Policies & Disclosures
HIPAA NOTICE OF PRIVACY PRACTICES
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the patient, significant new rights to understand and control how your health information is used. We are required by law to maintain the privacy of your protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information. HIPAA provides penalties for covered entities that misuse personal health information.
As required by HIPAA, we have prepared this explanation of how we are required to maintain the privacy of your health information and how we may use and disclose your health information.
Treatment means providing, coordinating, or managing health care and related services, by one or more health care providers. An example of this would include a physical examination.
Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collections activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.
Health care operations include the business aspects of running our practice, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, and customer service. An example would be an internal quality assessment review.
We may call your home or other designated location and leave a message on voicemail in reference to any items that assist the practice in carrying out its services, such as appointment reminders, insurance items and any calls pertaining to my clinical care, including laboratory results among others.
We may mail to your home or other designated location any items that assist the practice in carrying out services, such as appointment reminder cards and patient statements.
We may email appointment reminders and patient statements.
We may text message appointment reminders and patient statements.
We may access and share information with our partners for the purposes of facilitating care so long as we maintain HIPAA compliant business associate agreement.
We may access any pertinent health information database in which we have a business associate agreement or other registration including but not limited to multistate PDMP, CRISP, EPIC Care Everywhere, or any other relevant database in which Lukas Behavioral Health has access.
We may create and distribute de-identified health information by removing all references to individually identifiable information.
Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.
You have the following rights with respect to your protected health information, which you can exercise by presenting a written request to the Privacy Officer.
The right to request restrictions on certain uses and disclosures of protected health information, including those related to disclosure to family members, other relatives, close personal friends, or any other person identified by you. We are, however, not required to agree to a requested restriction. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it.
The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations.
The right to inspect and copy your protected health information.
The right to amend your protected health information.
The right to obtain a paper copy of this notice from us upon request.
This notice is effective as of January 19th, 2023 and we are required to abide by the terms of the Notice of Privacy Practices currently in effect. We reserve the right to change the terms of our notice of Privacy Practices and to make the new notice provisions effective for all protected health information that we maintain. We will post and you may request a written copy of a revised Notice of Privacy Practices from this office.
You have recourse if you feel that your privacy protections have been violated. You have the right to file written complaints with our office, or with the Department of Health & Human Services, Office of Civil Rights, about violations of the provisions of this notice or the policies and procedures of our office. We will not retaliate against you for filing a complaint.
Please contact the following for more information: The U.S. Department of Health & Human Services Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-677
Telehealth Treatment Policy and Disclosure
Lukas Behavioral Health offers telehealth services to patients deemed appropriate and eligible by the provider and Lukas Behavioral Health.
All policies held by Lukas Behavioral Health are applicable to telehealth services including attendance, late or no shows, payments and patient conduct.
Telehealth involves the use of electronic communications to enable providers at different locations to share individual client information for the purpose of improving client care. Providers may include primary care practitioners, specialists, and/or subspecialists. The information may be used for diagnosis, therapy, follow-up and/or education, and may include any of the following:
Client health records
Live two-way audio and video
Output data from health devices and sound and video files
Electronic systems used will incorporate network and software security protocols to protect the confidentiality of client identification and imaging data and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.
Expected Benefits:
Improved access to care by enabling a client to remain in his/her provider's office (or at a remote site) while the provider obtains test results and consults from practitioners at distant/other sites.
More efficient client evaluation and management.
Obtaining expertise of a distant specialist.
Possible Risks:
There are potential risks associated with the use of telehealth. These risks include, but may not be limited to:
In rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate decision making by the providers and consultant(s);
Delays in evaluation and treatment could occur due to deficiencies or failures of the equipment;
In very rare instances, security protocols could fail, causing a breach of privacy of personal health information;
In rare cases, a lack of access to complete health records may result in interactions or allergic reactions or other judgment errors;
The laws that protect privacy and the confidentiality of health information also apply to telehealth, and telehealth care is thereby protected under this practice’s Privacy Policies.
Patients have the right to withhold or withdraw consent to the use of telehealth at any time, without affecting the right to future care or treatment.
Telehealth may involve electronic communication of my personal health information to other practitioners who may be located in other areas, including out of state.
Not all insurances cover telehealth services. It is the responsibility of the patient to determine if telehealth services are covered by their insurer and what limitations, if any, apply. Patients are responsible for payment of telehealth at full billing rate if services are not covered by insurance.
It is the responsibility of the patient to ensure they have a reliable connection for their telehealth session.
It is the responsibility of the patient to ensure they are within the State of Maryland (or any state in which their provider is licensed) at the time of service.
It is the responsibility of the patient to ensure they are in a secure and quiet location at the time of service.
Controlled substances require an in-person face-to-face appointment prior to initiation by a Lukas Behavioral Health provider and at least every 12 months thereafter for continued refills. All other controlled substances policies apply to patients seen via telehealth.
Controlled Substances Policy
The following outlines Lukas Behavioral Health’s policy on the prescription of controlled substances:
Controlled substances are not guaranteed to be prescribed, regardless if prescribed by another provider in the past. Providers are not legally or ethically required to issue a prescription for a controlled substance.
Controlled substances are prescribed in accordance with evidence based guidelines and only for appropriate treatment and use.
Lukas Behavioral Health providers only prescribe benzodiazepines for the treatment of the symptoms of anxiety and anxiety related disorders, we DO NOT prescribe benzodiazepine as a primary or sole treatment of anxiety or anxiety related disorders. Lukas Behavioral Health does not prescribe benzodiazepines for non-psychiatric diagnoses. Benzodiazepines are strictly prescribed on an as needed basis and are not prescribed as a regular, straight, or around the clock prescription.
Patients being prescribed a benzodiazepine will be required to attend therapy as recommended by their prescriber.
Patients being prescribed a benzodiazepine will be required to take all non-controlled medications and treatments as directed in accordance with recommendations of the prescriber.
Patients on controlled substances, including benzodiazepines and stimulants are required to complete drug testing prior to initiation of the controlled substance and randomly during the course of treatment. Failure to comply with the requested drug test or failure of the drug test will result in discontinuation of controlled medications and application of a Controlled Substance Restriction on the medical record.
Patients are NOT to take or consume any other controlled drugs while being prescribed a controlled substance by a Lukas Behavioral Health provider; this includes but is not limited to marijuana and alcohol.
Providers have access to and are required to check the state Prescription Drug Monitoring database which shows all controlled substances prescribed previously by any provider and filled by any pharmacy.
Diversion can be defined as the transfer of a prescribed medication to any individual other than whom the drug is prescribed; or the improper use of a prescribed drug for purposes or by means other than that of its prescribed use. Diversion of controlled substances is illegal and strictly prohibited by Lukas Behavioral Health. Any evidence of diversion will result in a Controlled Substance Restriction and may also be required to be reported to law enforcement or child protective services if a minor is involved.
Patients that have been prescribed a controlled substance by another provider are not guaranteed to have their controlled substance continued and prescribed at Lukas Behavioral Health, continuation will be based on the clinical judgment and at the discretion of the prescriber.
Controlled Substance Restriction Notice: Any patient that violates the policies regarding controlled substances or who is deemed to be too high risk for treatment with controlled substances will have a Controlled Substances Restriction. A Controlled Substance Restriction is entered into and is a part of the medication record and signifies to other providers that the patient has either failed to comply with safe and appropriate use according to Lukas Behavioral Health policy or have been evaluated and are too high risk for treatment with controlled substances. This enables our providers and any provider with which you authorized us to share your records to clearly be able to ensure you are provided with the safest care possible.
Safe Spaces Policy
Lukas Behavioral Health has a ZERO TOLERANCE policy in regards to aggressive, violent behavior, or any other inappropriate behavior (including but not limited to sexual, racial, etc). In the event that a patient becomes verbally or physically aggressive, assaultive, or demeans, screams at, or threatens providers, staff, or other patients, the patient will be subject to the following:
Controlled substances (if involved) will be discontinued, and a Controlled Substance Restriction will be applied to the patient’s chart.
The patient will be discharged from the practice, with a 90 day prescription for non-controlled substances to provide adequate time for the patient to find replacement mental health care.
The patient may face any applicable criminal and/or civil charges.
If a patient’s family member or other person accompanying the patient violates this policy, the individual(s) will be promptly banned from Lukas Behavioral Health on a permanent basis.
Contacting staff or providers outside of approved contact method or publicly maligning staff or providers on internet platforms is strictly prohibited and is considered harassment. Such behavior is grounds for immediate discharge and may result in legal action.
Forms & Documentation Policy
Lukas Behavioral Health and its providers shall not be compelled, nor expected to complete or certify, by signature or other means; any forms, letters, or other documentation; regardless of the reason or cause for such documentation.
Such documentation of any kind shall only be completed or signed at the sole discretion of the provider and only if it is deemed clinically or legally necessary or appropriate.
Furthermore, no forms, letters, or documentation shall be completed until the client has been active and compliant with their prescribed treatment plan for no less than 6 consecutive calendar months; unless at the discretion of the provider, it is deemed clinically necessary to complete such documentation prematurely.
All completed forms, letters, and documentation are subject to the applicable service fees as published at the time of completion. Failure to pay the required service fees (not covered by insurance) will result in forfeiture or requested paperwork.
Emotional Support Animals (ESAs) Letters
Lukas Behavioral Health and its providers are not able to write letters of accommodation for “emotional support animals”.
Psychiatric Service Dog (PSD) Letters
Psychiatric Service Dogs (PSD) are protected by the Americans with Disabilities Act (ADA) and therefore do not require documentation. If an established patient wishes to have documentation for an ADA compliant PSD, and the patient’s provider deems it clinically appropriate; the provider may issue the Lukas Behavioral Health standardized form letter supporting the use of a PSD. PSD letters are subject to the applicable fee at the time of completion. Such letters are valid for one year.
Attendance Policy
Patients are expected to arrive for their appointment 20 minutes prior to their scheduled appointment time. Failure to arrive 20 minutes prior to the scheduled appointment time may be counted as a NO SHOW.
Telehealth Appointments: Patients being seen by telehealth should log on via the website link at least 10 minutes prior to their appointment time and be prepared for the session, by ensuring a good connection and a private and secure environment. Failure to comply with this policy will result in cancellation of the appointment which will be considered a Late Cancellation on part of the patient and will be subject to Late Cancelation fees.
Lukas Behavioral Health has a ZERO TOLERANCE appointment attendance policy and is outlined as follows:
No Shows: A no show is defined as failing to show for a scheduled appointment, whether or not confirmed, without prior notice.
No shows are strictly prohibited.
Patients who have 2 No Shows may be discharged from the practice with no more than 3 months of non-controlled medications and no more than 1 month of controlled medications (as long as they are in good standing in accordance with the Controlled Substance Policy); and the patient will be responsible for finding new care.
Patients will be liable for up to the full billable rate of the scheduled appointment in the event of a No Show, which will NOT be covered by insurance, and the patient will be fully responsible for this fee. Lukas Behavioral Health, may elect to set a lower standard fee in place of this at its sole discretion.
When a No Show occurs, a maximum of 10 days of medication will be provided upon request until another appointment can be rescheduled and only upon full payment of the No-Show fee. No subsequent refills will be authorized until seen. If the patient misses the rescheduled appointment, no further refills will be issued until the patient is seen.
Late Cancellations (cancellations less than 24 hours prior to appointment):
Patient with 3 cancellations less than 24 hours from their scheduled appointment may be discharged from the practice with no more than 3 months of non-controlled medications and no more than 1 month of controlled medications (as long as they are in good standing in accordance with the Controlled Substance Policy); and the patient will be responsible for finding new care.
Patients who cancel their appointment less than 24 hours from their scheduled appointment will be liable for up to a $50.00 late cancellation fee per late cancellation, which is NOT covered by insurance, and the patient will be fully responsible for this fee.
A maximum of 10 days of medication will be provided upon request until another appointment can be rescheduled, and only upon payment of the Late Cancellation Fee. No subsequent refills will be authorized until seen. If the patient misses the rescheduled appointment, no further refills will be issued until the patient is seen.
Appropriate cancellations:
Patients who cancel prior to 24 hours from their scheduled appointment will not be charged for cancellation and rescheduling.
A maximum of 10 days of medication will be provided upon request until another appointment can be rescheduled. No subsequent refills will be authorized until seen. If the patient misses the rescheduled appointment, no further refills will be issued until the patient is seen.
Patients who are on time for their appointment, but unable to stay due to the provider being delayed or late will not be counted as a late cancellation and will be rescheduled with priority, and any necessary refills will be issued.
NOTICE: LBH reserves the right to shift all appointments up to 15 minutes earlier or later than originally scheduled without prior notice. Patients arriving 20 minutes prior to scheduled appointment time will not be counted as late in this circumstance.
Payment Policy
ALL payments, fees, co-pays, co-insurance, deductible, and all other fees are DUE at the time of service and all fees and balances must be paid in full unless arrangements are made prior to receiving care.
Lukas Behavioral Health does not guarantee payment arrangements and such arrangements are at the sole discretion of the Lukas Behavioral Health administration.
Patients are fully responsible for any fees for services that are denied coverage or otherwise not covered by their insurance company.
Failure to provide updated and complete insurance information will result in patient liability at the full cash rate for any services not reimbursed by insurance.
An additional fee of $30.00 will be applied for any declined payments or returned checks in addition to the balance and is the full responsibility of the patient/guardian as this fee is NOT covered by insurance.
Any balances greater than 30 days past due will result in late fees at the current rate set by management.
Any unpaid balances may be sent to collections after a period of 3 months and the patient/guardian will be responsible for any collections, lawyer, and/or court fees incurred in the effort to collect past due balances.
Acceptable forms of payment include: Cash, Check, Credit Card, or Debit Card.
Lukas Behavioral Health does not accept: Money transfers, Bitcoin or other payment forms.
Communication Policy
Lukas Behavioral Health uses many forms of communication platforms to communicate and coordinate for business and patient care purposes.
Lukas Behavioral Health may utilize for the purposes of coordination of care and for business purposes the following: email, fax, telephone, USPS, FEDEX, UPS, automated text messaging.
Lukas Behavioral Health does not recommend the use of email for the purposes of patient contact and care; which includes, but is not limited to: appointment inquiries, medication inquiries, general medical or mental health questions, insurance or billing questions, etc.
Any use of email is at the discretion of the patient and at the patient’s own risk.
Use of social media or other unapproved communication methods to contact Lukas Behavioral Health or its staff in any capacity is strictly prohibited and is grounds for discharge.
Lukas Behavioral Health approves the following modes of communication for patients:
Telephone
Patient Portal
Fax
USPS/FEDEX/UPS
Discharge/Readmission Policy
Patients may be discharged for any of the following reasons:
Nonadherence to recommended treatment plan
Nonadherence/violation of Patient Care Policies
Lack of attendance for greater than 6 months
Patient Request
At the discretion of executive management
Patients who are discharged will be provided with a notice upon discharge and provided with refills of any active medications where appropriate and in accordance with Patient Care Policies. Patients will be provided with a list of local providers upon request.
Patients discharged due to violation of any Patient Policies are not eligible for readmission for at least one year from the date of discharge and only upon review and approval of management.
A request for readmission should be submitted via intake and will be reviewed by management.
Policies Regarding Minor Patients
Minors with active custody orders:
If a custody order is in place for a minor patient, the parent(s) must provide a complete and current copy to Lukas Behavioral Health LLC to have on file, and are required to provide any updated orders promptly.
Parental Access to a minor child’s health information:
Unless specifically ordered by a court, Lukas Behavioral Health LLC cannot and will not refuse to provide information to either parent of the minor child, as a lack of custody does not restrict this information from being shared pursuant to MD Code, Family Law, § 9-104.
Mandatory Child Abuse Reporting:
Lukas Behavioral Health and its providers are considered mandated reports of child abuse. Any report, inidication, or suspicion of child abuse will be reported to child protective services.
Age of Consent - Outpatient Mental Health - Maryland Law
In accordance with Maryland State Law: A minor who is 16 years old or older has the same capacity as an adult to consent to consultation, diagnosis, and treatment of a mental or emotional disorder by a physician, psychologist, or a clinic [Md. Code Ann., Health-Gen. II § 20-104(a)] The capacity of a minor to consent to consultation, diagnosis, and treatment of a mental or emotional disorder by a physician, psychologist, or a clinic does not include the capacity to refuse consultation, diagnosis, or treatment for a mental or emotional disorder for which a parent, guardian, or custodian of the minor has given consent.
CONFIDENTIALITY AND/OR INFORMING OBLIGATION OF THE HEALTH CARE PROVIDER
In accordance with Maryland State Law: Without the consent of or over the express objection of a minor, the health care provider may, but need not, give a parent, guardian, or custodian of the minor or the spouse of the parent information about treatment needed by the minor or provided to the minor [Md. Code Ann., HealthGen. II § 20-102(f)]
Medication Refill Policy
Prescribers of Lukas Behavioral Health make an effort to ensure that enough medications are sent to your pharmacy at each appointment in order to cover your medications needs until your next planned appointment. In the event that a patient will not have enough medication to last until the next scheduled appointment, it is vital to request a refill as soon as possible.
All medication refill requests require a minimum 5-7 business days advance notice to allow time for proper review and processing.
Failure to comply with the above statement may result in missed doses of medications.
Multiple phone calls, messages, or voicemails will NOT expedite the process; in fact such repeat requests often result in delay of processing refill requests due to increased administrative workload.
Refill requests can be requested by the following means:
Leaving a message on the Medication Refill Line
Patient portal message medication request.
Controlled Substances:
Controlled substances are only prescribed a maximum of 30 days at a time. Any subsequent refills without an appointment are at the sole discretion of the prescriber and must be requested 5-7 days prior to running out of medications. It is against the policy of Lukas Behavioral Health to issue prescriptions for any Schedule II medication (Stimulants) for more than a 30 day supply.
Missed appointment refills:
Any request made in connection with a No Show or Late Cancellation will be governed by the terms of the Attendance Policy.
Care Quality Assurance Program
(Complaint Policy)
In order for Lukas Behavioral Health LLC to be able to effectively and fairly investigate patient complaints or concerns, patients must submit all complaints, concerns, or feedback to Quality Assurance at qualitycare@lukasbh.org. Each inquiry will be investigated fully, and in doing so Quality Assurance will reach out to the patient to obtain additional information. Quality Assurance will provide the patient with a Care Quality Assurance Report upon the conclusion of the investigation. Failure to follow the appropriate procedure for complaints or concerns is a violation of Patient Care Policies and may be grounds for discharge. Lukas Behavioral Health LLC is unable to appropriately investigate such matters when complaints are lodged via unofficial means such as Google, Facebook, or other social media means. Furthermore, such comments may place the patient as well as our staff at risk. Any complaints that are recorded via unofficial means will be flagged and the following response will be entered on the respective platform:
“Lukas Behavioral Health LLC is unable to verify the validity of this review or comment due to HIPAA regulations and our Patient Care Policies. Lukas Behavioral Health LLC has a Care Quality Assurance Program in place to handle complaints appropriately. In accordance with our Patient Care Policies we ask our clients to submit the appropriate inquiry with our Care Quality Assurance Program so that we can investigate any legitimate complaints fairly and securely so that resolution can be obtained. Our patients are important to us. We strive to provide high quality, compassionate care while working to ensure security of private information. Such reviews or comments in public forums such as this degrade our ability to provide such care and security. All complaints submitted to your Care Quality Assurance Program are investigated fully in order to align with our standards. For more information, please visit our website at lukasbh.org/CareQuality”
To submit a complaint, report a concern, or provide any feedback please submit the following information in writing to qualitycare@lukasbh.org:
The patient's first and last name
The patient's date of birth
Names of all involved parties including patient family and LBH staff
Date of incident
Approximate time of incident
Detailed description of the incident
Patients should expect to receive a notice of investigation within 5-7 business days. During the investigation, our staff may reach out to the patient as well as any other parties involved. Upon completion of the investigation, our team will compile a final report and provide a summary to the filer of the inquiry which shall include a summary of the complaint, pertinent information obtained within the investigation, and investigation findings, and any corrective actions that resulted from the investigation. Upon receipt of the summary, inquirers will have 30 days to file an appeal. Appeals should be submitted in the same manner as the initial inquiry with a statement of appeal to qualitycare@lukasbh.org Appeals will be reviewed and within 30 days, if it is appropriate, a meeting will be held including all involved parties to further discuss and resolve the situation.
Alternatively, complaints and appeals may also be submitted in writing via the following:
Fax at: (240) 362-7118 ATTN “Care Quality”
Mail to:
Lukas Behavioral Health LLC
ATTN: Care Quality
257 Oakland Dr.
Suite 103,
Oakland, MD 21550