CNYCA Policies and Disclosures
By booking an appointment with CNY Community Acupuncture (CNYCA) you attest that you have read and agree to the following policies and disclosures (i-iv). A printed copy of these policies and disclosures can be obtained in-person at CNYCA or a copy can be emailed to you, such requests can be sent to CNYAcu@gmail.com. Any questions or concerns can also be addressed in-person or via email.
i. Financial and Cancellation Policy
CNY Community Acupuncture makes every attempt to make complimentary health care, as acupuncture and Chinese medicine, available to as many people as possible, at the most affordable rates. We have several policies in place that allow us to keep our costs lower so that we may keep our rates lower. By utilizing services administered by CNY Community Acupuncture and its staff you agree to and are bound by the the following financial and cancellation policy:
ii. Patient Advisory to Consult a Physician
In keeping with Article 160, Section 821 1.1 (b) of NYS Education law, and by seeking services from CNY Community Acupuncture and its staff it is affirmed that you understand the need to consult with your physician regarding the condition for which you are seeking acupuncture treatment. Acupuncture and Traditional Chinese Medicine play an important role as healthcare systems in modern integrative medicine. For integrative medicine to best serve your wellness needs, it is highly recommended that you make use of all tools that are available to you including those available through your biomedical physician.
iii. Informed Consent to Acupuncture Treatment
By seeking services from CNY Community Acupuncture and its staff you do voluntarily consent to acupuncture treatments with practitioners at CNY Community Acupuncture. You understand that the methods of treatment include but are not limited to acupuncture, heat therapies (infrared heat lamps, hot packs, etc.) and bodywork therapies. Possible side-effects of acupuncture can include bruising, itchiness or tingling at needling sites. You agree to inform your practitioner if you feel faint or dizzy during or after treatment. You agree to inform your practitioner if you are or may be pregnant. Because acupuncture uses techniques that penetrate the skin, there is a risk of infection at the needling site, this risk is extremely small as this facility uses best practices to ensure cleanliness including but not limited to using only single-use, surgically sterilized, disposable acupuncture needles. This list of possible effects is not all-inclusive and you agree to inform your practitioner immediately if you have any adverse reactions to treatment. Please understand that it is not possible for any practitioner to anticipate or explain all of the possible side effects or reactions to treatment.
iv. HIPPA Policy and Attestation
CNY Community Acupuncture and its staff is committed to protecting the privacy of individual health information in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the regulations promulgated there under. These policies and procedures apply to protected health information created, acquired, or maintained by CNY Community Acupuncture and its staff. We attest that we will never share any such protected health information without your prior written consent. Oftentimes, CNY Community Acupuncture staff works in concert with other providers to provide integrative holistic care. While sharing of any information that is written or electronic requires written consent, if you wish practitioners of CNYCA to discuss your case with your other providers, oral consent may be given. If you do not wish your case to be discussed with other practitioners, your request will be honored.
CNY Community Acupuncture makes every attempt to make complimentary health care, as acupuncture and Chinese medicine, available to as many people as possible, at the most affordable rates. We have several policies in place that allow us to keep our costs lower so that we may keep our rates lower. By utilizing services administered by CNY Community Acupuncture and its staff you agree to and are bound by the the following financial and cancellation policy:
- We require 24 hours notice, in advance of an appointment, to cancel or reschedule that appointment.
- All appointments that are missed without a call are deemed a “No Show/No Call” and will incur a $20 fee, payable at your next appointment.
- We understand that same day cancellations are sometimes unavoidable, however, on and after the second same-day cancellation there will be a $20 fee charged for a cancellation/reschedule with less than 24 hours notice. The fee will be payable at your next appointment.
- If you arrive late for your scheduled appointment, please be aware that you may be asked to reschedule or wait for the next available appointment that day. Because appointment slots, in most cases, are only 10 minutes, if you are even five minutes late we may not be able to honor your appointment time if it poses an inconvenience to others. It is best to always plan on arriving 5 minutes early to your appointment so that you have time to check in, pay and gather your items to get comfortable in your chair.
- If you are unable to pay for a service at the time of the service, a $20 fee will be charged, payable at your next appointment.
- We accept cash, checks and all major credit cards (including FSA and HSA cards) for payment. If a check is returned to us for any reason, you will be charged a $40 returned check fee, payable at your next appointment.
- We reserve the right to refuse personal checks as a form of payment at any time.
- We do not (and cannot – due to insurance company rules) bill insurance. But, we will give you a superbill at the time of payment which has all of the information you need to submit to your insurance company or FSA on your own for reimbursement.
ii. Patient Advisory to Consult a Physician
In keeping with Article 160, Section 821 1.1 (b) of NYS Education law, and by seeking services from CNY Community Acupuncture and its staff it is affirmed that you understand the need to consult with your physician regarding the condition for which you are seeking acupuncture treatment. Acupuncture and Traditional Chinese Medicine play an important role as healthcare systems in modern integrative medicine. For integrative medicine to best serve your wellness needs, it is highly recommended that you make use of all tools that are available to you including those available through your biomedical physician.
iii. Informed Consent to Acupuncture Treatment
By seeking services from CNY Community Acupuncture and its staff you do voluntarily consent to acupuncture treatments with practitioners at CNY Community Acupuncture. You understand that the methods of treatment include but are not limited to acupuncture, heat therapies (infrared heat lamps, hot packs, etc.) and bodywork therapies. Possible side-effects of acupuncture can include bruising, itchiness or tingling at needling sites. You agree to inform your practitioner if you feel faint or dizzy during or after treatment. You agree to inform your practitioner if you are or may be pregnant. Because acupuncture uses techniques that penetrate the skin, there is a risk of infection at the needling site, this risk is extremely small as this facility uses best practices to ensure cleanliness including but not limited to using only single-use, surgically sterilized, disposable acupuncture needles. This list of possible effects is not all-inclusive and you agree to inform your practitioner immediately if you have any adverse reactions to treatment. Please understand that it is not possible for any practitioner to anticipate or explain all of the possible side effects or reactions to treatment.
iv. HIPPA Policy and Attestation
CNY Community Acupuncture and its staff is committed to protecting the privacy of individual health information in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the regulations promulgated there under. These policies and procedures apply to protected health information created, acquired, or maintained by CNY Community Acupuncture and its staff. We attest that we will never share any such protected health information without your prior written consent. Oftentimes, CNY Community Acupuncture staff works in concert with other providers to provide integrative holistic care. While sharing of any information that is written or electronic requires written consent, if you wish practitioners of CNYCA to discuss your case with your other providers, oral consent may be given. If you do not wish your case to be discussed with other practitioners, your request will be honored.