Apple Tree Medicine, PLLC

Policies

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Tolerance Policy

Apple Tree Medicine is to be a safe space for all. Physical, verbal, and sexual harassment or abuse of any person on Apple Tree Medicine property or person associated with Apple Tree Medicine will not be tolerated and may result in dismissal from the practice.

Such unacceptable incidents include but are not limited to behavior or language of a violent or threatening nature, and discriminatory or hateful language regarding a person's race, religion, appearance, age, sex, gender identity, sexual orientation, disability, origin, or status. Remarks of a romantic or sexual nature directed at Apple Tree Medicine staff are also prohibited and may result in dismissal from the practice.

Should you have anyone accompany you to Apple Tree Medicine, that person is to abide by the tolerance policy too. You will be held responsible for any family member, friend, or trusted individual who violates the policy while on Apple Tree Medicine property as your guest, as well as in communication with or in person with staff or other patients elsewhere as a result of their involvement with you.

Should any of the above offenses occur, please inform Dr. Weeks as soon as possible.


Vaccination Policy

Vaccines are one of the most heavily studied subjects and are constantly under evaluation, which is why the CDC publishes new guidelines every year in order to stay on top of the most current knowledge. These vaccines help protect people from diseases that can cause death and disability. If a patient refuses to be vaccinated, they not only endanger themselves but they also endanger those around them, particularly the young, the elderly, and those with medical conditions that render such individuals unable to be vaccinated. All staff at Apple Tree Medicine maintain their immunization status per CDC guidelines for your protection as well as their own.

In order to help protect our patients from diseases that other patients may have, we require all children follow the CDC guidelines and we strongly recommend all adults be up to date on their immunizations as well. If you or your child have missed shots and are behind on immunization, we will help you get caught up per the CDC's guidelines.

The CDC guidelines include stipulations against vaccination in certain medical situations. If it would be unsafe for you or your child to receive a vaccine due to such a medical condition then Dr. Weeks would absoluetly recommend AGAINST getting that vaccine as per the guidelines.

If the guardian of a minor refuses to have the minor vaccinated in accordance with CDC guidelines then the minor will be dismissed from the practice. This is not only to protect other patients, but the physician-patient relationship is based on trust. You cannot have that relationship if Dr. Weeks recommends vaccination but you think she is trying to hurt or endanger your child. If this is your position then you should seek care for your child elsewhere.


Minors Policy

People of all ages are treated at Apple Tree Medicine. Should the patient be less than 18 years old and not legally emancipated then they are considered a minor and will need to be accompanied by a legal guardian to the office. The guardian must remain at the office while the minor is there.

Should a legal guardian wish for the minor to be seen without them, then the guardian must call the office beforehand to give verbal permission for Apple Tree Medicine staff to see and treat the minor as they see fit and the minor will need to deliver a note to that effect from the guardian to Apple Tree Medicine's staff when the minor checks in for their appointment. This procedure will need to be repeated each time the minor is unaccompanied.

If the guardian wishes for a non-guardian adult to accompany the minor and act as the decision-maker regarding examination and treatment then the phone call and written permission note must indicate such and name the approved adult. This procedure will need to be repeated for each visit during which a non-guardian is to serve in this capacity.

Per law, the exception to these rules is when a minor seeks sexual and/or reproductive healthcare, including but not limited to testing for or treatment of sexually transmitted infections, pregnancy, and contraception. In such cases they do not require their legal guardian's presence or permission and may request the guardian remain uninformed of their visit, testing, and treatment.


Appointment Policy

At Apple Tree Medicine, we understand that sometimes life happens and you may not be able to make it to an appointment as scheduled. Appointments are how we reserve time for specific patients and if a patient is not able to make it, but does not cancel or reschedule in a timely manner, this prevents other patients from being able to see the physician. If a patient is late and the physician sees them anyway, this can result in the physician being late to see every subsequent patient that day. We value each patient's time so the following policies have been created in an attempt to balance these factors.

  • If a patient will not be able to make it to an appointment, they are to call the office as soon as possible in order to cancel or reschedule. If a patient cancels or reschedules an appointment at least one business day prior to their scheduled appointment start time, there will be no penalty.
    • Example 1: Appointment is scheduled for Wednesday at 2 PM. Patient calls no later than Tuesday at 1:59 PM and reschedules their appointment for a later date.
    • Example 2: Appointment is scheduled for Monday at 4 PM. Patient calls no later than Friday at 3:59 PM and cancels their Monday appointment.
    • Example 3: Appointment is scheduled for Wednesday at 9 AM which is when the office opens. Patient must call before the office closes on Monday to change their appointment.
    • Example 4: The office is closed Monday for a holiday. Appointment is scheduled for Tuesday at 11AM. Patient must call no later than Friday 10:59 AM to change their appointment.
  • If there is less than one business day remaining before the scheduled appointment and a patient calls to cancel or reschedule, this will be considered a "last minute change".
  • If a patient is late for their scheduled appointment time by 10 or more minutes, the patient may be required to reschedule their appointment. If the physician deems it necessary to reschedule when a patient is late, this will count as a "last minute change". 
  • If five "last minute changes" occur within 365 days, a written warning will be sent to the patient by mail. Any additional "last minute changes" within that year's time frame will result in the patient being dismissed from the practice.
  • If a patient does not come for their scheduled appointment, and has not cancelled or rescheduled prior to their appointment start time, this is considered a "no show". If a patient is 10 or more minutes late and is asked to reschedule but the patient chooses not to, this also counts as a "no show".
  • The patient will be charged a fee of $25 for each "no show" as they will have prevented the practice from being able to make that appointment time available to other patients. The patient will be expected to pay this fee prior to the beginning of their next visit.
  • If a patient has two "no shows" within 365 days, a written warning will be sent to them by mail. If a third "no show" occurs within that year's time frame, the patient will be dismissed from the practice.
  • If the office closes due to inclement weather, physician illness, or physician family emergency, we will call the phone number you provided in order to inform you and offer to reschedule. This will be done prior to your appointment time and will not count against you as a "last minute change" or "no show".

Billing Policy

  • We do not accept or participate with any health insurance companies. This means that if you have insurance, we do not bill them and instead you pay us directly.
  • Payment is due in full at time of service. We do not send out bills or invoices after your visit.
  • We accept cash, Visa, Mastercard, American Express, and Discover credit/debit cards. We do not accept checks or prepaid cards.
  • All visits with the physician cost a flat fee of $85. Some procedures result in additional fees which are posted in the waiting room and here.
  • If you have insurance that is NOT Medicare or Medicaid, at your request we will provide you with a "super-bill". This is a document that contains the codes for the services provided and you can submit this to your insurance company to see if they will reimburse you for what you have paid us.
  • Please allow 1-3 business days for us to create the super-bill and let us know if you would prefer to pick it up or have it mailed to you. Note: Per government regulations, super-bills must not be submitted to Medicare/Medicaid because we do not participate with them.
    • Dr. Weeks has enrolled with Medicare and Medicaid to the degree that she may order, refer, and prescribe for patients with Medicare/Medicaid but she has submitted an affidavit to otherwise "opt-out" of the Medicare/Medicaid programs. This means that by law Dr. Weeks cannot bill Medicare/Medicaid for the services performed at Apple Tree Medicine and patients cannot receive reimbursement for these services from Medicare or Medicaid.

Refills Policy

It is your responsibility to take your medication, to monitor if you have refills left, and to have follow up appointments in order to receive additional refills.

If you are on a long-term medication regimen for a chronic condition and you notice that you don't have any refills left, it means it's time to schedule an appointment to reassess the condition that the medication treats. We do not want you to run out of medication before your follow up appointment and if the lack of refills came as a surprise then we can send in a one-time two-week refill to bridge you until your follow up appointment. Be forewarned, many times the pharmacy will charge a full month's price for just the two-week refill.

If you are unsure if you are supposed to continue to take a medication after your current amount is finished, please call us and ask.


Electronic Contact Policy

  • We will NOT respond to attempts to contact us by means other than phone, fax, mail, or at the office.
  • Do not attempt to use SMS (mobile phone text messaging) as the office phones are not equipped to receive such messages.
  • Dr. Weeks does not accept friend or contact requests from current or former patients on any social networking site (Facebook, LinkedIn, etc.). Doing so would compromise privacy and blur the boundary of the physician-patient relationship.
  • In order to protect the security of your private information we do not email or Facebook message/comment. Even if you don't care about such security, any such messages will NOT result in a response from Apple Tree Medicine staff though they may become a part of your legal medical record.
  • To protect your privacy, Apple Tree Medicine has not been registered as a "check-in" location on websites such as Foursquare, etc. If you use location-based services on your mobile phone, such as GPS tracking, you may wish to be aware of the privacy issues related to using such services.
  • It is possible to "Like" the Apple Tree Medicine Facebook page and its posts. Please be aware of the privacy issues related to doing so.

HIPAA Privacy Practices Notice

Your Information. Your Rights. Our Responsibilities. 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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say "no" to your request, but we'll tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say "yes" to all reasonable requests.

Ask us to limit what we use or share

  • You can ask not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless a law requires us to share that information.

Get a list of those with whom we've shared information

  • You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time. We will provide you with a paper copy promptly.

Choose someone to act for you.

  • If you have given someone medical power of attorrney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us using the contact information at the bottom of this web page.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.
 

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In the following cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Most sharing of psychotherapy notes

Note: we do not create or manage a hospital directory and we will never sell your personal information or contact you for fundraising efforts.

 

Our Uses and Disclosures

We typically use or share your health information in the following ways.

Treat you

  • We can use your health information and share it with other professionals who are treating you.
  • Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

  • We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  • Example: We use health information about you to manage your treatment and services.

Bill for your services

  • We can use and share your health information to bill and get payment from health plans or other entities.
  • Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information? We are allowed or required to share your information in other ways - usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Help with public health and safety issues. We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone's health or safety

Do research

  • We can use or share your information for health research.

Comply with the law

  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.

Respond to organ and tissue donation requests

  • We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers' compensation, law enforcement, and other government requests. We can use or share health information about you:

  • For workers' compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.
 

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
  • For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
  • We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.
  • Effective 9/1/2017 Privacy officer Dr. E.L. Weeks (757) 378-3952

Mandated Reporting

The staff at Apple Tree Medicine are designated as "mandated reporters" by law. This means that if there is reason to suspect abuse or neglect of a minor, an elderly individual, or an incapacitated individual then the staff must promptly report the matter to the Virginia Department of Welfare or Social Services.

By law, Apple Tree Medicine staff must also break confidentiality if there is a specific serious threat of bodily injury or death to someone. This may result in warning potential victims, notifying a law enforcement officer, or seeking your hospitalization. This also includes many illnesses and infections which we are required to report to Virginia's Department of Health. More information on this can be found at: http://www.vdh.virginia.gov/surveillance-and-investigation/commonwealth-of-virginiastate-board-of-health/