Office Policies
URGENT ISSUES: If the issue is an urgent clinical issue and you need to speak to me right away, call 203-551-4173. Please note this phone number is an office phone number and not a cell phone so please do not text as you will not receive a response. If we do not pick up, please leave a voice message indicating that it is an urgent issue and we will call you back. If no voice message is left then we will not call back and if the message does not indicate that the issue is urgent we will call back during office hours. Please note that refill requests, requests that forms be completed, canceling and rescheduling appointments, insurance issues are not considered urgent and will be addressed during office hours only.
APPOINTMENT/MEETING REQUESTS: Please call the office at 203-551-4173 during office hours and my staff can assist you in scheduling. Any requests received outside of our office hours will be addressed during business hours. Please note this phone number is an office phone number and not a cell phone so please do not text as you will not receive a response.
MEDICATION ISSUES: Medication refill requests, insurance issues, and issues with your pharmacy should also be addressed by calling the office during office hours at 203-551-4173. Refill requests will be addressed during office hours only and any request received outside of office hours will be addressed when the office reopens. Please note this phone number is an office phone number and not a cell phone so please do not text as you will not receive a response.
If you have not been seen for some time, cancelled or did not show up to the previous appointment or are requesting refills of controlled substances outside of appointments, the refill request will be denied.
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​The patient is responsible for updating the office on any change in pharmacies. In the event a pharmacy is out of stock of a medication, the patient is responsible for calling us and advising which pharmacy they would like their prescription to be sent to in lieu of their regular pharmacy.
INSURANCE/COST: Insurance issues should be addressed by calling the office during office hours at 203-551-4173. Any request received outside of office hours will be addressed when the office reopens. Please note this phone number is an office phone number and not a cell phone so please do not text as you will not receive a response. Patients are responsible for providing new or updated insurance information to the office and failure to do so timely may result in the patient being responsible for the total cost of the visit.
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Patients are responsible for understanding the insurance contracts they have with their insurance company and understanding any deductibles, co-insurance or co-pays that are a part of that contract. The insurance company is responsible for explaining their coverage directly to their members. Any questions surrounding deductible costs should be directed to the insurance company. Common insurance codes for reimbursement (CPT codes) that the office submits for reimbursement are:
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99204: New visit up to 60 mins
99205: New visit over 60 mins
99214: Follow up visit
99213: Follow up visit
90833: Psychotherapy up to 30 mins
90836: Psychotherapy up to 45 mins
90838: Psychotherapy up to 60 mins.
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Patients can contact their insurance company with these CPT codes and the insurance company should be advising the reimbursement (or cost) for the visit code.
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Please note I am in network with traditional Medicare but NOT with managed Medicare plans. If you have a managed Medicare plan, contact your plan to see if they allow for out of network billing
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The current out of pocket cost for services is $225 for an initial visit and $125 for follow ups. The cost of visits may change over time.
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Failure to pay deductibles, copays or coinsurance for services to provided will result in discharge from the practice.
FORMS: We require at least 3 business days (longer forms will require more time) to complete forms. Forms will only be completed during office hours. Any requests placed outside of our business hours (nights, weekends, holidays, etc) will be addressed during business hours only and I cannot complete last minute requests during those times. We may require you to come in for an appointment depending on what the form requires. Disability and FMLA paperwork will be done by appointment only. Patients are responsible for obtaining the forms that they wish to be filled out by this office directly from the other institution and providing it to us- this office does not obtain school forms, disability forms, FMLA forms, jury duty exemption forms or other forms from other institutions.
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We do not write letters or endorsements for emotional support animals in the practice.
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INITIAL VISIT REQUIREMENTS: For all initial visits that are telemedicine, we require intake forms (which include consents to treat), identification and insurance cards to be submitted to us at least 24 hours prior to the scheduled appointment. Failure to do so will result in cancellation of the appointment and the patient will be required to reschedule to a later date..
For initial visits that are in person, the patient may complete the forms in person immediately prior to the appointment but must bring their insurance cards and IDs with them to the appointment. If a patient does not have their insurance card or ID at the initial visit, the appointment will be canceled and they will be required to reschedule to a later date.
EMAIL: Email is intended non-urgent for quick messaging and communication. Please be aware that the time and thought that when emailing regarding new symptoms, requests for referrals or imaging, requests for lab work, issues with chronic conditions, requests for new prescriptions, or for medical counseling can equal or exceed an office visit and we may bill your insurance company as a result. You may be responsible for any co-pays, deductibles or non coverage if your insurance company does not reimburse for this communication medium. Furthermore, for communication that requires multiple emails it is more appropriate that we discuss the issue in an appointment, and if the issue requires this, I ask that you call the office and schedule an appointment. Please note I do not make medication adjustments of psychiatric medications by email and this should be discussed in an appointment. Chronic disease management requires periodic visits and cannot be solely completed via email. Persistent refusal to be seen for appointments and demands for email only care may result in discharge from the practice.
TELEPHONE COMMUNICATION: As a general rule, the practice does not issue antibiotics, antivirals, new prescriptions or make major psychotropic medication adjustments by phone as this should be discussed in an appointment. If patients are feeling unwell, it is medically appropriate to be seeing them and I am unable to provide phone only care as this can result in misdiagnosis, mismanagement and generally poor outcomes for the patient. Depending on the complaint that is being called in, you may be asked to schedule an appointment. Refusal to schedule an appointment or to be seen in person on the request of the provider will result in the provider referring to an urgent care or other appropriate venue. Furthermore, if the issue is deemed urgent and there is no availability for same day appointments, your provider may refer you to the appropriate urgent care or in person venue. Chronic disease management requires periodic visits and cannot be solely completed via phone. Persistent refusal to be seen for appointments and demands for telephone only care may result in discharge from the practice.
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TEXT MESSAGING: Text messaging is provided for appointment reminders and to provide a link to video visits only. I do not give out my cell phone number and do not text outside of the previously mentioned reasons due to privacy and regulatory reasons. If you need to reach me, please call the office 203-551-4173. Please note this phone number is an office phone number and not a cell phone so it should not be texted as you will not receive a response.
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CONTROLLED MEDICATIONS: Effective 4/17/23, I have made the decision that due to the risk inherent with these medications and potential for interactions, that I will not be prescribing controlled medications (including Xanax, Klonopin, Ativan, Adderall, Vyvanse, Concerta) for patients who are new to the practice. This includes if patients were initiated on these medications by another provider and are transferring practices. Controlled medications will not be refilled outside of office hours. If the medication is lost of stolen, it will not be refilled until your next appointment and a copy of a police report is needed or I will not be able to refill it. Controlled medications will not be refilled if patients no show to or cancelled their last appointment.
MEDICAL EMERGENCIES: Medical emergencies should be handled by calling 911 or 988 (for psychiatric crises). My office does not have the capability to provide emergency care offsite and calls indicating a medical or psychiatric emergency will be directed to these numbers. Email is not an appropriate medium to communicate medical emergencies.
ACCEPTABLE BEHAVIOR: The practice is committed to a zero tolerance standard for violence, intimidation, harassment, and abusive behavior. Violent behavior of any kind or threats of violence, either implied or direct, is prohibited. Abusive behavior includes shouting at staff, swearing, derogatory remarks and name calling. Unacceptable behavior will result in discharge from treatment and, when appropriate, criminal prosecution.
Policies are subject to change over time.
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CANCELLATION, LATE AND NO SHOW POLICY
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Thank you for trusting your medical care to Emily Garber APRN PLLC. When you schedule an appointment with Emily Garber APRN PLLC we set aside enough time to provide you with the highest quality care.
It is necessary for us to make appointments in order to see our patients as efficiently as possible. No-shows and late-cancellations cause problems that go beyond a financial impact on our practice. When an appointment is made, it takes an available time slot away from another patient. No-shows and late-cancellations delay the delivery of healthcare to other patients, some who are quite ill.
Should you need to cancel or reschedule an appointment please contact our office as soon as possible, and no later than 24 hours prior to your scheduled appointment. This gives us time to schedule other patients who may be waiting for an appointment. Please note our phone number is an office phone number and not a cell phone so please do not text as you will not receive a response.
Please see our Appointment Cancellation/Late/ No Show Policy below:
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• Any new patient who fails to show for their initial visit or provide at least 24 hours notice of cancellation will not be rescheduled or accepted as a new patient.
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• Effective January 1, 2022 any established patient who fails to show or cancels/reschedules an appointment and has not contacted our office with at least 24 hours notice will be considered a No Show and charged a $50.00 fee.
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• Any established patient who fails to show or cancels/reschedules an appointment with no 24 hour notice a will be charged a $50.00 fee.
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• The no show/late fee is charged to the patient, not the insurance company, and is due at the time of the patient’s next office visit.
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• If an established patient does not show or provide at least 24 hours notice of cancellation for two consecutive appointments or for three total appointments, they are considered discharged from the practice.
• Patients who are more than five minutes late for a follow up or 15 minutes late for an initial appointment have missed their appointment and will be required to reschedule.
• As a courtesy, when time allows, we make reminder calls for appointments. If you do not receive a reminder call or message, the above policy will remain in effect.
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We understand there may be times when an unforeseen emergency occurs and you may not be able to keep your scheduled appointment. If you should experience extenuating circumstances please contact our office manager, who may be able to waive the No Show fee. You may contact Emily Garber APRN PLLC at 203-551-4173. Should it be after regular business hours, you may leave a message.
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Telemedicine visit expectations:
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In order to preserve patient safety and privacy as well as abide by state and federal laws, it is expected that patients adhere to the following:
-Patients should not be operating an automobile or heavy machinery while conducting a video visit. This places you and others in the car at risk. It is acceptable to conduct a visit in a car that is not in operation (ie not being driven) if needed for privacy. The visit will be terminated immediately for safety reasons if a patient is driving during the video visit.
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-Privacy is important to ensure confidentiality and a quality visit. Patients should not be in public spaces (i.e. malls, restaurants, parks, subways, buses, stores, etc) while conducting their visit as this inhibits communication and adequate care as well as the patient provider relationship. In the same way that visits in the office are not conducted in the waiting room and are done in a private room, it is expected that telemedicine (video) visits will be conducted in a similar manner. To ensure patient confidentiality, I will not be able to proceed in conducting a visit if it is being held in a public location.
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-Visualization is an important part of the exam and can help in assessment and diagnosis. Therefore, I do require that the video be turned on when conducting a telemedicine visit and will not conduct phone only visits. We will need to terminate the visit and reschedule if video is unable to be used in a session. If a patient does not have access to video capability, we will need to schedule in person visits as telemedicine is not an appropriate medium in this case.
-Patients must be located in a state where their provider holds a license, otherwise that provider is considered to be practicing in the state the patient is located in without a license. If a patient is taking a video visit in a state where I am not licensed in or in another country, I will need to end the visit to abide by state and federal laws.
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-Not all situations are appropriate for telemedicine. The provider reserves the right to advise that a telemedicine visit is not appropriate for certain patient issues or complaints and may require that you come in for an in person appointment depending on the situation. This is for patient safety and to avoid misdiagnosis and dangerous care. Refusal to come in for in person appointments when they are deemed more appropriate will result in the provider referring to an urgent care or other appropriate venue.
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