Polices and Procedures

Candida Fink MD

12 Parcot Ave   New Rochelle NY 10801

Phone 877-534-1090  Fax 855-223-5458

www.finkshrink.com

 Treatment Agreement  

This form contains important information about my practice and how it works. We will review this form, along with the “Notice of Privacy Practices” at our first visit and I will ask you to sign this form to indicate that we have done this.  You can have a printed copy of both forms, or you can access them at any time at my website

Office Policies and Procedures

 Scheduling and Appointments

Most appointments are now held virtually, over Zoom.  That is the default for scheduling.

In-person appointments can be arranged at patient or doctor request.  Please ask Carol or Dr. Fink to arrange.

  • Initial appointments are scheduled through the office with my assistant Carol
  • Follow ups may be scheduled through Carol or with me in the office.
  • All patients receiving prescriptions must be seen regularly– even when stable.
  • After school/work appointments are scarce; please book in advance

Prescriptions

  • Due to state regulations, requests for controlled substance prescriptions take two business days to process  i.e. a Thursday request may not be filled before the following Monday. 
  • Other prescription refills require at least one business day to process but please try to notify the office as soon as you can, to prevent delays.
  • If a medication requires a prior authorization please contact Carol with the insurance information to assist with this process

Phone Calls

  • I make every effort to return routine calls by the next business day but this is not always possible.
  • For after-hours urgent matters only call: 914-819-2854.
  • For all concerns, including urgent ones, Monday to Friday 9 AM to 5 PM please call the office for assistance.
  • Please note:If there is a medical or psychiatric emergency, such as aggression or self -harm,  first call 911
  • If you or your child are in crisis, consider calling or texting 988 – the suicide crisis hotline.

EMAIL

  • Email is not for urgent or emergent concerns.  Please use the phone, as outlined above. to reach us for urgent or emergency concerns
  • Every effort is made to return email within two business days
  • Every effort has been made to keep email communications confidential, but this cannot be fully guaranteed due to the electronic nature of the communication. 

KLARA

  • Klara is our HIPPA secure text messaging system.  It can be used via your text messages and/or on the Klara App
  • Klara is a great way to communicate with us but it is not for after hours urgent matters or emergencies. ‘
  • Klara can be used for any type of communication or requests including prescriptions and scheduling

PATIENT PORTAL

  • Please speak to the office about setting up a patient portal that connects you to our practice
  • The portal allows you to request prescriptions, schedule appointments, or communicate about other matters
  • Through the portal you can also access your account and download and print receipts.

 

FINANCIAL POLICIES

HEALTH CARE PLAN PARTICIPATION STATUS

I am not a participating physician in any health insurance plans. A written statement of fees for non-emergency services is available upon request.

Because I am not a participating physician in your health insurance plan, you should check with your insurance company to determine what out of network coverage you be be eligible for

You are responsible for payment of the full fees regardless of what reimbursement you may or may not receive from your insurance company.

Payments

Payment is made at time of service. Our policy is to keep your credit card stored securely in our system.  If you require an alternative payment process please call the office to discuss your options.

 Cancellations and Missed Appointments

The office requires at least 24 hour advance notice if you are not able to attend your appointment.  If it is less than 24 hours notice there will be a fee applied.  Appointments missed without notification are billed for the full appointment.

Phone Calls

Short phone calls are not billed.  If a call requires more than 5 minutes we will ask you to schedule a phone visit which will be billed at the hourly rate.  Note that many insurance companies do not reimburse phone visits

 Unpaid Bills

We anticipate that payments will be kept up to date. If you are having difficulty making payments, please call Carol to discuss to that we can make arrangements.  Balances outstanding for more than 180 days may result in termination of clinical services.  

I hereby acknowledge that I have been given a copy of or access to this Treatment Agreement and the Notice of Privacy Practices

I hereby give consent for Dr. Fink to treat myself/my child.

Patient Name and DOB:_________________________________

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Patient or Patient Representative Name (Printed) and Relationship to Patient

 

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Patient or Patient Representative Signature and Date Signed

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