Inherent in Alma’s mission is a dedication to ensuring quality mental health care. This conduct policy's aim is to create an environment of safety and respect.
This policy outlines the varying forms of misconduct an Alma member or client can exhibit and the subsequent steps Alma can take toward rectifying these actions.
1. Assessment of misconduct
When assessing conduct, Alma will always ask for information from involved parties to determine the validity and context.
Alma uses the following framework to assess conduct issues (please note that this list not exhaustive, but is meant to be a guide):
Example |
||
Category 1: Poor Conduct |
Provider → Client |
Charging fees without properly communicating fee policies in advance |
Client → Provider |
Spamming providers through consultation requests |
|
Provider → Alma staff |
Failure to reply to Alma Staff in instances of insurance billing issues requiring provider acknowledgment |
|
Category 2: Inappropriate Language Or Inappropriate Behavior |
Provider → Client |
Demonstrated lack of cultural awareness or sensitivity |
Client → Provider |
Repeatedly not making payments to Alma providers |
|
Provider → Alma staff |
Name-calling or disparaging remarks |
|
Category 3: Endangerment Behavior presents a threat to health, well-being, safety, or functioning. |
Provider → Client |
Failing to appropriately terminate care; Provider fails to abide by applicable policies, regulations, and statutes at the state and federal levels |
Client → Provider |
Falsifying information |
|
Provider → Alma staff |
Yelling, threats, either personal or professional |
Some actions will automatically result in removal from Alma’s services:
- Targeting or harassing someone based on their identity. This includes written, verbal, and physical abuse.
-
Language or content that:
- Uses dehumanizing comparisons, generalizations and/or stereotypes towards racially marginalized groups, religiously marginalized groups, and other protected identities.
- Supports or glorifies hateful ideology (e.g., white supremacy, misogyny, anti-LGBTQ, antisemitism, xenophobia, and more)
- Disparages victims of violent tragedies
- Calls for exclusion and segregation practices
- Depicts, promotes, normalizes, or glorifies sexual violence
- Supports conversion therapy
- Spreads misinformation about diseases or international/domestic crises
- Wishes death, illness, or harm on another individual
- Uses profane terms to describe gender identities
- Targets transgender, gender fluid, or non-binary individuals through misgendering or deadnaming
- Targets a person or group on the basis of their protected identities
- Revealing the physical personal address or other identifiable information of another member or member of the Alma community with the intent of encouraging trolling or violence
Addendum for Providers
Failure to comply with our Insurance Program policies as agreed to in a Provider’s Membership Agreement is considered a Category 1 conduct issue. This includes, but is not limited to
- Collecting client cost-shares outside the Alma portal— Alma collects all client payment responsibilities associated with insurance clients' appointments
- Submitting eligibility checks less than one business day or after appointments
- Failing to communicate with clients appropriately about their insurance, e.g. not asking clients if they are submitting their most up-to-date health plan
2. Evaluating Conduct
If a conduct issue is reported, the Alma team may reach out for additional details, such as billing details or copies of correspondence.
We will email a written notification outlining the details and possible ramifications for each category.
Category 1 |
1st instance |
Written notification |
2nd instance |
Written notification |
|
3rd instance |
Written notification with committee review warning |
|
4th instance |
Written notification with immediate committee review |
Category 2 |
1st instance |
Written notification |
2nd instance |
Written notification with committee review warning |
|
3rd instance |
Written notification with immediate committee review |
Category 3 |
1st instance |
Written notification with immediate committee review |
3. Alma's Conduct Committee Review
When conduct requires committee review, the committee will review the details of the conduct and any relevant information provided, such as email correspondence. The committee may send a written request for additional information.
The individual will be notified of the determined sanction and how it will be carried out, as well as steps to appeal the committee’s decision, if desired, within 48-hours of the committee review.
4. Sanctions
At the discretion of the committee, a review may result in sanctions as outlined below:
- 1-2 week suspension from Alma’s services
- 2-3 week suspension from Alma’s services
- 3-4 week suspension from Alma’s services
- Removal from Alma’s services
Addendum for Providers
Suspension
If a provider is suspended, their profile will be removed from Alma’s directory, they will not be eligible for referral opportunities, and they will not be able to attend member events for the duration of their suspension.
Termination
If a provider’s membership is to be terminated, their member profile and Alma portal login will be deactivated and the Alma team will begin the process of terminating the provider’s credentialing immediately upon conduct committee decision.
5. Appeals
Appeals may occur one time. To appeal a decision:
- Submit a written request for appeal to support@helloalma.com within 48 hours of receiving the committee’s decision. The appeal must include:
- Why you believe the sanction is inappropriate.
- Steps you will take to remedy the conduct in the present and prevent it in the future
- The committee will review the appeal in an ad hoc meeting within 5 business days of receipt. The same review process for sanctions will be followed for appeals.
- No sanctions will be carried out until the appeal is reviewed.
How to submit a conduct issue and sanctions process
When a member or client would like to formally express their concern regarding the behavior of another Alma member or client, they must submit a form along with a written statement outlining the details of their complaint or concern.
The severity of the complaint and subsequent category will determine the timeline upon which the committee reviews the information.
Upon receipt of a formal complaint from a provider, Alma’s team will notify the individual in question. The individual in question will be asked to submit a written statement in return and will be encouraged to submit any supplementary information supporting their statement.
The individual’s statement, as well as the formal complaint, will be reviewed by the appropriate committee.
The individual will be notified of the date on which their case will be reviewed, possible ramifications based on the complaint category, and an estimate of when they can expect to receive the committee’s decision.