Alternative Living Solutions of North Carolina
1923 J.N. Pease Place
Suite 201
Charlotte, NC 28262
United States
ph: (704) 612-0566
fax: (704) 498-4846
alt: (888) 617-3868
info
OFFICE POLICIES
Co-payments and Insurance Cards
At every office visit, be prepared to show your current insurance card and make a co-payment if your plan requires so. If your child is sent with a childcare provider, please make sure that that person is prepared to make the co-payment and show a photo I. D.
Form Completion
Services provided outside of regular medication follow-up or psychotherapy visits may be charged at an additional rate. In general, additional fees are based on the amount of time a clinician needs to spend on your request. Your insurance pays for your medical and therapeutic treatment. For example, it does not cover time spent interfacing with school personnel, drafting letters, or completing medical leave or disability claim forms. At the discretion of your practitioner you may be billed for these services and will be informed in advance of these charges. You have the right to rescind your request for these services if you so choose. Please note that medical leave and/or disability claim forms are only completed for clients that are well-known to this practice/provider. Keep in mind that diagnosis of a mental illness is not necessarily equivalent to disability or functional impairment. An individual who has major depressive disorder is not legally disabled if he or she can engage in “substantive gainful activity.” Substantive gainful activity refers to a level of activity that SSA uses to establish disability. As a rule of thumb, a disabled individual should not be able to participate actively in the national economy.
There is a $15 per page (in advance) charge for all forms or drafted letters that need to be completed by the provider. During your form completion or letter drafting, the provider is not able to engage in direct care. The time spent can range from 10-60 minutes and is not billable to your insurance, therefore this expense is the responsibility of the client and/or their responsible party. Due to the high volume of forms we receive, please allow us 5-7 business days to return forms back to you. If there is a need for the form sooner, there is an additional $10 “rush” surcharge. Please read all forms before submitting them to us. We cannot falsify dates. Please fill out all portions of the parent’s section, especially any medication your child is receiving from another provider. All forms need to include instructions as to where to send the forms once completed.
Identification
For all clients and/or their legal guardians, a state issued photo I. D. is a mandatory requirement in our practice or your appointment will need to be rescheduled.
Late to Appointment
If you are a returning client and you are more than 10 minutes late to your appointment you will need to reschedule. This 10-minute grace period does not apply to new/initial visits as you must arrive 20 minutes prior to your appointment time, or you will need to reschedule. Missed appointment fees are applicable.
Missed Appointments / Late Cancellations
If you are unable to keep a scheduled appointment, call the office a minimum of 24 hours ahead to cancel or reschedule that appointment. Failure to cancel your appointment without 24 hours notice will result in cost of full session and office may use credit card on file or mail notice. Failure to cancel your appointment without 24 hour notice may also result in discharge from this practice. Please see our Cancellation Policy within your forms on our Forms page.
Record Transfers
If transferring to our office from another practice, please request the records be released to you and please bring them with you to your first visit in our office. If transferring out of our office, please download, complete and submit our Authorization to Disclose Information form. The form should be signed by the parent or legal guardian if the patient is under 18 years of age and by the patient themself if over the age of 18. There is a $25 fee for the copying and releasing of medical records that is due upon submission of the request.
Use of our Emergency Telephone System
The Clinical Therapist is available daily for emergency telephone contact. He/she can be reached through our office, the on-call service or the Clinical Therapist cell phone. If you reach the voicemail please leave your name, the nature of your emergency and a phone number you can be reached. We value your contact in real emergencies as it may smooth your treatment or help prevent unwelcome hospitalization. However, routine clinical updates or questions should await your session. Billing or other clerical matters can be handled through our support staff or the Alternative Living Solutions billing office during our regular weekday business hours which are Mon-Fri 8am-5pm.
Video Cameras or Voice Recording in Exam Rooms
For the privacy of our patients and our employees, we do not allow videotaping or voice recording in our office. Thank you for respecting this policy.
Walk-In Appointments
All visits in our office are by appointment only. Please call the office and we will make our best effort to get you seen in a timely fashion. We are unable to accommodate patients that walk-in the office without an appointment at that time, but will assess the situation and give an appropriate appointment.
Copyright 2018 Alternative Living Solutions of North Carolina. All rights reserved.
Alternative Living Solutions of North Carolina
1923 J.N. Pease Place
Suite 201
Charlotte, NC 28262
United States
ph: (704) 612-0566
fax: (704) 498-4846
alt: (888) 617-3868
info