Office Policies & Patient Responsibilities

Appointment Policies

Scheduling & Attendance:

  1. Once you schedule an appointment, it is your responsibility to attend on time.

  2. If you arrive 10 or more minutes late, you may not be seen and will be subject to a no-show fee.

  3. Repeated missed or late appointments may result in discharge from the practice.

  4. Cancellations & Rescheduling:

  5. Appointments may be canceled or rescheduled at least 48 hours in advance by calling our office.

  6. Last-minute rescheduling (less than 48 hours before your appointment) may result in a rescheduling fee.

  7. No-Shows & Multiple Cancellations:

  8. A "no-show" is defined as missing a scheduled appointment without canceling in advance.

  9. Multiple no-shows (2 or more) may result in discharge from the practice.

Medical & Prescription Policies

  • Medication Refills & Prior Authorizations:

  • Prescriptions are sent electronically to your preferred pharmacy.

  • Refills require at least 48 hours' notice and must be requested through your patient portal or by phone.

  • If you miss or no-show your follow-up appointment, a refill fee may apply.

  • Controlled substances: Initial evaluations for controlled substances require an in-person appointment.

  • Pharmacy Policy:

  • You must provide your preferred pharmacy during your initial visit.

  • One free pharmacy change is allowed per year. Additional pharmacy changes will incur a fee.

Emergency & After-Hours Care

  • During business hours: Call 240-669-7496 to request an emergency appointment.

  • After-hours emergencies: Call 911 or visit the nearest emergency room.

  • Crisis Resources:

  • Montgomery County Mobile Crisis Team: 240-777-4000

  • Washington, DC Helpline: 1-888-7WE-HELP (1-888-793-4357)

Confidentiality & Privacy

DMV Medical Group will only release confidential information under the following conditions:

  1. With written consent from the patient.

  2. If there is a clear and immediate danger to the patient or others.

  3. By court order.

  4. In cases of suspected abuse or neglect of a child under 18.

  5. To insurance companies for necessary treatment verification.

Physician Contact & Coordination of Care

  • If medical symptoms affect your psychological well-being, we encourage consultation with a medical provider.

  • We may coordinate care with your primary physician with your permission.

Patient Rights & Responsibilities

  1. Freedom to Withdraw from Treatment:

  2. You may discontinue therapy or medication management at any time.

  3. DMV Medical Group reserves the right to discharge patients for multiple missed/canceled appointments or failure to adhere to treatment plans.

  4. Testimonials & Reviews:

  5. If you voluntarily leave a testimonial or review online, it may be shared on Google, Kareo, Tebra, or other social media platforms.

  6. Any personal information you disclose is not protected once posted publicly.

  7. Notice of Privacy Policies:

  8. You have received a copy of our Notice of Privacy Policies before signing this agreement.

  9. You have the right to revoke consent in writing at any time.

  10. Advance Directives for Mental Health Treatment:

  11. Maryland law allows you to establish an Advance Directive for mental health treatment, which outlines your treatment preferences and designates a healthcare agent.

  12. Contact our office if you would like a copy of this directive.

Financial Policies & Fees

Payment Responsibilities

  • Payment is due at the time of service, including co-pays, deductibles, and co-insurance.

  • DMV Medical Group requires a credit/debit card on file in our EHR system and in our third-party billing system (Headway).

  • If a card is not on file the day before your appointment, DMV Medical Group reserves the right to cancel your appointment without notice.

Fee Schedule:

Service Fees:

  • Initial Therapy Session $300

  • Medication Management $225

  • Talk Therapy $250

  • Medication Management + Talk Therapy $375

Cancellation & No-Show Fees:

Policy Violation Fees:

  • Late Cancellation (<48 hours) $200

  • Rescheduling (<48 hours) $200

  • No-Show for Any Appointment $200

  • No-Show for Initial Appointment $300

  • Two or More No-Shows May result in discharge

Additional Service Fees:

Service Fees:

  • Form Completion (Case-by-Case) $175

  • Medication Refill Without Appointment $200

  • Additional Pharmacy Change $75

Policy Agreement

I understand that DMV Medical Group, LLC has reserved my appointment in consideration of my promise to abide by the policies above.

By signing below, I authorize DMV Medical Group and its affiliates to charge my card on file for:

  1. Any co-pay, deductible, or self-pay amount on the day of my appointment.

  2. Any no-show or late cancellation fees as outlined above.

  3. Any additional service fees I incur.

I acknowledge that if my insurance denies payment for Telemedicine/Teletherapy, I will be responsible for the full payment.