paying for services has the right to review all records.
Counselor Incapacitation or Termination of Practice and your Records:
In the unlikely event that your therapist becomes incapacitated through death, disability, or change in practice, you will be contacted as to who will be the custodian of your records. The owners of Choices of Alabama LLC will be responsible for providing an appropriate referral to another licensed counselor. Your records will be forwarded with the referral.
What to do in Emergency Situations:
If you have an emergency situation outside of business hours, especially if experiencing suicidal or homicidal thoughts or significant adverse reactions to medications, you will need to call 911 or go to the nearest Emergency Room. Email is not a confidential method of communication, and is not an appropriate method of communicating confidential, urgent or emergency information. You may also contact the Birmingham area Crisis Hotline at (205) 323-7777.
COA will charge persons receiving mental health services at the usual and customary rate prevailing in the Birmingham, AL area. Mental health services will be provided at no charge, or at a discounted charge, to persons unable to pay for care. We will not discriminate against any person receiving mental health services because of his/her inability to pay for services.
By signing this consent, I hereby authorize the release of any medical information necessary for the processing of insurance claims. I hereby assign all medical benefits for services rendered by Choices of Alabama LLC to be paid directly to Choices of Alabama LLC.
I understand that responsibility for payment is mine. Choices of Alabama LLC, will bill my insurance company as a courtesy if applicable, but I agree that if my insurance company does not remit payment to Choices of Alabama LLC, within 60 days or if I am a self-pay patient, I will pay my account. Cash, or credit cards are accepted.
I understand that understanding my insurance policy is my responsibility. It is likewise my responsibility to know whether I have a deductible and whether or not that deductible has been met. While this office will attempt pre-certification on my insurance prior to the visit if the needed information has been provided by me, it is ultimately my responsibility to pay any balances left by claims denied due to unmet deductibles and/or lack of pre-certification caused by my not providing the needed information to this office at least 48 business hours before my new patient evaluation and/or before my follow up visit if my insurance has changed.
IN REGARDS TO CO-PAYS, Choices of Alabama LLC does reserve the right to refuse to schedule a follow up appointment if there are outstanding co-pays owed.