Member Terms and Conditions
Last updated: December 15, 2022
We're so glad you're here. We’re pleased you have chosen Foresight Mental Health, PLLC and its affiliates (“Foresight Mental Health”, “we”, “us”, or “our”) for your mental health needs and excited to have the opportunity to support you on your path to well-being.
Mental Health Services and Foresight Professionals
Foresight Mental Health provides healthcare services in-person and/or using telehealth technologies, such as interactive audio, video, and/or messaging technologies, through the Foresight Health Apps including therapy, psychiatry, and nutrition services. By receiving mental health care from Foresight Mental Health, whether in-person or via Foresight Mental Health’s third-party mobile and web applications (the “Foresight Health Apps”) or any of the products and services that link to this page (the “Services”), you agree to comply with the terms and conditions set forth below, you certify that if you are using the Services as a parent, legal guardian, or legal representative of a minor child, you have the legal authority to do so.
As part of providing you these services, Foresight Professionals may order labs, imaging and other diagnostic tests conducted at locations outside Foresight Mental Health such as at clinical laboratories and testing centers, which may result in additional cost to you or your health plan. Foresight Professionals may also rely on information you share or records you provide from your other healthcare providers.
Our engaged healthcare professionals (the “Foresight Professionals”) include skilled and experienced Psychiatrists, Psychologists, Licensed Professional Counselors, Licensed Clinical Social Workers, Marriage and Family Therapists, Psychiatric Mental Health Nurse Practitioners, Nutritionists/Dietitians, and equivalent licensed professionals. Your Foresight Professional’s credentials will be made available to you before scheduling an appointment. If you have any questions about these credentials, please direct them to your Foresight Professional.
You will have an opportunity to develop ongoing care relationships with the Foresight Professionals, however, your initial encounter may begin as a consultation (to determine the most appropriate treatment setting for you to receive care) and will not necessarily give rise to an ongoing treatment relationship. For example, a Foresight Professional may determine that our clinical services are not appropriate for some, or all of your treatment needs and may elect not to provide certain clinical services to you.
Use of Foresight Health Apps
When you become a patient of Foresight Mental Health (a “Member”), you can use our Foresight Health Apps, which is accessible from your smartphone, desktop, or tablet computer that connects you to the Foresight Professionals and support team. Through the Foresight Health Apps, we provide personalized content and interactive resources for you, the ability to message Foresight Professionals , to serve as your hub of information, and your connection to our support team.
No Shows and Cancellations
Unless otherwise prohibited by a Member’s insurance plan, a late fee will apply when a Member does not show within 10 minutes of the scheduled appointment time or does not cancel at least two (2) business days prior to their appointment time, unless due to unforeseeable events to be determined by the Foresight Professional. Members who cancel and/or no-show for their scheduled appointment times may be terminated from receiving care with Foresight Mental Health and referred to an external mental health provider.
Late Cancellation & No Show Fee: Therapy = $150.00; Nutrition = $150.00; Psychiatry = $150.00
If you and your Foresight Professional decide to engage in group, family, or couples therapy (collectively “Group Therapy”), you understand that information discussed in Group Therapy is for therapeutic purposes and is not intended for use in any legal proceedings involving Group Therapy participants. You agree not to subpoena the Foresight Professional to testify for or against other Group Therapy participants or provide records in court actions against other Group Therapy participants. You agree to share responsibility with the Foresight Professional for the therapy process, including goal setting and termination.
Notice of Privacy Practices
You can find more information about your rights to your health information and about how Foresight Mental Health uses your information in Foresight Mental Health’s Notice of Privacy Practices.
For any uses and disclosures of my Protected Health Information outside of treatment, payment, or operations, Foresight Mental Health will need my permission and the completion of an Authorization to Obtain or Disclose my Protected Health Information.
You understand that if your health insurance coverage does not pay the charges for your services in full, you will be fully or partially responsible for payment. If you have to pay a deductible, copayment or coinsurance for your healthcare, the usual cost-sharing rules will apply. If you request, we will work with you to determine what your charges will be.
Members will be able to pay applicable fees via the Foresight Health Apps using a credit or debit card. If there is a fee associated with your appointment, you are required to keep a valid credit or debit card on file. By providing us with your card information, you understand that you are authorizing us to charge your card for agreed upon services and save your card information for future transactions on your account.
Requests for FMLA, Disability (STD/LTD), or Other Related Forms
If your Foresight Professional approves a leave and you need paperwork completed, you will need to request and complete our Provider & Patient Agreement on Filling out FMLA, Disability (STD/LTD), or Other Related Documentation. The minimum fee for filling out each paperwork/form will range from $50 to $100. The total cost will depend on the amount of time required by your Foresight Professional to complete the paperwork.
Updates to These Terms and Conditions
These terms and conditions, as well as any documents or policies referenced above, may be updated occasionally. We will notify you of any updates by posting the revised version on our website at https://www.foresightmentalhealth.com/.
If you have questions, please submit a message in a Foresight Health App. If you are not a registered Member, please call us at (888) 588-8995.