Practice Policies
Greenwich Child & Adolescent Psychiatry Practice Policies & Agreement
The following policies are designed to ensure clear communication, mutual understanding, and the highest quality of
care. Please review this document carefully and keep a copy for your records.
1. Payment Policy for All Providers
• Private Pay Practice: All providers at Greenwich Child & Adolescent Psychiatry are out-of-network with insurance
carriers and are not Medicare or Medicaid providers.
• Payment at Time of Service: Payment is due at the time of your visit. A credit card may be securely stored on file
for convenience and auto-pay enrollment.
• Insurance Claims: We do not bill insurance directly. We can provide an itemized statement (“superbill”) for you to
submit to your insurance for potential reimbursement. Reimbursement is at your carrier’s discretion.
• Fee Structure: Our fees are based on the time, expertise, and type of service provided. Fee schedules are available
upon request.
• Outstanding Balances: Accounts with unpaid balances after 30 days may be paused until the balance is resolved.
2. Cancellation & Missed Appointment Policy
• 24-Hour Notice Required: If you must cancel or reschedule, please provide at least 24 hours' notice.
• Late Cancellations/No-Shows: Appointments cancelled with less than 24 hours' notice or missed without notice
will be billed at the full session rate.
• Repeated Cancellations: Frequent late cancellations or no-shows may result in discontinuation of services and/or
referral to another provider.
3. Telephone & Electronic Communication Policy
• Routine Communication: Email or secure messaging (via our HIPAA-compliant platform) may be used for
scheduling or brief, non-urgent matters only.
• Clinical Questions: Clinical issues requiring provider input may require a telehealth visit rather than email or phone.
• Phone Consultations: Insurance does not reimburse for phone calls. Phone consultations beyond scheduling or
simple clarifications are billed at the provider’s hourly rate, prorated in 15-minute increments.
• Response Time: We aim to respond to non-urgent messages within 2 business days. Urgent clinical matters require
a call to 911 or going to the nearest emergency department.
4. Telehealth Policy
• Eligibility: Telehealth is available for most services unless in-person evaluation is clinically necessary.
• Fees: Telehealth session fees are the same as in-person visits.
• Technical Responsibility: Patients/families are responsible for ensuring adequate internet connectivity and a
private, distraction-free environment for telehealth sessions.
5. Minor Patient Policy
• Consent: A parent or legal guardian must provide consent for treatment of minors.
• Confidentiality: While parents/guardians have legal access to records, confidentiality between adolescents and
providers is critical to effective treatment. Providers will discuss with families how information will be shared,
respecting the minor’s privacy where appropriate and legally permissible.
6. Emergency & Crisis Policy
• Clinic Limitations: We do not provide 24-hour crisis services.
• Emergencies: For life-threatening or psychiatric emergencies, call 911 or go to the nearest emergency department.
• Crisis Lines: For mental health crises, call or text 988 (Suicide & Crisis Lifeline) or use local crisis services.
7. Confidentiality & Records
• HIPAA Compliance: All records are maintained confidentially in compliance with federal and state law.
• Limits to Confidentiality: Providers are mandated reporters and must break confidentiality in cases of suspected
child abuse, threats of harm to self or others, or as otherwise required by law.
•Access to Records: Requests for copies of records must be made in writing and may incur administrative fees.
8. Termination of Treatment
• Mutual Decision: Treatment typically concludes when therapeutic goals are met or when mutually agreed upon by
the patient/family and provider.
• Provider-Initiated Termination: Providers may ethically terminate care after discussion and referral if treatment is
not being effectively used, if recommended care is refused, or if there is ongoing non-payment.
• Non-Engagement: Failure to attend appointments for three consecutive weeks without prior arrangement may be
interpreted as discontinuation of care.
9. Professional Boundaries & Conduct
• Respectful Environment: We expect all interactions to remain respectful and professional. Abusive or threatening
behavior toward staff or providers will not be tolerated and may result in termination of services.
10. Agreement & Acknowledgment
By signing below, you acknowledge that you have read, understood, and agree to abide by these practice policies.