Practice Policies

Policies

Please review the following policies before your first appointment. Questions? Call us at 760-525-3111.

Payment Policies and Procedures

Effective date: 9/1/25

Amanda J Gretsch, Inc. (AJG) is considered an out-of-network provider for all insurance companies. Payment is due at the time of treatment.

As an out-of-network provider, some insurance companies will reimburse you for a portion of the fees paid for occupational therapy services. It is highly recommended that if you are seeking reimbursement from your insurance company that you call to verify your benefits. Please be aware that policies change from time to time, so it is strongly advised that you call them periodically while receiving treatment.

For patients who have out-of-network coverage, there are two options after payment:

You can be provided with a Superbill (invoice that contains all necessary insurance codes) and these invoices can then be submitted to your insurance company, if you choose.
You can provide us with your insurance information and our medical biller will directly submit your bills to your insurance company.

Please be aware that to avoid a fee when requesting that AJG rebill invoices due to insurance company requirements, AJG must be made aware within two months of the date of the invoice.

What are the Benefits of Private Pay?

Insurance companies require a diagnosis and often have policies regarding reimbursement that restrict the type, length, frequency, and duration of services. We have found that without the limitations and restraints placed by insurance providers, patients are able to avail themselves of the most up-to-date, evidence-based interventions for a duration that helps maximize outcomes. Finally, if confidentiality is a concern, the information will not become part of an individual's permanent medical file.

Payment Options

1. Cash or Check

We are happy to accept payment by cash or check at the time of the appointment. However, if you wish to schedule ongoing therapy sessions, you will be required to keep a valid credit card on file. The credit card will not be charged unless there is a no-show/late cancellation or if the patient chooses to use it to pay for treatment.

2. Credit Cards

For your convenience, we accept payment via Visa, MasterCard, and American Express. All information is maintained securely through our electronic medical records (EMR), scheduling, and billing system.

3. Health Savings Account (HSA) or Flexible Spending Account (FSA)

Via issued HSA or FSA credit card (this allows for services to be paid using pre-tax dollars). Please be aware that patients will also need to keep a credit card on file in the event that there are insufficient funds in the HSA or FSA account.

Cancellation Policy

AJG strives to provide you with the best, most consistent care possible. Scheduling is often consistent in nature with standing appointments on an ongoing basis. Attending these appointments is an essential part of treatment and patient management.

With the exception of illness, a minimum of 24 hours notice before the scheduled appointment is required for any cancellation or change (please note that if your appointment is on a Monday, the 24 hours excludes the weekend). If you do not cancel your appointment at 760-525-3111 within 24 hours, you will be charged a late cancellation/no-show fee of $225.00.

Good Faith Estimate Notice

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost. Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have a right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.

HIPAA Notice of Privacy Practices

Purpose of this Notice

We are required by law to maintain the privacy of your protected health information (PHI). This notice applies to all records of the health care and services you received by Amanda J. Gretsch, Inc. (AJG). This notice will tell you about the ways in which we may use and disclose your PHI.

AJG's Commitment

We are required by law to: (1) keep your PHI private; (2) give you this notice; (3) follow the terms of this notice; (4) train our personnel concerning privacy and confidentiality; and (5) mitigate any breach of privacy/confidentiality.

How We May Use and Disclose Information about You

For Treatment

We may use and disclose your PHI to personnel involved in your care at AJG, or to health care providers outside AJG who may be involved in your medical care.

For Payment

We may use and disclose your PHI so that treatment and services may be billed to your insurance company or a third party.

For Health Care Operations

We may use and disclose your PHI for our business operations, including quality review and staff performance evaluation.

As Required by Law

We will disclose your PHI when required to do so by federal, state, or local law.

Appointment Reminders

We may use and disclose medical information to contact you as a reminder that you have an appointment.

Your Rights

·Right to Request Restrictions on use/disclosure of your PHI
·Right to Request Confidential Communications
·Right to Inspect and Receive a Copy of your PHI
·Right to Amend your PHI if you believe it is incorrect or incomplete
·Right to an Accounting of Disclosures made in the past 6 years
·Right to a Paper Copy of This Notice at any time

For any privacy-related requests, contact: Amanda J. Gretsch, Inc., 543 Encinitas Blvd., Ste. 114, Encinitas, CA 92024 · 760-525-3111

We reserve the right to change this notice. Changes will be effective for medical information we already have about you as well as any information we receive in the future.

Questions about our policies?

We're happy to clarify anything before your first visit.

760-525-3111 amandajaneotr@yahoo.com