Practice Policies

Patient Communication, Prescription Refill & Telephone Consultation Policy

At Turned Leaf Psychiatry, our goal is to provide every patient with attentive, personalized, and high-quality psychiatric care. Because our providers are engaged in scheduled appointments with other patients throughout the day, they are not always immediately available to take or return telephone calls.

To help us address your needs as efficiently as possible, we ask that you please review and follow the communication guidelines below.

Calling the Office

When contacting our office, please be considerate of our staff's time and have all questions, concerns, medication issues, refill requests, and other matters you need addressed ready when you call.

Our administrative staff will document your concerns and relay the appropriate information to your provider.

Please provide complete and accurate information so that your provider can appropriately review your request.

Provider Response Time

Please allow up to 48 business hours for a provider to review and respond to routine telephone messages.

Messages are addressed based on clinical urgency and provider availability. Calling repeatedly regarding the same non-urgent request does not necessarily result in a faster response and may delay our staff's ability to assist other patients.

Prescription Refills & Medication Changes

For routine prescription refill requests, medication questions, or requests for medication changes, please allow up to 48 business hours for your provider to review and respond.

Please request refills before you are completely out of medication whenever possible.

A request for a medication change does not guarantee that a prescription will be changed without an appointment. Depending on the medication, symptoms, and clinical circumstances, your provider may determine that a scheduled appointment is necessary before making changes to your treatment.

Additional Telephone Consultations

Brief administrative communication and the relay of routine information through our staff are not considered telephone consultations.

However, when a patient requests or requires an extended clinical telephone conversation with a provider outside of a scheduled appointment, the following telephone consultation fees may apply:

• $25 — Phone Consultation (5–10 minutes)
• $50 — Phone Consultation (11–20 minutes)
• $75 — Phone Consultation (21–30 minutes)

If your concern requires more extensive assessment, medication management, treatment planning, or clinical decision-making than can appropriately be handled by telephone, you may be asked to schedule a regular appointment instead.

Telephone consultation charges may not be covered by your insurance and may therefore be the patient's responsibility when permitted by the patient's insurance plan and applicable law.

Emergencies & Suicidal Thoughts

Turned Leaf Psychiatry's routine telephone and messaging services are not emergency services and should not be used for an immediate psychiatric or medical emergency.

If you are experiencing a medical or psychiatric emergency, believe you may harm yourself or someone else, or are having suicidal thoughts with immediate safety concerns:

• Call 911 or go to the nearest emergency department.
• You may also call or text the 988 Suicide & Crisis Lifeline by dialing 988 for immediate crisis support.

Do not wait for a routine callback from Turned Leaf Psychiatry if you believe you are experiencing an emergency.

Respectful Communication

Turned Leaf Psychiatry is committed to treating our patients with respect, dignity, compassion, and professionalism, and we expect the same consideration to be extended to our providers and staff.

We understand that psychiatric symptoms, medication concerns, insurance problems, and other healthcare issues can be stressful. Our team will make reasonable efforts to assist you.

However, abusive, threatening, harassing, discriminatory, or persistently disrespectful behavior toward staff or providers is not acceptable.

Repeated misuse of non-emergency communication channels, excessive demands on staff resources, or continued failure to follow reasonable office communication procedures may interfere with our ability to provide appropriate care to all patients.

When these issues cannot be resolved, Turned Leaf Psychiatry reserves the right, consistent with applicable professional, ethical, contractual, and legal requirements, to initiate an appropriate transition of care to another provider or practice that may be better able to meet the patient's needs.

Our goal is never to create barriers to care. These guidelines allow our providers and staff to devote appropriate time and attention to every patient we serve.

Thank you for respecting the time of our patients, providers, and staff and for helping us provide safe, efficient, and compassionate psychiatric care.

Turned Leaf Psychiatry — Innovative | Personalized | Evidence-Based

Consent for Treatment & Patient Agreement

Participation is voluntary, and you may withdraw consent at any time as permitted by law.

Nature of Services

Services may include:

• Psychiatric evaluations
• Medication management
• Psychotherapy or counseling
• Coordination of care (with authorization)
• Mental health assessments and screenings
• Laboratory testing or drug screening as clinically indicated

You have the right to ask questions about any recommended treatment.

Risks and Benefits

Potential benefits may include:

• Improved mood and functioning
• Better coping skills
• Improved relationships
• Enhanced quality of life

Potential risks may include:

• Emotional discomfort
• Temporary worsening of symptoms
• Need to adjust treatment

If medication is prescribed, risks, benefits, and side effects will be reviewed with you.

Right to Withdraw

You may refuse or discontinue treatment at any time. A final session is encouraged when appropriate.

Confidentiality

Your information is protected under HIPAA and applicable law.

Information may be disclosed without authorization when required, including:

• Risk of harm to yourself or others
• Suspected abuse or neglect
• Court orders or legal requirements
• Medical emergencies or coordination of care

Telehealth Consent

You may receive services via telehealth (video and/or audio communication).

You understand that:

• Telehealth differs from in-person visits
• Benefits include convenience and improved access to care
• Risks include technical issues, interruptions, and potential unauthorized access despite reasonable safeguards

Additional terms:

• Telehealth via SimplePractice is not for emergencies
• In an emergency, call 911
• You agree not to share your session link with unauthorized individuals
• Sessions may be discontinued if the connection is inadequate
• Your provider will determine if telehealth is appropriate for your care

Use of Artificial Intelligence (AI) Tools

We use HIPAA-compliant AI tools for administrative and documentation support, including:

• Drafting clinical notes
• Scheduling and reminders
• Billing and insurance processing
• Practice management

We do not use AI to:

• Diagnose conditions
• Provide therapy or medical advice
• Make independent clinical decisions

All AI-assisted content:

• Is reviewed and approved by your provider
• Remains confidential and protected under HIPAA

Individual Needs & Continuity of Care

Turned Leaf Psychiatry is happy to offer a service to the public. We will try to accommodate specific needs when they arise; however, if you are wanting to opt out of AI recording or certain policies expressed here, then Turned Leaf Psychiatry may not be best suited for your individual needs.

If that is the case, a member of our staff will inform you that by law we reserve the right to refer a patient to one of the surrounding practices that may have the feasibility to meet your or your loved one's individual needs. We will uphold our commitment of continuity of care to ensure that you receive adequate treatment during the transition.

Notice of Privacy Practices (HIPAA Acknowledgment)

Your health information is protected under federal law.

We may use or disclose your information for:

• Treatment
• Payment
• Health care operations

We may also disclose information when required or permitted by law, including:

• Risk of harm to yourself or others
• Abuse or neglect reporting
• Court orders or legal processes

Your rights — you have the right to:

• Access your records
• Request corrections
• Request limits on disclosures
• Receive a copy of this notice
• Request confidential communication methods

Communication & Appointments

We may contact you for:

• Appointment reminders
• Scheduling updates
• Treatment-related communication

Patient Responsibilities

You agree to:

• Provide accurate and complete information
• Attend scheduled appointments
• Complete required forms prior to visits
• Follow treatment recommendations
• Notify the practice of any changes to contact, pharmacy, insurance, or payment information

Voluntary Consent & Right to Withdraw

You understand:

• Participation in treatment is voluntary
• You may withdraw consent for treatment or specific services at any time, except where otherwise required for legal or clinical documentation purposes

Patient Financial Policy

Insurance billing • Patient responsibility • Card on file authorization

Purpose. This policy explains how Turned Leaf Psychiatry LLC bills insurance, estimates and collects patient cost-sharing, processes Explanation of Benefits documents, handles balances and credits, and uses an authorized payment card. It applies unless a payer contract, government-program rule, or applicable law requires a different result.

Insurance Information and Eligibility

Patients must provide current insurance information, identification, and any information needed to submit claims. Patients must notify Turned Leaf Psychiatry promptly of changes in coverage, address, or contact information.

Eligibility and benefit information obtained before a visit is an estimate and is not a guarantee of payment. The insurance plan makes the final benefit determination after it processes the claim.

Copays, Deductibles, Coinsurance, and Allowed Amounts

A copay is a fixed amount assigned by the plan for a covered service.

A deductible is the amount a patient may have to pay for covered services before the plan begins paying benefits that are subject to the deductible.

Coinsurance is a percentage of the plan's allowed amount assigned to the patient, usually after the deductible has been met.

The allowed amount is the amount recognized under the applicable payer arrangement. When Turned Leaf Psychiatry is in network, contractual adjustments are not billed to the patient.

Payment Due at the Appointment

Patients are responsible at the time of the appointment for the estimated amount due, including any estimated copay, deductible, coinsurance, self-pay charge, noncovered service, or prior balance that may lawfully be collected. Because this amount is based on information available before claim processing, the estimate may differ from the final amount.

Claims and Explanation of Benefits

Turned Leaf Psychiatry will submit claims to the insurance plan when the practice participates with that plan or has otherwise agreed to file the claim. After processing, the plan generally issues an Explanation of Benefits, or EOB, to the patient and remittance information to the practice. An EOB is not a bill; it explains how the claim was processed.

After the claim is processed and the EOB is issued, the patient is responsible for the valid remaining patient-responsibility amount shown by the payer, less payments already made. This may include copays, deductible amounts, coinsurance, and properly assigned noncovered services. Turned Leaf Psychiatry will not knowingly bill a patient for a contractual adjustment or a provider-responsibility denial that cannot lawfully or contractually be transferred to the patient.

Required Card on File and Authorization

A valid credit or debit card must be placed securely on file before services are rendered, unless Turned Leaf Psychiatry approves another arrangement or applicable law or payer rules prohibit the requirement. Patients must keep the card information current. Card information is maintained through the practice's payment processor; staff should not place full card numbers in the clinical record.

By signing this policy, the patient or responsible party authorizes Turned Leaf Psychiatry to charge the card on file for amounts that are validly assigned as patient responsibility, including estimated amounts due at the appointment and balances established after claim processing. Turned Leaf Psychiatry may use this authorization for patient-responsibility amounts identified within three years of the applicable date of service, or for any shorter period required by law, payer rules, card-network rules, or the payment processor. This authorization does not permit charges above the patient's valid responsibility.

For an unexpected post-EOB charge of $100 or more, Turned Leaf Psychiatry will ordinarily provide at least five calendar days' notice before charging the card, unless a payment arrangement states otherwise. The patient may revoke authorization for future card charges by providing written notice before a charge is processed. Revoking card authorization does not cancel amounts already owed or eliminate the patient's duty to arrange another form of payment.

Outstanding Balances and Future Services

An unpaid balance may make a patient ineligible to schedule or receive future nonemergency services unless an approved payment arrangement has been established and maintained. Turned Leaf Psychiatry will apply this policy consistently and will consider continuity of care, clinical urgency, applicable nondiscrimination requirements, payer rules, and any duty to provide appropriate notice or transition assistance before ending ongoing care. The practice does not provide emergency services; patients experiencing an emergency should call 911 or go to the nearest emergency department.

Collection Efforts

Turned Leaf Psychiatry is generally required by its payer agreements to collect valid patient cost-sharing and may be required by federal or state program rules to make reasonable collection efforts. Routine waiver of copays, deductibles, or coinsurance may violate payer contracts and, for federal health care programs, may create compliance concerns. Financial-hardship adjustments may be considered individually when permitted and properly documented.

If an EOB assigns a valid amount to the patient and the patient does not pay or make an acceptable arrangement, Turned Leaf Psychiatry may send statements, contact the responsible party, charge an authorized card on file, use a collection agency, or pursue other lawful remedies. Before an account is referred to collections, patients who cannot pay the balance should contact the office promptly to request a payment arrangement or financial-hardship review.

Turned Leaf Psychiatry reserves the right to refer an unpaid account to a collection agency when the patient or responsible party refuses or fails to pay valid patient responsibility after reasonable notice and collection efforts. Any collection activity will be subject to applicable law, payer rules, and documented hardship exceptions.

Medicare, Medicaid, and Other Protected Cost Sharing

Special rules may limit what can be collected from Medicare, Medicare Advantage, Medicaid, Qualified Medicare Beneficiary, and other protected patients. Secondary coverage must be processed when required before determining the final patient balance. Turned Leaf Psychiatry will not knowingly collect an amount prohibited by these rules and will refund or credit an improper collection.

Credits and Refunds

If payments exceed the patient's final responsibility, the overpayment will be credited to the patient's account. A patient may contact the office to request a refund rather than retaining the credit. Please allow up to 14 calendar days for the billing team to review the account, confirm all claims and payments, and issue an approved refund. Bank or card-processing time may occur after the refund is issued. If a payer later recoups or reprocesses a claim, the account may be adjusted accordingly.

Questions, Disputes, and Payment Arrangements

Patients should contact Turned Leaf Psychiatry promptly if they believe an EOB or statement is incorrect, if they need an itemized statement, or if they need a payment arrangement. Raising a good-faith billing dispute pauses collection escalation while the practice reviews the disputed amount, although undisputed amounts remain due.

Legal and Payer Basis

This policy is based in part on payer participation agreements and government-program requirements. The U.S. Department of Health and Human Services Office of Inspector General has warned against the routine waiver of Medicare Part B copayments and deductibles. Medicare rules governing reimbursable bad debts also require reasonable collection efforts for beneficiary deductible and coinsurance amounts. Mississippi Medicaid rules limit a beneficiary's liability and generally require participating providers to accept applicable third-party or Medicaid payment as payment in full, except for authorized beneficiary cost-sharing. These authorities do not mean that every balance must always be collected regardless of hardship, error, or legal protection.

• HHS Office of Inspector General, Special Fraud Alert: Routine Waiver of Medicare Part B Copayments and Deductibles (1994), available at oig.hhs.gov/compliance/alerts
• 42 C.F.R. § 413.89, Bad debts, charity, and courtesy allowances, available at ecfr.gov
• Mississippi Administrative Code Title 23, Part 306, Rules 1.2 and 1.3, available at medicaid.ms.gov
• Mississippi Code § 15-1-29, actions on open accounts and unwritten contracts.

Behavioral Health Emergency & Safety Policy

Purpose

Turned Leaf Psychiatry, LLC ("TLP") maintains this policy to provide a standardized response when a patient presents with suicidal ideation, homicidal ideation, threats of violence, grave disability, abuse/neglect concerns, or another behavioral-health emergency.

This policy is intended to promote patient and public safety while ensuring that TLP personnel act within their training, professional scope, and applicable Mississippi and federal law.

1. Emergency Safety Assessment

Any report or observation suggesting a significant risk of suicide, self-harm, violence, or grave disability shall be promptly escalated to a qualified TLP clinician.

The clinician shall use professional judgment to assess relevant factors, including:

• Suicidal or homicidal thoughts;
• Plan, intent, means, and access to weapons;
• Identified or identifiable victim;
• Recent attempts or violent behavior;
• Psychosis, mania, intoxication, or severe impairment;
• Ability to care for basic needs;
• Protective factors and available supports; and
• Ability to participate safely in outpatient treatment.

Screening instruments may supplement but shall not replace individualized clinical judgment.

2. Emergency Disposition

When a clinician determines that emergency evaluation or hospitalization is indicated, TLP shall facilitate an appropriate higher level of care.

When clinically appropriate and the patient agrees, voluntary evaluation or hospitalization should generally be pursued.

When a patient refuses and the clinician believes Mississippi's emergency or involuntary-treatment criteria may be satisfied, the clinician shall initiate or facilitate the appropriate emergency or civil-commitment process within the clinician's legal authority.

Mississippi's commitment framework includes pre-affidavit screening and consideration of alternatives to involuntary commitment.

Nothing in this policy authorizes a TLP employee to detain, restrain, transport, or commit a person beyond the authority granted by applicable law and the employee's professional scope.

3. Threats to Others / Duty to Protect

Any actual or potentially credible threat of violence shall be immediately escalated to a clinician.

The clinician shall assess the threat and take reasonable action permitted or required by applicable law, which may include contacting emergency services, law enforcement, an appropriate receiving facility, an identifiable potential victim or guardian when legally authorized, and/or other appropriate persons or agencies.

Only information reasonably necessary and legally permitted or required should be disclosed.

4. Mandatory Reporting

TLP personnel shall comply with applicable mandatory-reporting requirements concerning suspected:

• Child abuse or neglect;
• Abuse, neglect, or exploitation of vulnerable persons; and
• Other circumstances for which reporting is required by law.

Staff shall not delay a legally required report merely to independently investigate or confirm an allegation.

5. Telehealth Emergencies

When an emergency occurs during telehealth, staff should obtain or confirm the patient's current physical location and callback information whenever possible.

If immediate intervention is indicated, TLP may contact emergency services or other appropriate resources serving the patient's physical location.

When reasonably safe and practical, the provider should maintain communication with the patient until an appropriate transfer of care or emergency response has been initiated.

6. Administrative Staff

Administrative staff, including virtual assistants, shall not independently determine suicide risk, violence risk, capacity, or commitment eligibility.

When a patient communicates a potential emergency, staff shall:

• Keep the patient engaged when reasonably possible;
• Obtain the patient's current location and callback number;
• Immediately notify a TLP clinician; and
• Contact 911/emergency services if an apparent life-threatening emergency exists and immediate clinical assistance is unavailable.

Administrative personnel shall not promise confidentiality or attempt to provide clinical crisis counseling.

7. Documentation

TLP clinicians shall document clinically significant safety events and the basis for their decisions.

Documentation should include, when applicable:

Risk identified → Assessment → Clinical judgment → Intervention → Disposition → Rationale.

The record should identify significant patient statements, relevant risk and protective factors, consultations, emergency contacts, referrals, patient acceptance/refusal, and the reasoning supporting the disposition.

8. Patient Refusal

A patient's refusal of a recommended treatment or hospitalization does not, by itself, establish grounds for involuntary commitment.

When a patient refuses recommended care, the clinician shall determine whether emergency intervention is legally and clinically indicated and document the assessment, recommendation, refusal, alternatives considered, and disposition.

9. Immediate Danger

When TLP personnel reasonably believe there is an immediate threat to life or serious bodily harm, 911/EMS or other appropriate emergency resources shall be contacted without unnecessary delay.

TLP is an outpatient psychiatric practice and is not an emergency service or emergency department.

Patients experiencing an immediate psychiatric or medical emergency should call 911, proceed to the nearest emergency department, or contact 988 when appropriate.

10. Professional Judgment and Limitation

No policy can anticipate every psychiatric emergency.

TLP providers shall exercise individualized professional judgment based upon the information reasonably available at the time of the encounter.

This policy does not:

• Guarantee prevention of suicide, self-harm, violence, hospitalization, or another adverse outcome;
• Require personnel to take actions outside their professional scope or legal authority;
• Replace individualized clinical judgment;
• Expand any employee's legal authority; or
• Replace applicable federal or Mississippi law.

When circumstances permit, clinicians may consult another TLP provider, the Medical Director/collaborating physician, receiving facility, malpractice risk-management service, or legal counsel.

When applicable law conflicts with this policy, applicable law controls.