CLINIC POLICIES

1) Insurance/Out of Network Policy

The providers at LouCouPsych do not accept or participate in any insurances and are considered "out of network" providers. This allows the providers to deliver the best and most appropriate care possible without the direction, demands, and limitations imposed by insurance companies. 

For those wishing to use their "out of network" benefits from their insurance companies, a Superbill can be provided at their request for their submission to their insurance company for potential reimbursement. 

While Dr. Mirza may be listed as "in-network" on some insurance lists, he is only "in-network" at his hospital-affiliated job; his work at LouCouPsych is separate and purely "out-of-network". 

2) Payments

Payment is due at the time of appointment and is accepted via cash or credit card (including debit and HSA/FSA cards), and checks only for established patients. Card payments will be taken via Clover, or can be kept on file via our secure electronic medical record system. For patients and clients who are not coming into the office and are being seen via telehealth, a credit card is required to be saved and kept on file either before starting sessions during registration or at the initial session, and will be charged at the end of each session.

 

3) Appointment Deposit

For patients of Dr. Mirza, a 50% appointment deposit fee for new patient evaluations is due at the time of booking. Dr. Mirza is currently available for 10 hours a week at his clinic, which results in a limited number of intake appointment slots available with recently, at least a month long wait list to be seen. Unfortunately, there have been a number of individuals who have missed their intake appointment; this is not fair to our staff's time, and most importantly, to the patients who are not able to be seen due to the time being reserved. To ensure that the best care is able to be provided to all, this deposit has become required to hold an appointment.

 

4) Cancellation/Missed Appointments

Appointments are able to be cancelled with notification to the appropriate provider at least 24 hours before the booked session. Appointments that are called within 24 hours will be considered missed, and charged the appropriate missed appointment fee. For therapy appointments, the full fee will be charged for missed appointments, and for Dr. Mirza's patients, the missed appointment fee is the greater of $100 or 50% of the appointment fee. Exceptions to this are at provider discretion for emergencies or illness.

 

5) Controlled Substance Policy

For controlled substances, all prescriptions are sent electronically directly to the pharmacy in order to eliminate lost or misinterpreted prescriptions. Controlled substances are not allowed to be filled for more than 30 or 90 days at a time, depending on the specific medication. For certain prescriptions, there may be required or random urine drug screens to ensure adherence as well as to monitor for misuse, or per insurance company policy for coverage or approval. There are no "early fills" unless with appropriate documentation. If a controlled substance is lost or stolen, a police report is required in order to replace the prescription. Periodic checks will be made on the National Prescription Monitoring Program to ensure no duplication of services. If there are are any concerns for suspicious or potentially illegal activities involving controlled substances, including but not limited to diversion, abuse, or falsification of urine drug screen results, Dr. Mirza and LouCouPsych has the right to terminate the relationship at any time and refuse any further prescriptions. 

6) Automated Refills/Pharmacy Requests

Due to the nature of psychiatric medications, as well as the safety and protection of our patients and their family members, Dr. Mirza does not respond directly to pharmacy requests for refills on medications. Expectations are that refill requests come directly from the patient. Please utilize Klara (the widget in the bottom right of the page or via patient.klara.com) for refill requests or questions.