Policies and Procedures

Policies & Procedures

Payment Policy

Payment for services is due at the time services are rendered. Payments can be made via credit card. If your insurance company denies coverage or payment, you are financially responsible for the visit fee. Clients with unpaid balances will not be scheduled for additional appointments until the balance is paid in full. Outstanding balances after 60 days will be sent to collection.

Refunds and Cancellations

Please remember to cancel or reschedule twenty-four (24) hours in advance. If cancelling with less than 24 hours notice, there is a fee up to the cost of the missed appointment. We will process the card on file for the fee. You will be responsible for the entire fee if cancellation is less than 24 hours. If cancelling with 24 hours or more notice, there will be no charge for the missed appointment. If you are late for a session, you may lose some of the reserved session time.

Termination of Partnership

Chelsea Johnson Nutrition, LLC reserves the right to terminate partnership with clients for any reason legally or ethically. Partnerships will not be terminated without discussion prior to termination.

HIPPA Notice of Privacy Practices

Notice of Privacy Practices

Chelsea Johnson Nutrition, LLC is committed to protecting your health information. Chelsea Johnson Nutrition, LLC is required by law to make sure your protected health information is kept private under the Health Insurance Portability and Accountability Act of 1998.

I hereby authorize Chelsea Johnson Nutrition, LLC to release information for the purposes outlined in this privacy policy statement and release Chelsea Johnson Nutrition, LLC from any liability which may arise as a result of the use of the information contained in the copy of records released. I also authorize Chelsea Johnson Nutrition, LLC to obtain my protected health information from other providers and/or services, including my medication history.

We are required by applicable federal and state law to maintain the privacy of your health information. We may use and disclose your health information for the purposes of providing services and quality care. For the avoidance of doubt, providing treatment services, collecting payment and conducting healthcare operations are all necessary activities for quality care. State and federal laws allow us to use and disclose your health information for these purposes. For uses and disclosures for purposes other than treatment, payment and operations, we are required to have your written authorization, unless the use or disclosure falls within an exception, such as those described below. Most uses and disclosures of medical nutrition therapy notes (as that term is defined in the HIPAA Privacy Rule), uses and disclosures for marketing purposes, and disclosures that constitute the sale of Personal Information require your authorization. Authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we may have already taken any action in reliance on your authorization. Disclosures can be made without an authorization in the following circumstances: emergencies, judicial and administrative proceedings, child/elder abuse or neglect, criminal activity or danger to others, health oversight reviews, business associate functions, research, general marketing, and scheduling appointments. Individual Rights are stated below.

Right to Inspect and Copy. You have the right to look at or get copies of your health information, with limited exceptions. Your request must be in writing. If you request a copy of the information, a reasonable charge may be made for the costs incurred.

Right to Amend. You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We have the right to deny your request under certain circumstances.

Right to an Accounting of Disclosures. You have the right to receive a list of instances in which we have disclosed your health information for a purpose other than treatment, payment, or health care operations. To request an accounting of disclosures, you must submit your request in writing to the Privacy Officer. Such accountings remain available for six years after the last date of service at the Practice.

Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you. For example, you could ask that we not share information with an insurance company, in which case you would be responsible to pay in full for the services provided. While you are in treatment, a written request should be made with your provider. We are not required to agree to your request, but we will consider the request very seriously.

Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. You must make this request in writing and it must specify the alternative means or location that you would like us to use to provide you information about your health care. We will make every attempt to accommodate reasonable requests.

Right to File Complaints. You may complain to us and to the Secretary of Health and Human Services if you believe your privacy rights have been violated.

Email and Text Messaging Use. As a client of Chelsea Johnson Nutrition, LLC, we may communicate with you over email or text message. This is to promote convenience, but for urgent or an emergency situation, you should not rely on email or text message communication with providers affiliated with Chelsea Johnson Nutrition, LLC. In those situations, you should call 911. Email messages on your computer, laptop, or other device have inherent privacy and security risks, and you should be aware of those before seeing a provider affiliated with Chelsea Johnson Nutrition, LLC. Your email or text message is not a private communication between you and your treating provider. At your health care provider’s discretion, your email or text message any and all responses may become part of your medical record. Please know that any information submitted via email or over the internet cannot be guaranteed as protected. You are sending this information at your own risk. If you are not comfortable with this policy, please communicate with me by phone, regular mail, in person, or through our HIPPA secure platform.

Telemedicine Informed Consent

I hereby authorize Chelsea Johnson Nutrition, LLC to use Telemedicine in the course of my diagnosis and treatment.

Nature of Telemedicine: Telemedicine provides nutrition counseling and/or medical nutrition therapy services using interactive audio, video and/or text conferencing tools in which the practitioner and the client are not at the same location. Telemedicine will allow the client to receive care without the need to visit the office.

Medical Records: All existing laws regarding access to medical information and disseminating medical records apply to care via Telemedicine.

Provider Choice of Care: The use of Telemedicine is determined by Chelsea Johnson Nutrition, LLC.

Rights: You have the right to withhold or withdraw consent to the use of Telemedicine at any time during the course of care in writing. Chelsea Johnson Nutrition, LLC cannot guarantee availability of face-to-face sessions.

Confidentiality: Reasonable and appropriate efforts have been made to eliminate any confidentiality risks associated with Telemedicine. All confidentiality protections that exist under federal law apply to information disclosed during Telemedicine sessions.

Potential Risks: Potential risks include, but may not be limited to: information transmitted may not be sufficient (poor resolution of audio and/or video): delays in medical evaluation and treatment due to deficiencies or failure of the equipment; security protocols can fail, causing a breach of privacy; and lack of access to all the information available in a face-to-face visit may result in errors in medical judgment.

Questions & Concerns

Please contact Chelsea Johnson, RDN with any questions or concerns at chelseaj@chelseajnutrition.com.