Description
The Mental Health Professionals Legal Package is designed for mental health professionals starting their own practice and includes 30 legal documents:
– Insurance Registration Form with assignment – insurance only
– Notice of Privacy Practices and HIPAA Consent Form – Mental health – This Notice (and consent) are required by State and Federal laws to clearly communicate how you will protect your patient’s protected health information. As a Healthcare Professional, there are noted exceptions to absolute patient privacy, which are clearly explained to the patient in this notice.
– Patient Information and Consent – This is the agreement that you give a patient/client to review and sign in order to govern your relationship as a professional with the patient/client. This protects you as a professional and establishes clear boundaries for communications, including using distance therapy, or “telemedicine”. Topics include:
- Mental Health Services
- Appointments
- Number of Visits
- Length of Visits
- Groups
- Relationship
- Goals, Purposes, and Techniques of Therapy
- Cancellations
- Payment for Services
- Confidentiality
- Duty to Warn
- Mandated Reporting
- Contact Information
- Risks of Therapy
- After-Hours Emergencies
- Contacting Your Healthcare Professional
- E-Mail and Text Messages
- Social Media
- Healthcare Professional’s Incapacity or Death
- Marital or Joint Therapy
- Audio and Video Recordings
- Defamation
- Cooperation of Client
- Distance Therapy
- Identity Verification
- Privacy and Security of Communications
- Risks Associated With Distance Therapy
- Communication Interruptions
- Consent to Treatment Using Distance Therapy
- Conflicts of Interest
- Legal
- Consent to Treatment
- Parental Waiver of Right to Child’s Records [If children are involved]
– Patient-Election-to-Self-Pay – This is how the patient can legally opt to not use their provider insurance coverage and pay you directly. Included is a revocation form for if the client chooses to remove this payment option
– Payment Authorization Form – This is a Payment Authorization Form, which allows you to hold patient payment information on file in order to charge for services rendered, or any other legal debts such as no-shows or missed appointments.
– No Surprises Act (for MN)
– Telehealth Consent Form
– Clinical Supervision Plan – Business to Supervisor Contract
– Clinical Supervision Plan – Supervisor to Supervisee
– Business Associate Agreement – [Blank] – Admin staff or Non-healthcare personnel or third parties – This agreement is required by law if you are going to partner with other businesses or professionals and share protected health information. These agreements are most commonly used for working with (1) an attorney (to protect yourself and confirm you are doing the right thing without unauthorized releases of your patient/client’s information) or (2) Billing, insurance, marketing and scheduling businesses, software or staff.
– Determination of Worker Status for Purposes of Federal Employment Taxes and Income Tax Withholding FSS8
– Independent Contractor Agreement Administrative Staff only – This Agreement is used to hire Independent Contractors to help you with scheduling, marketing, billing and routine office tasks, generally used in conjunction with a Business Associate Agreement so you can focus on what makes your practice the most money: behavioral health services. There are unique fee splitting and ethical rules involved when you hire an independent contractor in the healthcare space.
– Mental Heath Practitioner Independent Contractor Agreement with Business Associate Agreement -This Agreement is used to hire Independent Contractors to help you with scheduling, marketing, billing and routine office tasks, generally used in conjunction with a Business Associate Agreement so you can focus on what makes your practice the most money: behavioral health services. There are unique fee splitting and ethical rules involved when you hire an independent contractor in the healthcare space.
– New Independent Contractor Hire Checklist
– Unlicensed Mental Heath Practitioner Independent Contractor Agreement with Business Associate Agreement – This Agreement is used to hire Independent Contractors to help you with scheduling, marketing, billing and routine office tasks, generally used in conjunction with a Business Associate Agreement so you can focus on what makes your practice the most money: behavioral health services. There are unique fee splitting and ethical rules involved when you hire an independent contractor in the healthcare space.
– Client Information Amendment Form – Sometimes, your patient/client will need to change their information. This could be a minor change, such as a change of address, or a complete disagreement with your medical records/file. This can create tension (and legal issues) if not handled correctly. This form let’s you handle those amendments smoothly.
– HIPAA Policies-and-Procedures-
– HIPAA-Policies-and-Procedures-
– One Page authorization-for-disclosure-
– Website Terms of Use and Privacy Policy – Mental health services provider – This Agreement is placed on your website to indicate how you collect information about your visitors, it clearly outlines your Notice of Privacy Practices and Client Information form, as well as indicate that viewing the website does not create a doctor-patient relationship.
– Consent and Agreement for Psychological Testing and Evaluation
– Consent for Recording Sessions
– Couple Informed Consent Form – There are a few issues that need to be addressed when working with couples in therapy. This form addresses all of those issues and gets you on the same page with the couple so as to avoid any future tension and confusion.
– Disclaimers – website footer email and fax – This a Website Disclaimer and Email Signature Clause draft. The disclaimer goes at the bottom of your website to clarify that simply viewing the website information does not create a professional client relationship.
– Group Confidentiality – Group confidentiality agreement for health coaches is for group settings or events where it is important that all clients agree to keep what they hear confidential and also release the Company if another participant were to breach that confidentiality.
– Mental Health Services Termination Letter
– Professional-Will-Template – Professional Will Template designed to explain who is in charge of the transition of your patients and your practice in case of death. Not to be confused with your personal will or a succession or buy-sell agreement.
– Revocation-of-Patient-
– Safe Harbor Agreement
– Testimonial Intake Form – The Client Testimonial Consent and Release Form is designed to allow a Company to publish and use a client (or patient) testimonial on their website or for any/all marketing purposes through legal written consent.
