Legal Notices & Disclosures
This page contains important legal and regulatory information regarding services provided by Jack Wilkinson, MD, PLLC. Please review carefully.
No Surprises Act (Good Faith Estimate)
Under the No Surprises Act, patients who are not using insurance or who are choosing not to use their insurance have the right to receive a Good Faith Estimate of expected charges for medical services.
You are entitled to receive a written estimate of the expected cost of services upon request or prior to scheduling care.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you have the right to dispute the bill.
You may request a Good Faith Estimate at any time before or during treatment.
For questions or more information, visit:
https://www.cms.gov/nosurprises
Out-of-Network Provider Disclosure
Dr. Wilkinson is an out-of-network provider and does not participate in any insurance plans.
Payment is due at the time of service.
A superbill can be provided upon request for submission to your insurance company for possible out-of-network reimbursement.
Reimbursement is not guaranteed and depends on your individual insurance plan.
Patients are encouraged to contact their insurance provider directly to understand their out-of-network benefits.
Emergency Services Disclaimer
This practice does not provide emergency or crisis services.
If you are experiencing a psychiatric emergency:
Call 911
Go to your nearest emergency room
Call or text 988 (Suicide & Crisis Lifeline)
For additional resources, please refer to the Emergency Resources section of this website.
HIPAA & Privacy Practices
Dr. Wilkinson is a covered entity under the Health Insurance Portability and Accountability Act (HIPAA) and complies with all applicable federal and state privacy laws.
A full Notice of Privacy Practices will be provided to patients upon initiation of care.
This website is not intended for the transmission of protected health information (PHI).
Email and website contact forms are not secure methods for sharing sensitive medical information.
For details on how information is handled through this website, please review the Privacy Policy.
Telehealth Disclosure
Telepsychiatry services may be offered to patients located in New York and California, where Dr. Wilkinson is licensed.
Telehealth services are subject to state regulations and professional standards.
By participating in telehealth, patients acknowledge potential limitations, including technical issues and reduced ability to perform physical examination.
New York State Disclosures
In accordance with New York State Office of the Professions requirements:
Dr. Wilkinson is licensed to practice medicine in the State of New York.
Information about physician licensure, including how to file a complaint, is available at:
https://www.op.nysed.gov/professions/physicians
Patients may also contact the New York State Department of Health for additional information regarding healthcare services.
California Disclosures
In accordance with Medical Board of California requirements:
Dr. Wilkinson is licensed to practice medicine in the State of California.
The Medical Board of California can be contacted for questions or complaints:
Medical Board of California
2005 Evergreen Street, Suite 1200
Sacramento, CA 95815
Phone: (800) 633-2322
Website: https://www.mbc.ca.gov
Professional Disclaimer
Information provided on this website is for informational purposes only and does not constitute medical advice, diagnosis, or treatment.
Visiting this website or contacting the practice does not establish a physician-patient relationship.
A formal clinical relationship is only established after completion of an intake process and mutual agreement to proceed with treatment.
Forensic Services Disclaimer
Forensic psychiatric services are separate from clinical treatment.
Evaluations are conducted for legal purposes and do not establish a treatment relationship.
Confidentiality differs from clinical care and information may be disclosed in reports or testimony as required by law.
In most cases, the retaining attorney is the primary point of contact.
Updates to This Page
These notices may be updated periodically to reflect changes in laws and regulations.