Last updated 02/2020
At Foresight, we strive to prescribe medications safely and effectively. Our clinicians follow practice guidelines developed to provide consistency as well as room for clinical judgment.
Member Safety Statement
Foresight aims to promote an environment of safety and wellness for all of its members. As a part of completing a comprehensive assessment, you will be asked about past and current thoughts or behaviors associated with suicidal ideation. If at any point there are concerns for your imminent welfare, we will work with you to ensure your safety. These steps may include reaching out to a trusted person in your life to provide support to you, making a safety plan with you, or contacting emergency medical services to obtain appropriate care for you during the time of crisis. If you are in imminent danger of harming yourself, please call 911 or the National Suicide Prevention Lifeline at 1(800) 273-8255. Suicide is not an inevitability, and our team at Foresight values your safety and wellbeing above all else.
Missed Appointment Policy
As soon as you schedule your appointment when leaving our office, you are confirming your appointment time. We are holding this time and day ion our provider’s schedule. By not showing up, you waste providers’ valuable time that could be spent helping other members who are in need.
We send reminder texts and emails purely as a courtesy to our members; it is still your responsibility to make the appointment. If you cannot make the visit, you have to let us know with at least 24 hours notice.
We hope you understand that we are not able to make excuses for this policy, as that would be unfair to other members who have paid missed appointments or late cancellation fees.
Should you need to cancel an appointment with a therapy or psychiatry provider, it is your responsibility to cancel within 1 business day to avoid a late cancellation fee.
Cancellations made with less than 1 business day notice incur a late cancellation fee. The same rate applies to not showing up for a scheduled appointment.
Therapist: 50 minute session = $75
Psychiatrist/ Nurse Practitioner:
15/20 minute session = $75
30 minute session = $100
45 minute session = $135
To accommodate emergency situations, your provider has the ability to negotiate this fee. Please bring it up at your next scheduled appointment.
HIPAA Compliance Guidelines
At Foresight, honoring the confidentiality of your medical records is one of our highest priorities. HIPAA, the Health Insurance Portability and Accountability Act, is a law designed to protect your private health information (PHI). HIPAA protects written, spoken, or electronic data as well as transmission of data within and outside of a healthcare facility (e.g. communication with an insurance provider). To that end, it is important for you to understand key processes in place at Foresight to ensure HIPAA compliance.
Foresight utilizes HIPAA compliant platforms for storage and communication regarding PHI. When PHI is communicated outside of HIPAA compliant platforms (e.g. an email correspondence outside of Foresight’s gmail account), your PHI is de-identified (e.g. your name, address, contact information, social security number, and any other identifiers are removed from correspondence).
Foresight prioritizes safeguarding your PHI by using password protected platforms, limiting access to workstations or covering computers with privacy screens, and securely storing or destroying printed PHI.
Foresight’s portal is HIPAA compliant, and for that reason, it is best to electronically communicate with your providers through the portal. If you email your provider, it is likely that your provider will respond to your inquiry via the portal messaging system if it contains PHI
Under HIPAA, clients should be given a written copy of the”HIPAA: Notice of Privacy Practices” form at the outset of treatment, and clients verify it’s receipt by signing a form. A visible copy of the NPP should be available in every care provider’s office.
If you feel that private health information has been compromised or mishandled at Foresight, you can report violations here.
For any number of reasons, meeting with your provider in person may not be possible. Perhaps you are out of town visiting family, aren’t feeling well enough to get to Foresight’s office, or need to check in with your therapist in between your regularly scheduled sessions. Foresight is able to offer telehealth sessions for those times that you are not able to come to Foresight’s office. Foresight offers telehealth through a HIPAA compliant platform called Doxy.me. You are able to engage in audio and/or video therapy sessions through Doxy.me. There are a few important things to be aware of prior to pursuing a telehealth session:
Depending on the concerns you are addressing in counseling, telehealth may not be the most appropriate option for you. Talk to your provider about whether telehealth may be a good fit for you and your needs.
Not all insurance companies reimburse for telehealth sessions. Please contact your insurance provider to ask whether they cover telehealth sessions. You will be responsible for costs not covered by your insurance.
Though confidentiality remains paramount in telehealth sessions, engaging in telehealth can pose potential risks to confidentiality. For example, it is important for you to evaluate the privacy of the setting you will be in when engaging in the telehealth session.
If you anticipate wanting a telehealth session in the future, we recommend speaking to your therapist and insurance provider early on so that planning for your first telehealth session is seamless.
When you schedule a session it will be assumed to be face to face unless you specify otherwise.
As safety of our members is paramount at Foresight, a part of comprehensive assessment will include providers asking members about past or current intents or behaviors aimed at harming others. If a member presents with the intent of harming someone, Foresight providers will take steps to ensure the safety of our members and the community. These steps may entail safety planning with your provider, warning potential victim(s), or contacting the police.
Mental health treatment can come to a close for a number of reasons. In most cases, both you and your provider will determine that treatment is no longer needed. However, there are other circumstances where you or your provider will initiate the end (termination) of treatment. The most common reasons for termination are listed below:
Collective termination: When you begin working with your provider, you will collectively create goals and expectations that you would like to work towards throughout your treatment. Once those goals are met, you and your provider may reevaluate the course of treatment, or you both may determine that treatment is no longer needed.
Member-initiated termination: You may feel that you need a transition in your treatment due to a lack of progress towards your treatment goals, incompatibility with your provider, or simply needing a break from treatment. If you are feeling that you need a transition in your care or would like to end treatment, speak to your provider about your thoughts and they will help to address your concerns and change the course of treatment, or help to make your transition out of treatment as smooth as possible.
Provider-initiated termination: Your provider may observe that treatment is not benefiting you. This could be due to a lack of provider competencies in your areas of concern, an incompatible working relationship, or additional reasons that hinder your provider from providing the treatment that you need. In this event, your provider will explain the need for a transition in your care, and will equip you with referrals for support that may better suit your needs.
Terminating treatment can mark a positive shift in your growth, but it can also present emotional and logistical hardships. Foresight providers aim to create an environment where you can address these difficulties in your appointments, as well as gain knowledge and resources that will support you as you move forward in your life.
At Foresight we strive to prescribe medications safely and effectively. Our clinicians follow practice guidelines developed to provide consistency as well as room for clinical judgment.
It is best for all involved to prescribe your medications at the time of visit when possible. The frequency of visits will be determined between you and your clinician based mainly on:
Acuity of your situation
Types of symptoms you have
Type of medication being prescribed
Availability of additional supports such as family or therapist
Medications will only be prescribed after a face-to-face evaluation, but your prescriber may agree to a combination of on-line and face-to-face follow up visits. If you are being prescribed a controlled medication, more frequent face-to-face meetings will be required. Your clinician may place conditions on prescribing, such as a requirement of being in psychotherapy, for a set frequency of visits, or to speak with other providers first (only with your written consent).
If you are prescribed medications at the first visit, it will usually be a 1-month supply, occasionally with 1 refill. Our prescriptions may be limited by your insurance company, for example it is not uncommon for them to limit you to 30 pills when we are trying to titrate your medication 1 per day, 2 per day, 3 per day; the pills won’t last the month. They may also limit your prescriptions to 1 month at a time when we would not. Be aware that you usually have options to self-pay for medication.
If visits, labs, and reports are up to date, and you are clinically stable, we may prescribe up to 90 days without an office visit. After that we will require a visit in order to continue your prescriptions. The visit can be telemedicine, which your insurance may or may not cover. If the 3-month visit is telemedicine, a face-to-face visit at 6 months would be required in order to continue. Our clinicians have some flexibility, but not much beyond 6 months without in-office session. If you are so stable that you don’t need minimum visits at this level, please consider asking your primary care MD to prescribe your medications. Sometimes a consultation at Foresight can aid in this decision.
Please request refills 3-5 days before they are due. An additional fee may be charged for emergency requests.
The State of California requires clinicians to check a state databank (“CURES”) before prescribing controlled substances such as benzodiazepines (i.e. Xanax, Ativan, Klonopin), some sleeping meds (i.e. Ambien), and stimulants (i.e. Adderall, Ritalin, Vyvanse). Foresight does not prescribe opiates or treat pain. However, inform our clinicians if you have pain issues as many of the medications we use in psychiatry can help pain.
If you have recently been prescribed a controlled medication from another provider, or from an emergency room, our clinician may not prescribe the medication without additional information, such as a discussion with the other provider who is prescribing (with your written consent only).
We see many patients previously diagnosed with Attention-Deficit Disorder (with or without hyperactivity). Some have had actual testing for it, others none. Many people who have been tested only had screening tests. While we do not require all the formal testing prior to initiating treatment, we do require thorough neuropsychological testing for adults 18 and over in order to continue medications beyond 3 months. You may be placed on “Provisional Diagnosis” until all testing is received. While on provisional status, prescriptions will be limited to 30 days each time. Our staff will try to assist you in finding a Neuropsychologist who can do the proper testing, but you will likely want to go through your insurance panel to find the clinician, and there may be hurdles to deal with.
Prescribing controlled substances can be much more time-consuming for the clinician, as they have to check the CURES and they are not refillable. It is simplest for all to keep up with routine visits and take care of refills then. While we do not charge for common refills between visits, if controlled medications have to be filled between visits there may be an additional charge. This additional fee may not be paid by your insurance.
If you have any other questions please ask the office staff or your clinician.