Behavioral Medicine Associates

A Soundings®, LLC Company

Notice of Privacy Practices

This notice describes how your healthcare information may be used, shared, and how you can access it.  Please review it carefully.

Behavioral Medicine Associates | Soundings®, LLC (the PRACTICE) understands that information about you and your health is very personal and private.  The Practice is committed to protecting your health information in accordance with applicable laws, and, the American Psychological Association Code of Ethics.  This includes full transparency regarding the policies and procedures used to create and maintain records of your care at the Practice.  These records ensure quality care and compliance with legal requirements.

This notice tells you about the ways in which we may use and share information about you.  It also describes your rights, and, certain obligations we have in the use and sharing of this information.  While some scenarios may not apply to you, we are required by law to inform you of them.

We are required by law to:

• Ensure your identifiable information is kept private.

• Provide you with this notice of our privacy practices and legal obligations

• Follow the terms outlined in this notice

Uses and Disclosures of Your healthcare Information

1. Treatment. Protected Health Information (PHI) refers to information that may identify you and that relates to your past, present or future physical or psychological health conditions and related treatment.  Your PHI will only be shared with your written permission, unless otherwise allowed by law.  The practice may communicate with your other healthcare professionals involved in your care (e.g., your medical providers, psychotherapists, etc.), to coordinate or manage treatment.

2. Payment. Your healthcare information may be shared with you, your healthcare insurer, or a collection agency, so that the practice can be paid for services provided to you, and will include information that identifies you, as well as the nature of the treatment provided.  Information may also be shared with your insurer to obtain prior approval, verify coverage, confirm medical necessity, or ensure correct payment to the Practice.

3. Healthcare Operations. Your healthcare information may be used to assess and improve the quality of care or allocate resources effectively.  Non-identifiable details of your treatment (excluding full name, residence, family names, etc.) may be shared with relevant providers, department meetings, or peer supervision groups to evaluate and optimize your treatment.  Additionally, we may combine your information with data from other patients to assess treatment effectiveness, evaluate staff performance caring for you, or to make decisions about additional services we might offer.  Finally, information may also be shared with business associates essential to practice operations (e.g., transcription, billing, fax services, management, collections, legal, and accounting), with strict contractual agreements to protect your information per legal requirements.

4. Certain Uses And Disclosures That Do Not Require Your Authorization. Federal and state laws require the Practice to share your healthcare information under certain circumstances without your consent. Examples include suspected abuse or neglect of a minor, elder, or disabled person, or to prevent a serious threat to your health or the safety of others.  Disclosure of your PHI without consent is also mandated in the following situations:

• When required by law, including judicial or administrative proceedings, court orders, subpoenas, or lawful processes (after notifying you or seeking protective orders where possible)

• For Worker’s Compensation cases

• To public health or legal authorities for disease, injury, or disability prevention

• During a medical or psychiatric emergency, to another healthcare provider

• To correctional institutions if you are incarcerated

•  For Health Oversight, if requested by regulatory boards (e.g., Massachusetts or Vermont Boards of Psychological Examiners)

• For research purposes, such as comparing therapeutic outcomes across treatments

• For specialized government functions, such as military operations, presidential protection, intelligence activities, or ensuring safety within correctional facilities.

5. General Communications of PHI.  Your provider or the Practice may disclose PHI without your consent when contacting you regarding appointments, satisfaction surveys, or other related matters, including electronic communications (e.g., email, text, or the Patient Portal). With your written permission, PHI may also be shared with family, friends, or others involved in coordinating your care.

6. Insurance Reimbursement.  To set realistic treatment goals, it’s essential to assess your resources for covering treatment costs. You always have the option to pay directly for services to avoid potential issues, such as uncovered services or disclosure of your information to an insurance company.  Insurance policies often cover behavioral health services, though rising healthcare costs have made benefits more complex. You are responsible for paying the Practice’s fees unless there is a prior arrangement with your insurance provider. Be sure to verify your coverage by reviewing your insurance booklet and consulting your plan administrator.  Your health insurance contract requires this Practice to release relevant treatment information, including diagnoses, treatment plans, and prognoses, to your insurer. The insurer may also request additional details, possibly including your full patient record. The Practice will strive to limit the information shared to what is necessary for the purpose requested.  Once shared, your information may become part of the insurer’s electronic files and, potentially, a national medical information database. While insurers claim confidentiality, this Practice has no control over how they manage your information. You may request a copy of any report submitted by making a written request.

7. Psychotherapy Notes. Your provider may keep “psychotherapy notes” (as defined in HIPAA Privacy Rule 45 CFR § 164.501).  These notes are not part of your healthcare and billing record; they are considered separate, and these notes are maintained apart from these areas.  The notes are created for your healthcare providers personal use and contain impressions, insights, and observations during a psychotherapy or counseling session.  They do not include the following (which are part of the regular medical/healthcare record): (a) Medication prescription and monitoring; (b) session/consultation start and stop times; (c) modalities and frequencies of treatment furnished; (d) results of clinical tests or administration of psychological or health screens, measures, psychological testing, or; (e) summaries of diagnosis, functional status, treatment plan, symptoms, and/or prognosis.  Psychotherapy notes are considered highly sensitive and are protected under Vermont, Massachusetts, and federal (HIPAA) laws. In most cases, these notes require your explicit written consent before being disclosed to third parties, except in limited situations, such as for legal or regulatory purposes.  IMPORTANT: If the use or disclosure is for: (i) your providers use in treating you; (ii) your provider or this practices’ use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or psychotherapy; (iii) your providers use in defending themself in legal proceedings instituted by you; (iv) for use by the Secretary of Health and Human Services to investigate this practice or your providers compliance with HIPAA; (v) required by law and the use or disclosure is limited to the requirements of such law; (vi) required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes; (vii) required by a coroner who is performing duties authorized by law, and; (viii) required to help avert a serious threat to the health and safety of othersThese protections are stricter than those for general medical records.

8. Recording of Consultations.  Occasionally, your provider may audio record consultations for informational purposes ONLY, such as conveying ideas in future publications (e.g., articles, books, etc.). No identifying information (PHI) will be used in these recordings. You may request a copy if a recording has been made.

9. Electronic Communications & Telehealth.  This Practice provides telehealth services exclusively.  Note that confidentiality of electronic communication (e.g., email, text, etc.) cannot be fully guaranteed.  Under Massachusetts law (2020 Act Promoting a Resilient Health Care System) and Vermont law (8 V.S.A. § 4100k), telehealth includes audio-video, telephone, and online communications for evaluating, diagnosing, treating, and monitoring health conditions. We use electronic media for administrative tasks (e.g., billing, etc.), PHI storage, and telehealth services (e.g., psychotherapy, counseling, and, consultation/non-clinical  services).  For all clinical communications, please use the Patient Portal, and allow time for responses.  While your provider will make every reasonable effort to return messages in a timely manner, your provider and this Practice cannot guarantee an immediate response.  Electronic communications may be delayed or lost due to technical issues, so to confirm scheduling, please call the office directly instead of using email or text.  The Practice does not monitor electronic media outside of business hours, including weekends, holidays, or vacations. IMPORTANT: For medical or psychiatric emergencies, do not use electronic communication. Instead, contact your family physician, visit the nearest emergency room, or call 911.

10. Social Media. While this Practice may use social media to share general information about services and programs, it will not interact with individual patients on platforms like X, Facebook, or LinkedIn, to protect confidentiality and avoid dual relationships. If an online connection with a patient is inadvertently established, it will be canceled immediately, as such relationships conflict with the American Psychological Association’s Ethical Principles & Code of Conduct, which guides this Practice.  If you have questions about this policy, please discuss them with your provider. Your provider may participate in social networks personally, and accidental online encounters are possible. If this happens, please address it in your next consultation. Refrain from reaching out to your provider through social media; any accidental connections will not be acknowledged, to preserve therapeutic boundaries.  For transparency, no patient names will appear in the Practice’s or provider’s social media connections. If an existing social media contact becomes a patient, the provider will disengage to maintain these boundaries. Please do not be offended by this policy: It is in place to prioritize your best interests.

11. Marketing Purposes & Sale of PHI.  This Practice and your provider will not use or disclose your PHI for marketing purposes and will not sell your PHI as part of their business operations.

12. Other Uses and Disclosures.  Any other sharing of your healthcare information will only occur with your written permission.

13. Revocation of Authorization.  You may revoke your authorization for this Practice to disclose your information at any time by submitting a written request.  If you choose to do so, please be aware of the following: because this Practice is committed to providing collaborative care and honoring all legal requirements, your provider may no longer be able to see you.  Additionally, prior disclosures made in reliance on your prior authorization or those required for insurance coverage cannot be undone.

Notice of Patient Rights & Responsibilities

At Behavioral Medicine Associates | Soundings®, LLC our goal is to provide the highest quality healthcare. Essential to our commitment to deliver quality care, is our profound respect for your individual needs and rights—which are also congruent with applicable Federal and State laws.  These rights apply to all patients at our Practice.  You also have the right to receive a written copy of these rights.

Your Rights

As a patient at our Practice, you have the right to:

1. Confidentiality of all records and communications, to the extent provided by law (see above, Notice of Privacy Practices).

2. Services are provided via telehealth; we ensure that your provider has a private and secure area for the delivery of services.

3. Receive confidential communications of your information at an alternative location or by alternative means, as provided by law.

4. Prompt and adequate responses to all reasonable requests, within our capacity to respond.

5. Inspect your healthcare record and to receive a copy for a fee (based on copying costs), in accordance with applicable State laws, upon request.

6. Refuse treatment or evaluation when the primary purpose is educational or informational rather then therapeutic.

7. Be informed about and participate in decisions about your care, including informed consent to the extent provided by law.

8. A clear explanation of proposed treatments and procedures, including:

    • Potential benefits and drawbacks

    • The likelihood of success

    • The possible results of non-treatment, and any significant alternatives

9. Access to protective services, such as protective intervention for vulnerable or abused adults.

10. An explanation of the cost of proposed treatment, if you are self-paying (see below).

11. To receive a copy of the bill or other statement of charges submitted to any insurance company or third party for your care, upon request.

12. Information about financial assistance or free care, if you request it.

13. Receive healthcare that meets the highest standards.

14. Revocation of Authorization.  You may revoke your authorization for this Practice to disclose your information at any time by submitting a written request. Please be aware that, due to collaborative care commitments and legal requirements, this revocation may affect your provider’s ability to continue care. Additionally, prior disclosures made in reliance on your authorization or those required for insurance coverage cannot be undone.

Your Responsibilities

As a patient, you have an important role in helping us provide the best possible care. As a partner in your healthcare, your responsibilities include:

1. If using health insurance, please contact your insurance company before your first visit to confirm service approval, ensure your provider is in-network, and verify the allowed number of visits. Your provider will ask for this information during your initial consultation.

2. If you are unclear about any aspect of your care or instructions, including your treatment plan, please ask for clarification.

3. Share accurate, up-to-date information about your current concerns, past illnesses, hospitalizations, medications, and any other relevant health details.

4. Actively participate in treatment planning, set goals and desired outcomes, and follow the recommended treatment from clinicians and other healthcare professionals.

5. To provide the highest quality care, your provider may consult with your other healthcare professionals, such as your primary care provider, as research shows that collaborative care significantly improves patient outcomes.  Patients are expected to sign a release allowing communication with their healthcare providers. Please note that ongoing treatment generally requires a medical doctor of record (e.g., primary care physician). If you prefer not to provide this information, your provider may offer an assessment and recommendations only, with no treatment until a medical provider of record is in place and consent to collaborate is given.

6. Please arrive promptly to telehealth appointments. If you anticipate being 5-10 minutes late, kindly call ahead to inform your provider. Arrivals later than 15 minutes without prior notice may require rescheduling, and a $185 cancellation fee (not covered by insurance) may apply.

7. Canceling an appointment:  Please cancel appointments at least two business days in advance, except in cases of illness, medical emergency, or serious accident. For example, if your appointment is on Monday, notify us by the prior Thursday; if on Friday at 8 a.m., call by 8 a.m. on Wednesday. Unlike many medical visits, each counseling session requires 45 minutes to one hour, making late cancellations disruptive to both your provider’s schedule and other patients awaiting services. Cancellations with less than two business days’ notice may incur a $185 fee, which is not covered by insurance. By scheduling, you agree that the Practice may charge this fee automatically to your card on file for late cancellations. Exceptions granted for this fee do not alter the Practice’s right to charge the full amount for future late cancellations. Persistent late cancellations may lead to termination of services at your provider’s discretion.

8. If you do not attend a scheduled appointment without prior notice and it is not due to a serious accident or medical emergency, a fee of $185 will be charged for the provider’s reserved time, which is not covered by insurance. By scheduling, you agree that the Practice may charge this fee automatically to your card on file in the event of a no-show. Repeated no-shows may result in termination of services at the provider’s discretion. Please be mindful that missed appointments prevent other patients from accessing care and disrupt your provider’s schedule. Any exceptions to this fee are not guaranteed in future cases of missed appointments.

9. If you are being treated for chronic pain: If you are being treated for chronic pain, please do not cancel your appointment due to a pain flare-up. Your provider is trained to help manage these episodes, and attending appointments during flare-ups is essential to your progress.  Repeated cancellations due to pain may be counterproductive to your treatment and could lead to discharge from the practice.

Policy on Patients Involved in Legal Proceedings  The Practice and your provider reserve the right to refer patients to other providers if it is learned that they are involved in legal proceedings, such as Worker’s Compensation claims, disability benefit applications, or lawsuits.

Contacting Your Healthcare Provider  Due to your provider’s consultation schedule, they may not be immediately available; please leave a message on their voicemail.  Messages will generally be returned within 24 hours during regular business hours, Monday through Friday (excluding weekends, holidays, and vacations).  Please include several times when you are available and your contact number, even if you think the provider has it. You may also reach out via the Patient Portal, though replies follow regular business hours only.  If your provider will be unavailable for an extended time, they can provide contact information for a colleague if needed.  IMPORTANT: For medical or psychiatric emergencies, do not use electronic communication.  Instead, contact your family physician, and/or immediately go to the nearest emergency room, or call 911.

No Surprises Act/Good Faith Estimate of Costs for Services  This Good Faith Estimate (GFE) is an estimate of the cost of services provided for self-pay/uninsured patients ONLY; it does not pertain to those patients using their health insurance.  If you are self-paying, your provider will provide you with an estimate of the cost most new patients may likely incur.

Professional Fees (Other Than Psychotherapy or Counseling)  $215.00/hour, billed in 10 minute increments for services beyond regular clinical consultations.  These may include report writing, clinical telephone calls lasting over 10 minutes, preparing records or treatment summaries, and time spent performing other requested services outside of clinical consultations.  If your provider’s involvement in legal proceedings is required, you will be responsible for their professional time, including preparation, consultation with attorneys, and travel expenses. Please note:  Due to the complexity of legal cases, fees are doubled for any preparation or attendance related to legal proceedings.  These fees are typically not covered by insurance.  IMPORTANT NOTE:  The Practice reserves the right to refer patients involved in legal matters, including Worker’s Compensation claims, disability benefits, and lawsuits.

Billing & Payments  Due to the nature of telehealth consultations, payment is required at the time of each consultation via credit, debit, or HSA card, unless otherwise arranged. This shall include full-payment if you do not have insurance (or if this Practice is not on a particular insurance panel). If this Practice accepts your insurance, copayments are due at the time of service, unless agreed otherwise in writing. At your request, the Practice can provide a monthly statement with details commonly required for insurance reimbursement.  Patients with out-of-network coverage are responsible for filing claims and for notifying this Practice of any changes in address or insurance status. (See “Insurance Reimbursement” section for further details). Staying current with payments and appointments is essential to maintain therapy without interruption and/or discharge from the Practice.  This will be discussed with you in advance of any such action being taken.  If payments are more than 30 days overdue and no payment arrangement has been made, the Practice may pursue legal means for payment collection.  This may involve a collection agency or small claims court, potentially requiring disclosure of limited information (as outlined above).  In most collection situations, the only information released regarding a patient’s treatment is your name, services provided, and the amount owed.  If such legal action is necessary, its costs will be included in the claim.  If no payment plan is in place, outstanding balances may incur interest at 1.5% or the maximum rate permitted by law.

Professional Records  This Practice is required by law and standard of care to maintain Protected Health Information (PHI) about you in your Healthcare Record. You have the right to access a copy of this record, except in unusual circumstances where there is a substantial risk of imminent psychological harm or serious physical danger to yourself or others. To access your records, please submit a written request as outlined above. Should any portion of the record be withheld, your provider will notify you.  Please note that these records are professional documents, which may be complex and potentially unsettling to untrained readers. Therefore, we strongly recommend reviewing your records initially with your healthcare provider or having them forwarded to another health professional. This approach allows you to discuss the contents in an informed and supportive setting.

Complaints If you are dissatisfied with your care or any aspect of service, the Practice encourages open communication, and we urge you to discuss your concerns with your provider directly. If you believe that your provider or this Practice has violated your privacy rights, or if you disagree with a decision regarding access to your records, please contact the Practice.  Additionally, you may reach out to the Massachusetts Board of Psychology at (617) 727-9925, or if you are in Vermont, the Vermont Board of Psychological Examiners at (802) 828-1505. Alternatively, you may submit a written complaint to the Secretary of the U.S. Department of Health and Human Services.  IMPORTANT: By endorsing this Notice of Privacy Practices and Treatment Consent Agreement, you agree not to publish or disclose your opinion of the treatment received at this Practice on the Internet, whether positive or negative. Instead, if you feel your care was not appropriate, ethical, or fair, you agree to address your concerns through the process outlined in this “Complaints” section.

Effective Date, Restrictions and Changes to Notice of Privacy Practices and Treatment Consent Agreement  This Practice reserves the right to change the terms of this notice and treatment agreement and to make the new notice provisions effective for all PHI that is maintained.