Terms & Conditions

1. About This Practice

Quantum Blue Nursing is a solo telehealth psychiatric nurse practitioner practice operating in the State of California. Services are provided by Gretchen Genato, MSN, FNP-BC, PMHNP-BC, a nurse practitioner licensed in California and double board-certified as a Family Nurse Practitioner and Psychiatric Mental Health Nurse Practitioner.

Quantum Blue Nursing operates in compliance with California Business and Professions Code § 2290.5 (telehealth), applicable California Nursing Practice Act requirements, and all applicable federal and state regulations governing nurse practitioner practice.

2. Services & Scope of Practice

Quantum Blue Nursing provides outpatient telehealth psychiatric services to adults (18+) in the State of California, including:

• Comprehensive psychiatric evaluations and diagnostic assessments
• Medication evaluation, initiation, and ongoing management
• ADHD evaluation and medication management (including QBCheck objective testing)
• Treatment of anxiety, depression, ADHD, sleep disorders, and stress-related mental health conditions
• Administrative services including form completion, letters, and documentation

This practice does not provide services to patients outside California. All patients must be physically located within the State of California at the time of each appointment.

3. Patient Eligibility

To receive services from Quantum Blue Nursing, you must:

• Be 18 years of age or older
• Be physically located in the State of California at the time of your appointment
• Have access to a device with a working camera, microphone, and reliable internet connection
• Be clinically appropriate for outpatient telehealth psychiatric care
• Not currently be in acute psychiatric crisis requiring emergency services

Quantum Blue Nursing reserves the right to decline to establish care or to refer a prospective patient to a more appropriate level of care if clinical judgment determines that outpatient telehealth is not the appropriate setting.

Patients with the following presentations may not be appropriate for this practice and will be referred to appropriate services:

• Active suicidal ideation with plan or intent
• Active psychosis requiring stabilization
• Primary substance use disorder requiring specialty addiction treatment
• Active eating disorders requiring medical monitoring
• Conditions requiring in-person assessment or procedures

4. Telehealth Consent & Requirements

By scheduling and attending a telehealth appointment with Quantum Blue Nursing, you consent to the delivery of healthcare services via telehealth technology as permitted under California Business and Professions Code § 2290.5 and applicable federal law.

What You Should Know About Telehealth

• Telehealth involves the use of electronic communications to enable healthcare providers to deliver services at a distance
• The clinical standard of care for telehealth is the same as for in-person care
• Telehealth has limitations — certain assessments that require physical examination cannot be performed remotely
• Technical issues may occasionally interrupt sessions; if this occurs, your provider will attempt to reconnect or reschedule
• Sessions are conducted via HIPAA-compliant encrypted video platforms
• Sessions are never recorded without your explicit written consent

Telehealth Platform

All telehealth sessions are conducted via Doxy.me, a HIPAA-compliant encrypted video platform. Doxy.me operates under a signed Business Associate Agreement and is specifically designed for healthcare providers. Sessions are end-to-end encrypted and are never recorded without your explicit written consent.

AI-Assisted Clinical Documentation

Quantum Blue Nursing uses Freed.AI, an AI-assisted documentation tool, to support accurate clinical note-taking. Freed.AI listens during sessions to generate draft notes, which are always reviewed, edited, and approved by your provider before being finalized in your medical record. Freed.AI operates under a signed HIPAA Business Associate Agreement.

You will be informed at the start of each session that Freed.AI may be in use. You have the right to opt out at any time by sending a written request to gretchen.genato@quantumbluenursing.com. Opting out has no effect on your care.

Your Responsibilities During Telehealth Sessions

• Attend from a private, reasonably quiet location to protect confidentiality
• Confirm your location within California at the start of each session
• Do not attend sessions while driving or operating machinery
• Ensure your device is charged and internet connection is reliable before each appointment
• Have emergency contact information accessible during sessions

In-Person Option

Consistent with California telehealth requirements, patients who prefer in-person care will be provided with referrals to in-person providers. Quantum Blue Nursing is currently a telehealth-only practice.

5. Prescribing Policy

Quantum Blue Nursing follows evidence-based prescribing practices consistent with current clinical standards and California and federal law.

General Prescribing

• Medications will only be prescribed when clinically indicated and appropriate
• Prescriptions are sent electronically to your pharmacy of choice
• We do not guarantee continuation of any medication that has not been evaluated by this practice
• Prescribing decisions are made based on clinical assessment and may differ from requests

Controlled Substances

Prescribing of controlled substances (including stimulant medications for ADHD such as amphetamines and methylphenidate) is subject to California and federal law, including DEA regulations. The following apply:

• An in-person or telehealth evaluation is required before any controlled substance is prescribed
• Controlled substances are prescribed in compliance with current DEA telehealth prescribing regulations
• Patients receiving stimulant medications are subject to regular monitoring and follow-up requirements
• We do not prescribe benzodiazepines for new patients without prior evaluation and generally prefer alternative treatments
• We do not prescribe opioids or pain medications
• Misrepresentation of symptoms to obtain controlled substances may result in immediate termination of care and reporting as required by law

Prior Authorizations & Letters

Prior authorization requests and supporting documentation are completed at our discretion and based on clinical appropriateness. Administrative fees apply for letters, forms, and documentation as listed on our Self-Pay & Fees page.

6. Fees, Payment & Insurance

Insurance Patients

For patients using insurance, services are billed through Headway. You are responsible for your applicable copay, coinsurance, and deductible as determined by your insurance plan. We recommend verifying your benefits with your insurer prior to your first appointment. Insurance coverage is not guaranteed and is subject to your plan terms.

Self-Pay Patients

Self-pay rates for all services are listed on our Self-Pay & Administrative Fees page. Payment is due at the time of service for clinical visits and at the time of request for administrative services. We accept payment via Stripe, Zelle, and Venmo.

Administrative Fees

Administrative services (form completion, letters, disability documentation, record requests, care coordination outside of scheduled visits) are not covered by insurance and are billed separately for all patients, including those with active insurance coverage. All administrative fees are listed on our Self-Pay & Fees page.

Returned Payments

Returned or failed payments may result in suspension of services until the balance is resolved. We reserve the right to charge a returned payment fee.

7. No Surprises Act — Good Faith Estimates

Under the No Surprises Act (effective January 1, 2022), you have the right to receive a Good Faith Estimate (GFE) of expected charges before you receive healthcare services, if you are uninsured or if you choose not to use your insurance.

The Good Faith Estimate shows the cost of services that are reasonably expected for your care. The estimate is based on information known at the time of scheduling.

• You have the right to receive a Good Faith Estimate in writing at least 1 business day before your scheduled appointment
• You can also ask for a Good Faith Estimate before you schedule an appointment
• If your actual billed charges exceed your Good Faith Estimate by $400 or more, you have the right to dispute the bill
• Make sure to save a copy of your Good Faith Estimate

For questions or to request a Good Faith Estimate, contact us at gretchen.genato@quantumbluenursing.com.

For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

Price Transparency

All self-pay rates are publicly listed on our Self-Pay & Administrative Fees page in compliance with federal and California price transparency requirements. We are committed to transparent, upfront pricing with no hidden fees.

8. Cancellation & Late Policy

Cancellation Policy

We ask that you provide at least 24 hours notice if you need to cancel or reschedule an appointment. This allows us to offer the time to other patients who need care.

• Cancellations with 24+ hours notice: No charge
• Late cancellations (less than 24 hours): A late cancellation fee may apply
• No-shows (no contact, no attendance): A no-show fee may apply

Fees for late cancellations and no-shows are not covered by insurance and are the patient's responsibility. Repeated no-shows may result in discharge from the practice.

Late Arrivals

If you arrive more than 15 minutes late to a scheduled appointment, we may need to shorten or reschedule your session. The full session fee may still apply.

Provider Cancellations

In the rare event that we need to cancel an appointment, we will provide as much advance notice as possible and reschedule your appointment promptly at no additional charge.

9. Emergencies & Crisis Protocol

Our practice is not equipped to provide crisis intervention, emergency care, or same-day crisis services. Between sessions, if you are experiencing a mental health emergency, please use the following resources:

• 911 — life-threatening emergencies
• 988 (call or text) — Suicide and Crisis Lifeline, 24/7
• Crisis Text Line — text HOME to 741741
• Nearest Emergency Room — for psychiatric emergencies requiring immediate evaluation

You will be asked to provide an emergency contact and local emergency services information at the start of care. This information may be used if we have serious concern for your safety during or after a session, consistent with our legal and ethical obligations under California law (including Tarasoff duty-to-warn requirements).

10. Medical Records

Patients have the right to access and obtain copies of their medical records as provided under HIPAA and the California Confidentiality of Medical Information Act (CMIA).

• Record requests must be submitted in writing using a signed Release of Information form
• Records will be provided within the timeframes required by California law (generally within 15 days)
• A records preparation fee may apply for documentation requests as listed on our Self-Pay & Fees page
• Records are maintained in accordance with California's 10-year minimum medical records retention requirement

11. Termination of Care

Voluntary Termination by Patient

You may discontinue care at any time. We ask that you let us know so we can assist with transitions of care, including referrals and transfer of records, and so that we can ensure you have an adequate supply of any current medications during the transition.

Administrative Discharge by Practice

Quantum Blue Nursing reserves the right to discharge a patient from care for the following reasons, with appropriate notice and transition planning:

• Repeated no-shows or late cancellations
• Non-payment of outstanding balances
• Misrepresentation of symptoms or identity
• Conduct that is threatening, abusive, or disrespectful toward staff
• Clinical determination that a higher level of care is required
• Patient's care needs fall outside the scope of this practice
• Relocation outside the State of California

In the case of administrative discharge, we will provide reasonable notice (generally 30 days), continue medically necessary prescriptions during the transition period, and assist with referrals and records transfer.

12. Website Use & Disclaimer

The content on this website (quantumbluenursing.com) is provided for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Information on this website should not be used as a substitute for professional medical advice from a qualified healthcare provider.

Reading this website, submitting a contact form, or requesting information does not establish a provider-patient relationship. A provider-patient relationship is established only through a completed intake process and confirmed clinical encounter.

We make reasonable efforts to keep the information on this website current and accurate but make no warranties about the completeness, accuracy, or timeliness of the content.

13. Limitation of Liability

To the fullest extent permitted by California law, Quantum Blue Nursing and Gretchen Genato, NP shall not be liable for indirect, incidental, special, or consequential damages arising from your use of this website or our services, except as required by applicable healthcare law.

Nothing in these Terms limits our liability for gross negligence, fraud, or as required under California professional liability law.

14. Governing Law

These Terms and Conditions are governed by the laws of the State of California. Any disputes arising from these terms or our services shall be subject to the jurisdiction of the courts of the State of California, with venue in Los Angeles County, California.

These terms do not limit any rights you have under applicable federal healthcare law, including HIPAA, the No Surprises Act, or other patient protection statutes.

15. Contact

For questions about these Terms and Conditions or our services, please contact us: