As Children Blossom Therapy Center

Financial Policy

Services at As Children Blossom must be paid for at the time they are rendered. Individual services will be delivered in 50 minute, 40 minute, or 25 minute treatment time appointments. Non-treatment time is intended for discussion of the program, recommendations for home-based exercise, and checking out. If additional consultation time is needed, please discuss this with your therapist and a separate consultation time may be scheduled (please see list of current charges). Progress reports will be provided after 6 months of therapy at no charge, all re-evaluation reports will be done for a charge (please see list of current charges).

As Children Blossom does not bill medical insurance for therapy provided. As a courtesy to those families pursuing reimbursement for individual treatment through their health insurer, As Children Blossom will provide an invoice that can be submitted to your insurance company for reimbursement. This will include service codes as well as diagnosis codes required by insurance companies. In order to add diagnosis codes, a prescription from your child’s physician is required. Invoices will be handed out at your child’s next regular scheduled appointment. Any alterations to provided invoices must be requested within 90 days of their issuance. Any requests to re-print one or more invoices must be made in writing and may take 10 business days to process; the current fee will be assessed for each request (please see list of charges).

Group services are based on a monthly per-session tuition system and payment is required in full the 1st of each month. In the event a child misses a class, a replacement class will not be offered. Tuition is not pro-rated or refundable for a missed class unless that class is canceled by As Children Blossom.A 30 day notice is required to disenroll a child from the group therapy services. Clients who are electing to seek reimbursement through their health insurance provider for group services may do so by enrolling under the insurance reporting fee option. Clients must choose to enroll in this option within one week of enrolling in the class. For those clients choosing to do so, the therapists will provide the necessary invoices, treatment and diagnostic codes as well as the required treatment plan and progress reports for the health insurance provider.______________(initial here to indicate understanding).

Caregivers must return to pick up their child by the end of the treatment time. Caregivers who do not arrive by the end of the session’s consultation time will be assessed a child supervision fee of $25 dollars per 10 minutes or portion thereof that they are late.

In order to insure that services end in a professional and therapeutically appropriate manner, a minimum notice of two weeks is required for private-pay clients.
We do accept all credit cards, however payment in check, debit card or HSA card is preferred.

Cancellation policy

All appointments require a minimum of 24-hour’s advanced notice for cancellation. All missed appointments with less than 24 hours notice will be assessed a cancellation fee of 50-percent of the session’s cost. Appointments cancelled 24 or more hours in advance will not be assessed the cancellation fee. An appointment that is cancelled with less than 24 hours advance notice but for which a make-up session can be scheduled will not be assessed the 50-percent cancellation fee. Appointments that are missed without notice will be assessed a no-show fee equivalent to the full charge for the session. Therapy service fees will not be pro-rated for arriving late or leaving early for any scheduled appointment

A limited number of advance notice cancellations (absences with more than 24 hour notice) are provided without incurring a charge. The following are offered:

-2 sessions during summer-mid-June to late August (two weeks for groups)
-3 sessions during fall-late August to end of December
-3 sessions during winter/spring-January to mid-June
If your child is seen twice weekly 5 sessions each period are provided.

The following holidays will not be counted as missed appointments:

-New Years Day
-Memorial Day
-Fourth of July
-Labor Day
Thanksgiving Day and Friday after Thanksgiving
Christmas Day

The first week of your child’s school and the week between Christmas and New Year’s Day are also optional days and missing those days will not be counted toward the number of advanced cancellation days.

All fees are due before the beginning of the child’s next treatment session or class. Refusal to pay incurred fees will result in removal from the treatment schedule; subsequent payment does not provide guarantee that the same spot in the schedule will remain available.

As Children Blossom is barred by law from collecting fees for missed appointments from families with third-party-payers such as Kaiser Permanente or San Andreas Regional Center; as such, these families may have no more than three absences during any six-month period. Families who exceed the number of permitted absences may be removed from the treatment schedule.

Group services are based on a per-session tuition system and payment is required in full at the beginning of each month. In the event a child misses a class, a replacement class will not be offered. Tuition is not pro-rated or refundable for a missed class unless that class is canceled by As Children Blossom. Clients who are electing to seek reimbursement through their health insurance provider for group services may do so by enrolling under the insurance reporting fee option. Clients must choose to enroll in this option within one week of enrolling in the class. For those clients choosing to do so, the therapists will provide the necessary invoices, treatment and diagnostic codes as well as the required treatment plan and progress reports for the health insurance provider.

Cancelled or missed session that result from a therapist’s absence do not incur fees.

Please email or call your therapist as soon as you are aware that a cancellation is required.

As Children Blossom Sick Client Policy

As part of As Children Blossom’s commitment to serving and protecting our children and their families, we request that our families agree to follow the Sick Client Policy. Children who are currently symptomatic, ill, or recovering do not benefit from their treatment. As Children Blossom staff sees many clients throughout the day and it is in the best interest of all clients that their therapists, peers, and families be exposed to as few illnesses and diseases as possible.

A parent or caregiver must cancel their child’s session whenever they exhibit one or more of the following symptoms within 24 hours of their scheduled treatment time.

• Temperature of 100 degrees Fahrenheit or more (child must be fever free without use of medicine for 24 hours);
• 2 or more episodes of diarrhea;
• Vomiting;
• Rash;
• Infection of the eye;
• Hacking or persistent cough;
• Productive cough with yellow or green phlegm;
• Stuffy or runny nose with yellow or green phlegm;
• Excessive irritability;
• Excessive irritability;

If any member of the household is experiencing a highly contagious disease or condition such as Pink Eye, Streptococcus infection, Head Lice, Impetigo, and Hand-Foot-Mouth Disease then the child’s session should be canceled.

As Children Blossom and its staff reserve the right to use their discretion to cancel a session at any point should the child demonstrate symptoms of illness.As Children Blossom staff will likewise cancel sessions if they are showing signs of illness.

We appreciate our families assisting us in keeping our clinic healthy.

As Children Blossom Privacy and Use of Information Policy

Our responsibilities under the health insurance portability and accountability act (hipaa)

As Children Blossom Therapy Center (ACB) is subject to the federal law governing your child’s medical information, known as HIPAA, as a healthcare-related treatment provider. During the course of your child’s treatment, ACB staff will generate and, from time to time when deemed appropriate, request access to relevant medical diagnostic and treatment-related information. Healthcare-related information ACB may generate includes, but may not be limited to,assessments, standardized testing and measures, progress and exit reports, ongoing treatment notes, and invoices. Records and documentation generated or requested will be used to inform and plan treatment and to evaluate and report its progress.

ACB takes its responsibilities under federal and applicable state laws seriously. Please read the policy below carefully and completely in order to understand how ACB and its employees will and will not store, access and utilize your child’s healthcare information.

How We Access Your Child’s Medical Information

ACB will seek your consent for release of medical information relevant to your child’s treatment. This may include, but is not limited to: verbal or written consultation with your child’s other medical providers (e.g. pediatrician, neurologist, clinical behaviorist, consultation with ACB staff, etc.); diagnostic information; medical charts; assessments; and treatment reports. You will be asked to sign a written consent for release of this information. You will have the opportunity to exclude certain categories or providers from this consent. You also may exercise the right to revoke this consent at any time.

How We Store Your Child’s Medical Information

Federal law requires that ACB retain client information until their 27th birthday. Your child’s information will be retained in a hard copy file stored consistent with current federal and state law. Your financial and billing information will be retained in encrypted electronic format as well as hard copies consistent with federal and state law.

What We Do With Your Information

Medical information will be accessed as by ACB staff involved in your child’s treatment as required to assess, plan, and evaluate your child’s treatment. Financial information will be accessed as required by ACB staff for accounting purposes.

What We Do Not Do With Your Child’s Medical Information

ACB does not sell, trade, disseminate, or allow access to your information to third parties without specific consent to release or legal authority to access that information.

Who We May Release Your Child’s Medical Information To

ACB will release information it generates or retains to other entities in possession of a valid consent to release information. ACB will also release information to parties legally entitled to access that information including, but not limited to: law enforcement, health insurance providers, government-sponsored funding agencies, child protective services, medical or financial auditors, and in response to subpoena. Regular reporting is provided to third-party public or private treatment-funding agencies such as your child’s health insurance provider or designee, school district, or Regional Center as specified by contract and/or law.

Communication Regarding Your Child’s Medical Information

ACB may communicate and disclose to entities in possession of valid consent or legal authority to your child’s information via personal interaction, telephone, facsimile, written documentation or e-mail. ACB utilizes a HIPAA-certified provider to transmit healthcare-related information via e-mail through a sign-on system; ACB does not assume responsibility for the security protocols of other entities including other providers or families and does not guarantee the protection of your child’s information sent to ACB or once received from ACB. Should a family consent to communicate healthcare-related information via e-mail, it is their responsibility to provide user-end security of that information . If you would like to receive non-healthcare related information via email, i.e. scheduling or cancellations please let us know.

ACB staff utilize a consultative approach to your child’s treatment. As such, your child’s therapist may choose to discuss your child’s history, diagnosis, treatment, and progress with other ACB staff or Business Associates as required for their treatment planning. Group assistants may sometimes be made aware of pertinent diagnostic information about a child in order to structure their teaching style appropriately. All staff members are required to keep any information about our clients confidential and all ACB staff are trained on and subject to following the Privacy and Use of Information Policy. Consent to treatment by ACB staff includes consent to this consultative practice.

Your Rights Under This Policy

You are entitled to:

• receive a copy of this policy upon request;
• to revoke consent at any time;r
• to revoke consents to release information before their expiry date;
• to receive notification of disclosure of information except where prohibited by law;
• request to receive healthcare information in a preferred and agreed-to manner.

For Additional Information Or To Report a Problem

If you want more information about or privacy practices or have questions or concerns please contact Jodi Huber or Lisa Worrell. If you disagree with a decision we made regarding access to your child’s health information or in a response to a request you made in writing please contact Jodi or Lisa. You may also submit a written complaint to the U.S. Department of Health and Human Services.