Policy and Disclaimers

Kameron Health PLLC does not discriminate on the basis of religion, race, gender, marital status, age, sexual orientation, national origin, previous incarceration, or disability or public assistance status.

Every client:
• Shall be informed prior to or at the time of the intake appointment of the services available at Kameron Health PLLC and of any payments that will be required if not covered by the client’s health insurance.
• Can expect complete and current information concerning your diagnosis and treatment plan.
• Can expect courteous and respectful treatment.
• Has the right to be informed of, and to refuse to participate in, any experimental research.
• May assert the client rights without retaliation.

In addition to the rights listed above, clients utilizing services offered by practitioners licensed by the State of Texas have the right to:
(a) expect that a practitioner has met the minimal qualifications of training and has the experience required by state law
(b) examine public records which contain the credentials of the practitioner
(c) obtain a copy of the rules of conduct.
Danielle Fortingo, MSN, FNP-C, PMHNP-BC is at this time the sole practitioner at Kameron Health PLLC. Danielle is Board-certified as both Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner licensed to practice in the state of Texas, Maryland and Colorado. She has a collaborative practice agreement with Dr. Kevin Tomsic, and may consult with him about your care.

Health Insurance Procedure

Kameron Health PLLC now accepts United Health, Blue Cross Blue Shield of Texas, Aetna, and Superior Health insurance plans. If we are in-network with your insurance company, as a courtesy to you, we will work directly with them in an effort to collect the reimbursement allowed by your benefits. It is important that you understand your benefit coverage. For benefit coverage questions, please call the customer/member service phone number on the back of your insurance card. Although we can assist you, ultimately it is your responsibility, prior to your first appointment, to verify your plan’s limitations, deductibles and exclusions and to obtain updates as required. We will make all attempts to verify your insurance benefit coverage and obtain any necessary authorizations for you. Verification of benefit coverage is not a guarantee of claim payment. All benefits are subject to the terms and conditions outlined in your contract with your insurance company. We have no authority to make representations to you regarding coverage of items or services covered.

In compliance with health insurance contracts, Kameron Health PLLC requires that all co-payments be collected at the time of service. This includes payments towards coinsurance and deductibles. In some cases, the coinsurance/deductible amount collected will be an estimate, and adjustments will be made once a response is received from your insurance company regarding the claim. This may result in a credit to your account or additional charges. We do not have the option to waive co-payments, deductibles or coinsurance amounts due as that would be a violation of the contract, we have with the insurance company.

It is your responsibility to pay the full fee for services at the time they are rendered unless the Kameron Health PLLC is in-network with your insurance plan. Please provide your insurance card at your initial appointment so that we may keep a copy in your record in accordance with our contract with the insurance company. It is your responsibility to provide us with updated information if your insurance company or plan changes or your coverage terminates. It is also your responsibility to notify us of any changes in address or other contact information. If the insurance information you provide to us is later determined to be inaccurate resulting in a denial of your claim, you will be responsible to pay the amount denied by your carrier. It is your responsibility to pay any charges not eligible and/or not covered by your insurance plan.

If you discontinue care for any reason, all balances will become immediately due and payable in full by you, regardless of any claim submitted. You will receive an Explanation of Benefits (EOB) from your insurance company detailing charges, amounts you are responsible for, and amounts they have paid. We do not automatically send billing statements when there is an amount due. Should you need a statement or payment itemization, please request it.

Treatment Policies

Kameron Health PLLC is a private practice of Danielle Fortingo, MSN, APRN, FNP-C, PMHNP-BC and the sole provider. Danielle provides medical and psychiatric diagnosis, medication management and, if openings are available, may also offer individual psychotherapy sessions.

The initial treatment sessions will involve an evaluation of your needs. The goal of this initial assessment is to provide you with some first impressions of what our work will include and a suggested treatment plan. Medication and counseling can have both benefits and risks. While benefits are expected from the treatment process, specific results cannot be guaranteed.

Adolescents & Parents: Danielle Fortingo is licensed to treat children and adolescents. Adolescents have the right to independently consent to and receive mental health treatment without parental consent, and in that situation information about the treatment cannot be disclosed to anyone without the teenager’s agreement. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is also essential to successful treatment and requires that some private information be shared with parents. It is our policy to request a verbal agreement between our underage client and their parents allowing us to share general information about the progress of treatment and their attendance at scheduled sessions. Any other communication will require the adolescent’s authorization, unless we feel that they are in danger or are a danger to or are a danger to someone else, in which case we will notify the parents of our concern. Before giving parents any information, we will discuss the matter with the teenager, if possible, and do our best to address any objections they may have.

Referrals: In cases where a referral to another provider is needed, the client will be responsible for contacting suggested providers and evaluating the alternatives.

Appointments and No-show Policies

Successful treatment requires a commitment on the part of the client. It is important that you keep each appointment if possible. All appointments are via Telehealth.

We realize that, on occasion, you may not be able to make a scheduled appointment. If you need to cancel or reschedule an appointment, please notify us via phone (leaving a voicemail) at least 48 hours prior to your scheduled appointment. Please remember that your appointment time has been reserved for you alone. A missed or late cancelled appointment will be considered a “no-show.” It is our policy to charge $40 for each no-show for a medication management appointment. The no-show charge for psychotherapy appointments is $40 for the first and$80 for each thereafter. Clients who have three (3) or more no-shows may be referred elsewhere for services and discharged from Kameron Health PLLC.

Communications Policies

Please be aware that email is not a secure form of communication and confidentiality cannot be guaranteed. Use of email for communication is therefore strongly discouraged. Danielle Forting usually does not respond to emails. Clients are encouraged to use the Patient Portal to send messages and/or requests for appointments or changes of appointments. Please ask for instructions on how to sign on to and use Patient Portal. If you prefer to not use Patient Portal, we request you call and leave a message. If using personal emails, you agree to accept the risk of a breach in confidentiality and will not hold Kameron Health PLLC liable.

Electronic or written communications are NOT to be used to communicate:
• Suicidal or homicidal thoughts or plans
• Urgent or emergency issues
• Serious or severe side effects or concerns
• Rapidly worsening symptoms
In a life-threatening emergency, clients need to call 911 or proceed to the nearest hospital emergency room.

Returning Phone Calls:

Kameron Health PLLC is operated solely by Danielle Fortingo, MSN, APRN, FNP-C, PMHNP-BC and therefore there will be times that no one is able to answer the phone. Please leave a message. Routine calls will be answered typically within 2 business days. Established clients will also have access to an on-call line for urgent issues; e.g., problems with side effects or increases in symptoms that are not life-threatening or emergency situations. Urgent calls will typically be returned within 6 hours.

Medications:

For medication refills, have your pharmacy fax a refill request form to 972-433-5038. Please note that at this private practice, as in many others, Danielle Fortingo, MSN, APRN, FNP-C, PMHNP-BC is not in the office every day. Please allow sufficient time for her to receive and respond to your message. If you personally leave a refill request via phone message, please specify the medication name, dose, and the name and phone number of the pharmacy of your choice. Medication refills may take 3 business days from the day the request is received. Please request refills at least 1 week prior to running out of medications. Medication Prior-Authorizations may require 5-7 business days. There is a $15 replacement fee for lost prescriptions or replacement prescriptions. Lost prescriptions for federally controlled medications are typically not replaced and require the client to contact the office to discuss treatment options.

*We only authorize one-time medication refills. Patients are required to make it to their monthly appointment to get medications refilled to evaluate medication compliant.

After Hours Emergencies

For after-hours medical emergencies or if you need immediate assistance, call 911 or visit your local emergency room

Medical Records, Forms and Documents

All information within your medical record is confidential and will typically not be released without your written consent except as required to assure coordination of your care. Requests for medical records must be given in writing. Please allow up to 5 business days for transfer of medical records. If there is a request for printed copies, a fee up to $10 may be charged. If you request a letter, forms, or reports related to your care, please understand that preparation of these documents requires time for chart review and often a discussion with the client. There is a charge for these services: $25 for each of the first 3 pages and $15 each additional page. Please allow 5 business days for letters and other documents to be completed.