Welcome to our practice. This page explains our professional services, office policies, and the Health Insurance Portability and Accountability Act (HIPAA) , federal law that along with Iowa state law safeguards your privacy rights.  Thank you for reviewing this information.  HIPAA requires that we obtain your signature acknowledging that we have provided you with this information on the first date of service.

Our administrative assistants are Jean Davis, Carol Bartels, and Terri Fitzgerald.  All of us will do our best to provide courteous, caring, and confidential services to you or family members in need.  Considerate and appropriate care is your right, regardless of ethnicity, age, religious beliefs, nationality, or social background. 

PSYCHOLOGICAL SERVICES

This practice has an educational, self-care philosophy; the treatment approach is based on scientific research.  Today and in subsequent visits, we will provide information on potential treatment options or problem-solving strategies.  Typically, we will recommend self-care homework to accelerate positive changes in you or your family member’s psychological adjustment.  We hope that you will commit yourself to self-care.  Of course, it is your right to decide whether or not you agree with the suggested treatment plan or suggested self-care homework and to change or modify recommended problem-solving strategies with our assistance to better meet your health care needs.

In our first visit, we will gather information about you or your child or dependent adult, concerns, and personal or family background.  This is necessary so that we can provide the best possible assistance later.  In some situations, we will suggest psychological testing to provide more precise information about strengths and difficulties.  Together, we will develop a plan to best address you or the patient’s goals and concerns.  With your written consent, we will be able to coordinate services with key physicians and other professionals if you so desire.

In this practice, we endeavor to provide patients with a toolbox of stress-alleviating and problem-solving techniques.  We can’t know which techniques will work and which will fail until we try them, but we do think that a willingness to try new ways of thinking, acting, and feeling accelerates the empowering life changes that most of us desire.

Today or at a later date, we may realize that you might benefit from a referral to someone else who has expertise we lack or who could see you more frequently than our busy practice allows.  Do not hesitate to ask for referrals to other health care providers for any reason!

CONTACTING Drs. McCormick, Haymaker, and Davis-Gage

Should an urgent situation arise, we will do our best to provide you with an appointment here or with an alternative health care provider if necessary as soon as possible.  We make every effort possible to return phone calls from patients promptly, answering your questions or concerns to the best of our ability.  Since we are not medical doctors, we cannot answer questions about medications or medical treatment.  Please share these concerns with your physician.  Also, we recommend that patients and families immediately go to the Emergency Room of their preferred hospital in case of a serious or potentially life-threatening medical or mental health emergency.  After hours telephone numbers (psychologists’ or mental health counselors' cell-phone numbers) are available on our practice voice mail. Please call if urgent matters develop outside of business hours.  Of course, we can only assist you for limited periods of time on the telephone.  Substantive concerns are better addressed during office visits.

 When the office is on vacation or one of us is away on business, a pre-recorded message on our business telephone (319/226-5301) will provide the names and telephone numbers of the on-call psychologist or mental health counselor as well as the availability of Emergency Room Services.

Office Policies

Psychologists and mental health counselors see only one patient or family at a time, and there is often a waiting list for our services.  Overhead expenses must be covered regardless of whether or not patients appear for scheduled visits.  For these reasons, patients are expected to pay a fee for missed appointments that had not been cancelled with office staff 24 hours in advance.  You will need to pay this fee before we can schedule you again for additional appointments.  The only exception to this policy is when we both agree that there had been emergency circumstances beyond your control responsible for the cancelled visit.  Generally, individuals who fail to show up for two scheduled visits without providing 24-hour notice are informed that we will be unable to provide additional services.

PROFESSIONAL FEES

Self-pay patients are expected to pay in full for services at each visit.  Patients whose care is covered by health insurance are responsible for preauthorizing the initial visit, if necessary, with Managed Care and paying the deductible and co-pay expenses either at the time of your visit or within two weeks of billing.  For some individuals, there may be additional fees for special administrative services (such as when you want your psychologist or mental health counselor to consult with your attorney).  We will do our utmost to notify you of professional fees on a timely basis and suggest payment plans that help you avoid excessive debt. 

LIMITS ON CONFIDENTIALITY

The law protects the privacy of all communications between a patient and a psychologist. In most situations, we can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements.  However, in the following situations, no authorization is required:

• Your psychologist or mental health counselor may occasionally find it helpful to consult with another health or mental health professional to  provide better psychological services.  During consultation, we make every effort to avoid revealing the identity of our patients. The other professionals are also legally bound to keep the information confidential.  Guidance from professional colleagues improves our skills in helping people while safeguarding privacy.
• Our three assistants, Jean Davis, Carol Bartels, and Terri Fitzgerald, have access to patient records for administrative reasons.  All of us have signed an oath to safeguard your confidentiality rights.  We are all committed to protecting your privacy.

There are three circumstances in which the law requires your psychologist or mental health counselor to share confidential information, even without patient or guardian consent.  Psychological records or the testimony of a psychologist and mental health counselor can be: (1) court-ordered or (2) mandated by state or federal law to protect human health and safety without written consent.  (3) If your visit is related to a workplace, motor vehicle, or other accident, we have a legal obligation to provide information about diagnosis and services to the relevant insurance carrier.

You will want to sign a Release of Administrative and Diagnostic Information form if you want our services to be partially or fully paid by your health insurance plan.  Since treatment works best when there is teamwork, we will ask if you are willing to consent in writing to sign a Release of Confidential Information to the referring physician and/ or other provider(s) of your choice.  This decision is entirely up to you.

CLINICAL RECORDS

We almost always share pertinent information with patients or alternatively, their guardians about assessment of strengths and difficulties, psychological test findings, consultations, and treatment options during office visits, providing written handouts as needed.  We will always take your opinions seriously and will record your comments about our work in your psychological record.  Protected clinical information is safeguarded in your clinical record.  With the exception of unusual circumstances, adults have the legal right to examine and/ or receive a copy of information in their clinical record, providing that they request this in writing.  Untrained readers can misinterpret technical information in mental health records.  Therefore, we recommend that you initially review your clinical record in our presence during a follow-up psychotherapy visit, or sign a release enabling us to forward this information to another mental health professional with whom you can discuss the contents. There is a nominal cost, payable in advance and not covered by insurance, for photocopying, postage, and staff time in handling records.  We will ask you to pay this fee when you provide us with a signed, written request for this information.  Special HIPAA-compliant forms are available at this office to enable you to request a review of your protected mental health record.

PATIENT RIGHTS

HIPAA provides you with several new or expanded rights with regard to your clinical record and disclosures of protected health information. These rights include requesting that we amend your record and requesting an accounting of most disclosures of protected health information.  Another right is that patients’ complaints about our policies and procedures are to be recorded in their records.

Children and Dependent Adults: Patients under 18 years of age who are not emancipated from their parents and dependent adults should be aware that the law may allow parents or family caretakers with power of attorney to examine an individual’s treatment records. Because privacy in psychotherapy is often crucial to successful progress, it is sometimes our policy to request an agreement that parents or guardians consent to give up their access to their dependent’s records. Of course, we will update you on your child’s or dependent adult’s progress and look forward to your guidance in treatment planning.  The exception to this policy is the rare situation in which we feel that an individual is in danger or is a danger to someone else, in which case, we will notify parents or caretakers of our concern immediately. Before giving family caretakers any information, we will discuss the matter with our patients, if possible, and do our best to handle any objections that they may have. 

BILLING AND PAYMENTS

You will be expected to pay for each session at the time it is held, unless we agree otherwise or unless you have insurance coverage that requires another arrangement. Payment schedules for other professional services will be agreed to when they are requested. [In circumstances of appropriately documented, unusual financial hardship, we may be willing to negotiate a fee adjustment or payment installment plan.]  Co-payments for those covered by insurance are due on the day of your appointment.

If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, we have the option of using legal means to secure the payment. This may involve employing an attorney who assists us in collections or going through small claims court which will require us to disclose otherwise confidential information. In most collection situations, the only information we release regarding a patient’s treatment is his/her name, the nature of services provided, and the amount due. 

INSURANCE REIMBURSEMENT

Please understand that your contract with your health insurance company requires that you authorize us to provide information relevant to the services that we provide. If you are seeking reimbursement for services under your health insurance policy, you will be required to sign an authorization form that allows us to provide such information. We are required to provide a clinical diagnosis and procedure (treatment) code. Sometimes, we will be requested to provide additional clinical information such as treatment plans or summaries.  Occasionally, insurance examiners request copies of complete progress notes describing our work with patients to determine if our services were medically necessary.  (If you refuse such authorization, the insurance company can deny your claims and you will be responsible for paying for services yourself).  In such situations, we will make every effort to release only the minimum information about you that is necessary for the purpose requested.  All insurance companies claim to keep such information confidential.  However, we have no control over what they do with it once it is in their hands.

Once we have all of the information about your insurance coverage, we will discuss what we can expect to accomplish with the benefits that are available and what will happen if they run out before you feel ready to end your sessions. It is important to remember that you always have the right to pay for our services yourself to avoid the problems described above [unless prohibited by contract].

QUESTIONS AND COMPLAINTS

Please contact Dr. Naomi McCormick, the CEO, your psychologist, or our staff if you want more information about our privacy practices and have questions or concerns.  You are also free to submit a written complaint to the U.S. Department of Health and Human Services.  We support your right to the privacy of your health information.