Financial Policies including Payment and Refund Policies

If you have medical insurance, we are eager to help you receive maximum allowable benefits. In order to achieve this goal, we need your assistance and your understanding of our payment policy. You will be asked to update your personal and insurance information periodically, including providing our office with copies of your information to your insurance card and driver’s license. We are required by law to obtain your signature for permission to release information to your insurance carrier. Our failure to obtain these updates could result in criminal and civil penalties and/or expulsion from your insurance plan. Please assist us in complying with your insurance requirements. We will gladly submit fees for you covered medical services to your insurance company, if your provider is considered in network. However we expect payment of all services rendered within 60 days. It may become necessary for you to pay your account in full if your insurance company fails to pay for services within 60 days. It is your responsibility to understand your coverage and benefits, including pre– certifications, referral and authorization requirements. We will, however assist you to ensure that all plan requirements are met.

Co-payments and coinsurance fees are due and payable in at each session. We accept cash, credit cards and checks. Make checks payable to “Loudoun psychiatric care”

If you pay in advance by credit card for Tele- Psych session and no show for any reason and or do not call us 24 hours before your appointment, that payment will not be refunded.

Delinquent accounts over sixty days (60) days old and will be charged 2% interest per month. Failure to pay fees within a sixty (60) days period may result in your account being turned over to an outside collection agency.

We charge a $35 service fee for checks returned for non-sufficient funds.

MEDICAL APPOINTMENT CANCELLATION / NO SHOW POLICY

Guidelines and fee schedules as set forth in this policy by Loudon psychiatric care.

1. All appointments must be canceled by 11 AM of the business day before the scheduledappointment.
2. Failure to do so will result in missed appointment charge. The fees are as follows: $75 for psychiatrist, $75 for therapist or nurse practitioners visit.
3. If you arrive 15 or more minutes late for an appointment, you may be charged for a missed appointment.
4. If you have a balance on my account that it needs to be paid before your appointment and that failure to pay the debt may result in not being seen and a missed appointment fee being added to your account. If you are unsure of your balance you may call Loudon psychiatric care.
5. If it is a third No Show or cancellation/reschedule with no 24 hour notice should occur you may be dismissed from Loudoun Psychiatric Care.
6. The fee is charged to the patient, not the insurance company, and is due at the time of the patient’s next office visit.
7. In the event of snow or inclement weather you may cancel an appointment with less required notice if and only both of the criteria as are met: Loudoun County government [not school system is closed. Please call or email to cancel your appointment prior to the appointment time
8. If a patient is unable to make an appointment due to illness that they may cancel the appointment with less than required notice if and only if acceptable proof is provided for sickness.
9. Please call 703-542-3737 and leave a message for cancellation or send an email at INFO@LoudounPsychiatricCare.com. The email shall not have any other information except cancellation notice.

Medication Use / Refill Policy

You are required to take all medications as prescribed. If you lose my medications for any reason you may not get refill from the doctor. You will go to either an emergency room, urgent care center or other doctor to get refill until your regular appointment.

You will complete all lab works as ordered.

You agree to notify my prescriber if you are pregnant ( if applicable).

If you experience difficulties with medications and the doctor is unavailable, you will go to the nearest emergency room or you will call 911 immediately.

You will keep Loudoun Psychiatric Care updated with all medications prescribed by any other doctor elsewhere.

You will not get same prescription from any other source without consent from this doctor.

You will report all difficulties with medications to the doctor regardless of source of medication.

You agree to pick up my medication refill scripts during your follow-up appointments. Pharmacy initiated refill orders are entertained only under exceptional reasons.

You agree and give your consent to Loudoun Psychiatric Care to use surescripts drug history and Virginia Drug Monitoring Program to review your medications.

Privacy Notice

This privacy notice discloses the privacy practices for www.loudounpsychiatriccare.com or www.LPCAshburn.com. This privacy notice applies solely to information collected by this website. It will notify you of the following:

1. What personally identifiable information is collected from you through the website, how it is used and with whom it may be shared.
2. What choices are available to you regarding the use of your data.
3. The security procedures in place to protect the misuse of your information.
4. How you can correct any inaccuracies in the information. 

Information Collection, Use, and Sharing
We are the sole owners of the information collected on this site. We only have access to/collect information that you voluntarily give us via email or other direct contact from you. We will not sell or rent this information to anyone.

We will use your information to respond to you, regarding the reason you contacted us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g. to ship an order.

Unless you ask us not to, we may contact you via email in the future to tell you about specials, new products or services, or changes to this privacy policy.

Your Access to and Control Over Information
You may opt out of any future contacts from us at any time. You can do the following at any time by contacting us via the email address or phone number given on our website:

• See what data we have about you, if any.
• Change/correct any data we have about you.
• Have us delete any data we have about you.
• Express any concern you have about our use of your data.

Security
We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline.

Wherever we collect sensitive information (such as credit card data), that information is encrypted and transmitted to us in a secure way. You can verify this by looking for a lock icon in the address bar and looking for “https” at the beginning of the address of the Web page.

While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to personally identifiable information. The computers/servers in which we store personally identifiable information are kept in a secure environment.

If you feel that we are not abiding by this privacy policy, you should contact us immediately via telephone at 703-542-3737 or via email info@loudounpsychiatriccare.com.

Terms and Conditions

CONDITIONS OF USE

Welcome to our online payment store! Loudoun Psychiatric Care and its associates provide their services to you subject to the following conditions. If you visit or shop within this website, you accept these conditions. Please read them carefully. ​

PRIVACY

Please review our Privacy Notice, which also governs your visit to our website, to understand our practices.

ELECTRONIC COMMUNICATIONS

When you visit Loudoun Psychiatric Care or send e-mails to us, you are communicating with us electronically. You consent to receive communications from us electronically. We will communicate with you by e-mail or by posting notices on this site. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

COPYRIGHT

All content included on this site, such as text, graphics, logos, button icons, images, audio clips, digital downloads, data compilations, and software, is the property of Loudoun Psychiatric Care or its content suppliers and protected by international copyright laws. The compilation of all content on this site is the exclusive property of MYCOMPANY, with copyright authorship for this collection by Loudoun Psychiatric Care, and protected by international copyright laws.

LICENSE AND SITE ACCESS

Loudoun Psychiatric Care grants you a limited license to access and make personal use of this site and not to download (other than page caching) or modify it, or any portion of it, except with express written consent of Loudoun Psychiatric Care. This license does not include any resale or commercial use of this site or its contents: any collection and use of any product listings, descriptions, or prices: any derivative use of this site or its contents: any downloading or copying of account information for the benefit of another merchant: or any use of data mining, robots, or similar data gathering and extraction tools. This site or any portion of this site may not be reproduced, duplicated, copied, sold, resold, visited, or otherwise exploited for any commercial purpose without express written consent of Loudoun Psychiatric Care. You may not frame or utilize framing techniques to enclose any trademark, logo, or other proprietary information (including images, text, page layout, or form) of Loudoun Psychiatric Care and our associates without express written consent. You may not use any meta tags or any other “hidden

text” utilizing Loudoun Psychiatric Care s name or trademarks without the express

REVIEWS, COMMENTS, EMAILS, AND OTHER CONTENT

Visitors may post reviews, comments, and other content: and submit suggestions, ideas, comments, questions, or other information, so long as the content is not illegal, obscene, threatening, defamatory, invasive of privacy, infringing of intellectual property rights, or otherwise injurious to third parties or objectionable and does not consist of or contain software viruses, political campaigning, commercial solicitation, chain letters, mass mailings, or any form of “spam.” You may not use a false e-mail address, impersonate any person or entity, or otherwise mislead as to the origin of a card or other content. MYCOMPANY reserves the right (but not the obligation) to remove or edit such content, but does not regularly review posted content. If you do post content or submit material, and unless we indicate otherwise, you grant MYCOMPANY and its associates a nonexclusive, royalty-free, perpetual, irrevocable, and fully sublicensable right to use, reproduce, modify, adapt, publish, translate, create derivative works from, distribute, and display such content throughout the world in any media. You grant MYCOMPANY and its associates and sublicensees the right to use the name that you submit in connection with such content, if they choose. You represent and warrant that you own or otherwise control all of the rights to the content that you post: that the content is accurate: that use of the content you supply does not violate this policy and will not cause injury to any person or entity: and that you will indemnify MYCOMPANY or its associates for all claims resulting from content you supply. MYCOMPANY has the right but not the obligation to monitor and edit or remove any activity or content. MYCOMPANY takes no responsibility and assumes no liability for any content posted by you or any third party.

RISK OF LOSS

APPLICABLE LAW

By visiting Loudoun Psychiatric Care, you agree that the laws of the state of Virginia, without regard to principles of conflict of laws, will govern these Conditions of Use and any dispute of any sort that might arise between you and Loudoun Psychiatric Care or its associates.

QUESTIONS:

Questions regarding our Conditions of Usage, Privacy Policy, or other policy related material can be directed to our support staff by clicking on the “Contact Us” link in the side menu. Or you can email us at: info@LoudounPsychiatricCare.com