• Our office is following the guidelines established in Federal Health Insurance Portability and Accountability Act (HIPAA) regulations addressing the privacy of health care information, found at 45 CFR §§ 160 & 164 and Maryland’s Confidentiality of Medical Records Act (MCMRA), codified at Health-General § 4-301 et seq. HIPAA and MCMRA both establish a general rule of confidentiality for health care information. MCMRA requires a health care provider to keep the medical record of the patient confidential and disclose information only as provided by the act itself or as otherwise provided by law. HIPAA enumerates permitted disclosures slightly more specifically by allowing disclosures: to the individual (patient); for treatment, payment, and health care operations; incident to a use or disclosure permitted by the act; and pursuant to authorizations, agreements or certain public use exceptions.

• All services provided in our Psychosomatic Center (CIPM LLC) are qualified as a self-pay. The self-pay patients or patients with out-of-network benefits will be required to pay the full fee prior to each service provided. We accept only cash payments for any Initial Psychiatric Evaluations. We accept cash (in person at the office only), checks, and PayPal payments for any follow-up appointments. No credit cards are accepted.  We require patients to make a payment before the services provided. You can make payment via Business PayPal, cash (in person at the office only), or by sending us a check in advance so we would be able to close the accounting books for that day. If we do not receive the payment check or cash payment by the time of your appointment, we might have to be re-schedule your visit for a different day. There is a % fee ($4-10) associate with the use of Business PayPal. Please log in to PayPal and search for our business email [email protected] to make a payment prior to the services provided. Patients should contact their insurance companies to determine their out-of-network benefits. Effective January 2014 Dr. Venera Miller’s Medicare status has changed to Non-Participating Medicare Provider. We will provide information to help patients submit for Medicare or out-of-network reimbursement on their own from their insurance company.  

• In our office, we are offering secure telemedicine powered by Doxy.me ( https://doxy.me). Doxy.me utilizes state-of-the-art security and encryption protocols, making this platform compliant with HIPAA and HITECH requirements. All the patient needs to start a telemedicine visit is a web link to the doctor's Doxy.me room using a standard computer or Doxy.me app on a mobile device. No special hardware or software is necessary. If you scheduled for a telepsychiatry session with Dr. Miller, please log in to https://doxy.me/cipmllc at the time of your appointment and sign your name. 

• Past due balances and fees for miscellaneous requests are due at the time check of the visit. There is a $50.00 charge for all returned checks. The patient will receive one phone call regarding this matter. The payment is required within 48 hrs. of notification that check was returned. We will not accept the check from those patients whose check returned at least once. Non-payment will result in legal action from the State’s Attorney Office.

• There is a 24-hour notice required to cancel a routine appointment (medication management, substance abuse treatment appointment, group therapy, individual/couples/family psychotherapy). A cancellation with less than 24 hours notice will be charged the late cancellation fee which is equivalent to the missed appointment fee. Any Initial evaluation/consultation appointment should be canceled during working office hours at least 48 hrs. in advance to avoid missed/canceled initial evaluation/consultation appointment charges. No further appointments will be scheduled until all missed/canceled fees are paid. If the office is closed and you find it is necessary to cancel your appointment you may leave a message on the answering machine (410-535-6520) or email us at [email protected] with your name, phone number, day and time of your call and day/time of your scheduled appointment. To ensure you are not charged, it is your responsibility to call the office during normal office hours (8:30 am-4:00 pm Monday – Thursday; 10:00 am – 12 pm Friday; closed Saturday and Sunday) to confirm the appointment was canceled within the appropriate time period. Two missed initial evaluation appointments will result in no further appointments being scheduled. Two consecutive missed appointments for any services provided will result in discharge from all services. 

• Regular Medication Management appointments are 15-20 minutes at a cost of $100.00. If you need additional time with Dr. Miller (20-30 minutes) an additional charge of $50.00 for the Extended Medication Management will be charged at check out. You can, of course, let the receptionist know in advance if you feel you will need additional time with Dr. Miller and we will give you an appointment time will allow for the additional time you need. 

• You have to arrive 15-20 minutes early for the initial evaluation to fill out the paperwork. Twenty or more minutes late for the initial evaluation will result in cancellation of your appointment and appropriate cancellation fees will be applied. 

• While we attempt to make reminder calls for appointments, this is done as a courtesy only. The absence of a reminder call does not relieve you from your responsibility to provide us with a 24-hour cancellation notice for follow-up (routine psychotherapy and medication management) appointments and a 48-hour cancellation notice for initial evaluation you are unable to keep. 

• If you are Experiencing Medical or Psychiatric Emergency please call 911 or proceed to the nearest emergency room. If you are calling after hours, Friday or on a weekend and believe that you are having an emergency situation, please call 911 or proceed to the nearest emergency room. For any other non-emergency issues please leave the message on answering machine or email us and we will get back to you on Monday. In a case that Monday is the Federal holiday we will return your call on Tuesday. 

• If you have not been seen in our Psychosomatic Center for more than 1 year – you will be automatically discharged for non-compliance with treatment. In order to receive any services from us again, you will need to re-enroll as a new patient and comply with associated new patient’s rules, policies, and fees. The re-enrollment is done on a case by case basis and depends on the patient’s treatment history or circumstances of the discharge. 

• We are requiring 48-72 hrs. to refill the prescription. Please call (410) 535-6520 and speak slowly and clearly your name, date of birth, contact phone number, medication you are requesting and pharmacy name and phone number. Medication requests are not filled after hours (after 4:00 pm during weekdays) or on weekends (closed Friday, Saturday, and Sunday) and holidays so please plan accordingly. It is wise to schedule your appointment in advance to avoid running out of important medications. If you require prior authorization for the prescribed medication, your pharmacy should fax us the Prior Authorization Form at (410) 535-6523 and it will be your responsibility to make sure that we received that form. We need 48-72 hrs. to complete the prior authorization process. If you are requesting the prior authorization on Thursday, we may not be able to complete the process until Monday. 

• If you have not been seen by the physician for more than 6 months you will not be given refills on any medications (scheduled or non-scheduled). You must schedule a follow-up appointment and be re-evaluated for the effectiveness of the current medication regimen and possible side effects or complications. If you have not been seen in an office for more than 3 months you will not be given refills on any Anxiolytic Medications (Benzodiazepines: Xanax, Ativan, Valium, Klonopin and other) as well as ADHD medications (Stimulants: Adderall, Ritalin, Vyvanse, Concerta, Dexedrine and other). Make sure you allow sufficient time to have your appointment scheduled to be re-evaluated for the necessity of the currently prescribed controlled medication and to avoid possible withdrawal symptoms due to the abrupt discontinuation of Benzodiazepines. 

• All patients under Dr. Venera Miller’s care will be subjected to randomized drug analysis (oral or urine testing) to assure compliance with the prescribed medication regimen and the presence of illegal substances. Refusal or failure to comply will result in termination of the patient-doctor relationship and discharge from the practice. An additional charge of $ 25.00 could be applied for randomized urine or oral toxicology screen for any patients who have been prescribed scheduled controlled medications (Stimulants, Benzodiazepines, and Medications for sleep). 

• If we suspect the Diversion, Multiple Sources, or Illegal/Illicit drug use, Dr. Miller will determine, based on available facts and circumstances, the necessity for the continuation of medical care or discharge from the practice for non-compliance. If medical care will continue, serious limitations in regards to prescribing medications (Stimulants, Benzodiazepines, Buprenorphine, Sleep Medications, and other) will be implemented with ongoing random toxicology monitoring. If the patient is being discharged from the practice for non-compliance, the referral to another physician or facility will be provided.

      Diversion – drug screen negative for drugs prescribed. If diversion is suspected, prescribing controlled substances is illegal. No prescription will be provided by Dr. Miller. A repeat test must be completed within 48 hrs.

      Multiple sources – drug screen positive for controlled substances not being prescribed by our practice. The patient appears to be receiving benzodiazepines, stimulants, buprenorphine, buprenorphine/naloxone from multiple physicians. Dr. Miller will not continue to prescribe controlled substances for these patients.

     Illegal/illicit drugs– a positive screen. Absolutely no controlled prescription will be prescribed. Controlled substances cannot be safely prescribed in patients taking illicit drugs, including cannabis.

• If a patient qualifies for certification to use Medical Cannabis for health reasons, he/she must disclose the Cannabis use, name of the recommending physician, and present the official medical documentation, that would confirm the necessity for medical cannabis administration. It is up to Dr. Miller’s discretion to evaluate the legitimacy of the presented medical documentation, qualifications of recommending physician, and the justification for the medical use of cannabis. 

• If you lose a scheduled medication prescription for Stimulants (Methylphenidate, Dextroamphetamine, Amphetamine, Vyvanse, Dexedrine, Adderall, Ritalin and other), Opioid Dependence medications (Suboxone/Subutex/Buprenorphine, Zubsolv, Bunavil), Benzodiazepines (Xanax, Ativan, Klonopin, Valium and other) and Sleep Medications ( Ambien, Sonata, Lunesta and other you will not be given another prescription until it’s time for a scheduled routine refill and you will be required to provide detailed information about the incident and copy of the police report. Based on circumstances and physician determination you may or may not be prescribed this specific medication again. Please make sure to give us 7 days for all ADHD medication refills outside of the regular doctor’s visit. ADHD medications are scheduled controlled substances and must be written by a physician in the office. You can only get 1 month supply of stimulant medications and must be written by a physician at the time of the appointment and this type of medication can not be called into a pharmacy. The office staff will also not be calling pharmacies to check the availability of medication. The patient may want to call the pharmacy prior to requesting a new prescription to ensure the pharmacy has the requested medication.

• Comprehensive Suboxone® Program includes medication management, mandatory group therapy sessions, and regular toxicology screen (urine, oral, or hair testing). Fees for medication management, group sessions, and urine toxicology screen are due at the time of service. All Suboxone/ Subutex (Buprenorphine/Naloxone; Buprenorphine, Zubsolv) prescriptions will be provided only during routine Opioid Dependence treatment appointments. All patients will be subject to toxicology screens at every visit as well as randomized screens, some of which may or may not be observed. We will give as such notice as possible to the patients. In case of doubt accuracy of results and the patient is re-tested the patient will be responsible for payment of the second specimen cup/oral swab. Due to stricter regulations Benzodiazepines will no longer be prescribed to patients who are taking Buprenorphine. 

• Any court or other legal appearance requested to be made by Dr. Venera R. Miller, other practice Physicians, Psychotherapists, or Providers to serve as a testimonial witness or to give a deposition will necessitate the cancellation of patient treatments for the entire day. As such, court or other legal appearances will be charged on a per-day basis and require full payment (according to treatment charges) in advance (minimum two weeks in advance) via retainer and a two-week cancellation notice must be given for fees to be returnable. Unless canceled a minimum of two weeks in advance, the fees are non-refundable, even if testimony or deposition is deemed not necessary.

• Past due balances and delinquent accounts for all services rendered are subject to collections under the following guidelines: two telephone attempts to reach patients and two statement mailings resulting in non-payment will automatically be referred to Practice Attorneys for Court Processing and to a Debt Collection Agency. 

• As a supplement to in-office appointments, we are inviting you to use email to communicate with our clinic. Our email address is [email protected] and is HIPAA compliant under the Business Associate Addendum (BAA) with Google LLC. Your decision to utilize email is strictly voluntary and your consent may be rescinded at any time. The email will be accessed, and responses will be provided via phone or email communication by Dr. Miller or a staff member within 24-72 hrs depending on weekdays or weekend schedules. You may use email to communicate with our office for prescription refill requests, appointment requests, or other matters not requiring an immediate response. The email should never be used in a case of an emergency If you are experiencing any desire to harm yourself or others, if you are experiencing a severe medication reaction or If you need an immediate response. Unlike trading voicemail messages, email allows you to see exactly the question the doctor is responding to and to have a written record of that exchange for future reference. Risks of communicating via email include but are not limited to: Email may be seen by unintended viewers if addressed incorrectly; Email may be intercepted by hackers and redistributed; Someone posing as you could access your information; Email can be used to spread computer viruses; There is a risk that emails may not be received by either party in a timely matter as it may be caught by junk/spam filters; Emails are discoverable in litigation and may be used as evidence in court; Emails can be circulated and stored by unintended recipients; Statements made via email may be misunderstood thus creating miscommunication and/or negatively affecting treatment; There may be an unanticipated time delay between messages being sent and received. You must let Dr. Miller know immediately if my email address changes. If I do not receive a response from Dr. Miller or office staff in the time frame indicated, I will contact the clinic by telephone if a response is needed. You must advise Dr. Miller in writing should you decide that you would prefer not to continue communicating via email. Statements made via email may be misunderstood thus creating miscommunication and/or negatively affecting treatment; There may be an unanticipated time delay between messages being sent and received. You must let Dr. Miller know immediately if my email address changes. If I do not receive a response from Dr. Miller or office staff in the time frame indicated, I will contact the clinic by telephone if a response is needed. You must advise Dr. Miller in writing should you decide that you would prefer not to continue communicating via email. 

• In the case of office closure due to inclement weather or other urgent situations, office staff will attempt to notify patients scheduled. Patients are encouraged to call the office and confirm office hours if inclement weather is in question.