Policies

Regular follow-up appointments are an important part of ensuring your child receives consistent, high-quality care. Appointments are scheduled for up to 45 minutes depending on the complexity of your child's needs, and that time is reserved specifically for your family — so we ask that you do your best to arrive on time. If you are late, the appointment will conclude at the originally scheduled end time, or may need to be rescheduled so that your child's care isn't rushed.

If you miss an appointment or unexpectedly need to cancel, we'd love to hear from you within 30 days to get you back on the schedule. If we aren't able to reach you within 90 days of a missed or canceled appointment, we will assume you are receiving care elsewhere and will close your file accordingly. Please know that once discharged from the practice, we may not be able to re-enroll you in the future, so don't hesitate to reach out if life gets busy. We're always happy to help you find a time that works.

We know that life can be unpredictable, and we always do our best to accommodate your family. However, if you arrive 10 or more minutes late and there isn't enough time remaining to give your child the attention they deserve, we may need to reschedule so that the appointment doesn't feel rushed. If you're running behind, please give us a heads up. Even a quick text goes a long way and allows us to plan accordingly.

We understand that cancellations are sometimes unavoidable. When you need to cancel, we ask that you let us know as soon as possible so we can offer that time to another family in need. Repeated cancellations or missed appointments make it difficult to provide the consistent care your child deserves, and in those cases we may need to have a conversation about how to best move forward.

As a courtesy, we offer appointment reminders by text and email for families who provide their contact information. While we're happy to send these, please keep in mind that the responsibility for tracking and attending appointments remains with your family. We're always happy to help you find a time that works if your schedule changes.

Email and text are a convenient way to stay in touch for everyday questions, and we're glad to offer that access to our families. Because these channels aren't fully secure, we ask that sensitive or complex clinical matters be discussed during appointments or through the secure patient portal instead. This helps us protect your family's privacy while keeping communication simple and accessible.

Refills are sent electronically to your pharmacy of choice. Please allow up to three business days for refill requests, and try to plan ahead so there's no interruption in your child's medication. If more than three months have passed since your last visit, a follow-up appointment may be required before a refill is sent.

As part of our approach to safe, thoughtful prescribing, we routinely review prescription history through available platforms, including state monitoring systems.

Controlled substance medications require a few additional steps that we want you to be aware of. Patients or their legal guardians are required to sign Silverwing's Controlled Substances Treatment Agreement before these medications can be prescribed, and the agreement is renewed each year. If the agreement is not signed, we will adjust the treatment plan to explore non-controlled alternatives.

Nevada law requires us to check the Nevada Board of Pharmacy's prescription monitoring profile for all patients receiving controlled substances. This is a routine step we take to keep your child safe. An in-person visit is also required before starting any new controlled medication or receiving a refill. Drug, alcohol, or pregnancy testing may occasionally be necessary as well. We appreciate your understanding of these requirements and are always happy to answer any questions you may have.

Most medications are covered by insurance, but some brand name or higher-cost medications require prior authorization before your insurance will approve them. When this happens, we will advocate on your behalf by submitting medical justification to your insurance company. While we cannot guarantee coverage, please know that we will do everything we can to support access to the medications your child needs.

Silverwing Psychiatry is a concierge practice and is not in-network with any insurance panels, including Medicare. For families with PPO plans, we are considered an out-of-network provider. While we are not able to submit claims or negotiate directly with insurance companies, we are happy to provide you with a detailed superbill — the documentation your insurance company needs to process a potential reimbursement claim on your behalf. Please be aware that reimbursement is not guaranteed and will depend on your individual plan, but we want to make the process as easy as possible for your family. If you have questions about what to expect, we encourage you to contact your insurance provider directly before your first appointment.

Privacy and discretion are something we take seriously for every family in our practice. We ask that patients and families extend the same respect to others they may encounter here. Outside of the clinic, our staff will always follow your lead. We won't acknowledge you in public unless you acknowledge us first out of respect for your confidentiality.

Everything discussed in your appointments is confidential, and we take that responsibility seriously. We will never share information about your care without your explicit permission, with a few exceptions required by law that we want you to be aware of.

As mandated reporters, we are legally required to notify the appropriate authorities if we have reasonable concern about the abuse or neglect of a child, disabled person, or elderly person. We are also required to report if we believe someone is in imminent danger of harming themselves or others. Disclosure may also be required in cases of grave disability or in response to legal proceedings.

From time to time, we may consult with other medical professionals in the interest of providing the best possible care. When this happens, no identifying information about you or your child is ever shared.

Finally, if another person, such as a family member or friend, is helping to cover the cost of care, please know that they will not receive any information about your treatment without your explicit written consent.

Silverwing Psychiatry is focused on providing the highest quality clinical care for your child and family. As such, we are not able to provide disability evaluations, worker's compensation evaluations, forensic evaluations, legal services, or legal testimony. Should legal testimony become necessary during your time with us, you may need to work with an independent forensic psychiatrist. We are always happy to help connect you with the right resources.

HIPAA Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Our Obligations

We are required by law to: 

• Maintain the privacy of protected health information 

• Give you the notice of your legal duties and privacy practices regarding health information about you 

• Follow the terms of our notice that is currently in effect 

How We May Use and Disclose Health Information 

Described as follows are the ways we may use and disclose health information that identifies you (“Health Information”). Except for the following purposes, we will use and disclose health information only with your written permission. You may revoke such permissions at any time by writing to our practiceʼs privacy officer. 

Treatment

We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care. 

Payment

We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company, or a third party for treatment and services you receive. For example, we may give your health plan information so that they will pay for your treatment. 

Health Care Operations

We may use and disclose Health Information for health care operation purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care to operate and manage our office. For example, we may use and disclose information to make sure the psychiatric care you receive is of the highest quality. We also may share information with our entities that have a relationship with you (for example, your health plan) for their health care operation activities. 

Appointment Reminders, Treatment Alternatives, and Health Related Benefits and Services

We may use and disclose Health Information to contact you and remind you that you have an appointment with us. We also may use and disclose Health Information to tell you about treatment alternatives or health related benefits and services that may be of interest to you. 

Individuals Involved in Your Care or Payment for Your Care

When appropriate, we may share Health Information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort. 

Research

Under certain circumstances, we may use and disclose Health Information for research. For example, a research project may involve comparing the health of patients who receive one treatment to those who receive another for the same condition. Before we use or disclose Health Information for research, the project will go through a special approval process. Even without special approval, we may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes.

Special Situations

As Required By Law

We will disclose Health Information when required to do so by international, federal, state, or local law. 

To Avert a Serious Threat to Health of Safety

We will disclose Health Information when necessary to prevent a serious threat to your health and safety or the public or another person. Disclosure, however, will be made only to someone who may be able to help provide treatment. 

Business Associates

We may disclose Health Information to our business associates that perform functions on our behalf or to provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than that as specific in our contract. 

Organ and Tissue Donation

If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking, or transportation of organs, eyes, or tissues to facilitate organ, eye, or tissue donation and transplantation. 

Military and Veterans 

If you are a member of the army forces, we may use or release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military. 

Workerʼs Compensation

We may release Health Information for workerʼs compensation or similar programs. These programs provide benefits for work-related injuries or illness. 

Public Health Risks 

We may disclose Health Information for public health activities. These activities generally include disclosure to prevent or control disease, injury, or disability; report child abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; inform a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and report to the appropriate government authority if we believe a patient has been a victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required by law. 

Health Oversight Activities

We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes 

If you are involved in a lawsuit of a dispute, we may disclose Health Information in response to a court or a court administrator order. We also may disclose Health Information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. 

Law Enforcement

We may release Health Information if asked by a law enforcement official if the information is: (1) in response to a court order, subpoena, warrant, summons, or similar process; (2) limited information to identify or locate a suspect, fugitive, material witness, or missing person; (3) about the victim of crime even if, under certain circumstances, we are unable to obtain the personʼs agreement; (4) about a death we believe may be the result of criminal conduct; (5) about criminal conduct on our premises and; (6) in an emergency to report a crime to the location of the crime if victims, or the identity, description, or location of the person who committed the crime. 

Coroners, Medical Examiners, Funeral Directors

We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release Health Information to funeral directors as necessary for their duties. 

National Security and Intelligence Activities 

We may release Health Information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations. 

Protective Services and Intelligence Activities

We may release Health Information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.

Inmates or Individuals in Custody 

If you are an inmate of a correctional institution or other custody of a law enforcement official, we may release Health Information to the correctional institution or law enforcement official. This release would be made if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others, or; (3) for the safety and security of the correctional institution. 

Your Rights

You have the following rights regarding Health Information we have about you: 

Right to Inspect and Copy

You have the right to inspect and copy Health Information that we may used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this information, you must make your request in writing to our Privacy Officer. 

Right to Amend

If you feel that Health Information we have is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our office. To request an amendment, you must make your request in writing, to our Privacy Officer. 

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures we made of Health Information for purposes other than treatment, payment, and health care operations or for which you provided written authorization. To request an accounting of disclosures, you must make your request, in writing, to our Privacy Officer.

Right to Request Restrictions

You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operation. You also have a right to request a limit on the Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. For example, you can ask that we not share information about your particular diagnosis or treatment with your spouse. To request a restriction, you must make your request in writing to our Privacy Officer. We are not required to agree with your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment. 

Right to Request Confidential Communication

You have the right to request that we communicate with you about your medical matters in a certain way or at a certain location. For example, you can ask that we contact you only by mail or at work. To request confidential communications, you must make your request in writing to our Privacy Officer. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests. 

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice. You must ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice by contacting our office. 

Changes to This Notice

We reserve the right to change this notice and make the new notice apply to Health Information we already have as well as any information we receive in the future. We will post a current copy of our notice at our office. The notice will contain the effective date on the first page, in the top right hand corner. 

Complaints

If you believe your privacy has been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. To file a complaint with our office, contact our Privacy Officer. All complaints must be made in writing. You will not be penalized for filing a complaint.