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FAQ & Office Policies
Payment & Coverage
Pura Vida Psychiatry accepts Cigna, Aetna and BCBS of MA, Tufts, Harvard Pilgrim, Carelon Behavioral Health, and Optum (United Healthcare, Oscar Health, and Oxford) and is out-of-network for all other insurances including Medicare and Medicaid.
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For all other insurance HMO plans will not reimburse any portion of the visit, in which case sessions would be out-of-pocket.
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Many insurance plans have an out-of-network mental health component that will reimburse you directly after you submit a superbill, which can be provided to you upon your request. Please call your insurance company to verify out-of-network coverage prior to scheduling your appointment. See bottom of page for more information about requesting out-of-network coverage.
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We will obtain your insurance information prior to the first session as this information is necessary for ordering lab work and creating the superbill.
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Self-pay payments are made by credit card through the scheduling system and due in full at the time of appointment booking. This is considered necessary to hold your appointment.
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All major credit cards are accepted.
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The following types of insurances may reimburse you a portion of your session fees following an annual deductible.
​​​Preferred Provider Organizations (P.P.O.)
Point of Service Plans (P.O.S.)
Cancellation
Medication
In-person & Telehealth
In order to maintain professional boundaries and the viability of the practice, we have a strict cancellation policy.
72 hours advanced notice is required to cancel or reschedule an appointment. Cancellations or appointments rescheduled within less than 72 hours in advance will incur a $50 fee, those canceled or rescheduled within less than 48 hours in advance will incur a $75 fee, and those cancelled or rescheduled within less than 24 hours in advance will be required to pay the full session cost. No shows will also be required to pay the full session cost and will not be refunded.
If a client cancels or no shows and does not respond after 2 attempts of contact within two weeks, client will automatically be discharged from services.
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If maintaining a scheduled in-person appointment is ever a concern due to inclement weather, the option for a telehealth session is available.
Although there are a number of treatment approaches that are better offered face-to-face, we do offer both in-person and telehealth appointments based on the client's preference.
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We do our best to respond to emails and voicemails within two business days. If you have a medical emergency, call 911 or go directly to the nearest ER.
Pura Vida Psychiatry is not able to provide emergency services. See bottom of page for additional crisis information.
We practice from a root-cause perspective. Because the monoamine theory of depression (and other mental health conditions) has not been proven, psychopharmacology cannot be considered a means of treating the cause of an illness. Often, medications mask symptoms, and while they can help a patient to feel better for a time, they do not treat the root cause of symptoms. They can lead to medication dependence, cause withdrawal symptoms, and in the long-term can do more harm than good.
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When a client is in acute distress and unable to take the steps toward change and wellness due to their current mental state, conservative psychopharmacology may be considered as a supportive, albeit temporary treatment measure. We do however, have a policy to not prescribe controlled substances such as stimulants (i.e., Adderall) or benzodiazepines (i.e., Ativan, Klonopin).
Prescription Refills
For prescription refills please contact your pharmacy and have them fax over the medication refill request. Our fax number is (915) 221-6127. It may take up to 72 business hours to process a prescription refill. Please plan ahead to avoid any interruptions in your medications. There is a $35 charge to process medication refills in-between appointments, which must be paid at your subsequent session. Pura Vida Psychiatry may refuse to refill medication if it is deemed clinically necessary to evaluate patients before prescribing a medication.
Medical Records
Once you have scheduled your appointment, you will be sent links to complete a client information sheet and a virtual intake form. These must be completed within 72 hours (3 days) of your scheduled appointment and if it has not been completed, the appointment will need to be rescheduled to a future date. You will also be required to sign a form acknowledging that you have read our policies and that you agree to them and understand how our practice operates.
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The intake visit will include an in-depth health history and a biopsychosocial-spiritual assessment.
The second visit we will order any pertinent labs or administer any additional assessments and obtain collateral data.
Intake
It is your responsibility to obtain previous medical records from other physicians, or health care providers that you feel would be pertinent to your care and would like us to review. These records can only be released with your authorization. Please contact your other providers to obtain these records and fax or email them to us or bring them to your initial appointment. For uninterrupted care, please make sure they have been delivered to us no later than your second intake appointment.
In addition, we request that you gather as much collateral information as possible to bring to your first session. This could include previous allergy testing, blood work, lab work, nutritional evaluations and psychological testing. Also be sure to accurately provide information on any current medications including over-the counter, supplements, and herbal preparations.
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You will complete additional forms such as a release that allows us to speak with your other provider(s), a HIPAA form, our lab work policy, other consent forms, etc.
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You may be asked to complete specific health assessment questionnaires, prior to your first visit, during your first visit, or during subsequent visits.
Out-of_Network (OON) Coverage
Prior to scheduling your appointment, contact your insurance company (member service number can be found on your insurance card) and inquire as to whether your plan reimburses for out-of-network behavioral health services.
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If you are informed that your plan does in fact cover out-of-network behavioral health services, you may ask additional questions regarding this coverage, including:
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Are the following CPT codes covered?
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Intakes: CPT code 90792, 99204, 99205
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Follow-up visits: CPT code 99214, 99215, 90833, 90836, 90838
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Are any diagnoses excluded from reimbursement?
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How much is my deductible?
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After meeting my deductible, how much will the plan reimburse for each visit?
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Do out-of-network services count toward the deductible?
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What is the percentage of reimbursement?
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Is the number of visits limited?
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Is there specific information I need from my OON provider?
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How can I submit a claim?
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If your insurance plan provides reimbursement for OON behavioral health services, please notify the office and you will be provided with an invoice known as a superbill which can be submitted to your insurance company. Pura Vida Psychiatry will not submit the claim directly to your insurance company as an OON provider.
Please note that your insurance company may only reimburse you for a portion of the session fee. Reimbursement rates vary by insurance provider and plan (usually between 20-80%).
Emergency & Crisis Assistance
Emergency/Crisis Services
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If you are experiencing a psychiatric emergency, call 911 or go to your nearest emergency department.
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If you or someone you know in Massachusetts are experiencing a mental health crisis, the Emergency Service Program/Mobile Crisis Intervention is available 24/7, 365 days a year.
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Toll-free: (877) 382-1609​
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Additional Assistance​​
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National Suicide Prevention Hotline: 800-273-8255
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National Domestic Violence Hotline: 800.799.SAFE (7233)
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National Alliance on Mental Illness (NAMI): https://nami.org/Home