Patient Communication Policy
Last updated: May 18, 2026
Practice Better secure messaging is the channel for all clinical and program-related communication. Messages are HIPAA-secure and become part of your chart.
Phone is used for time-sensitive scheduling matters that the portal cannot handle, and for clinical situations where Dr. Stefanie initiates a phone call as part of your care. Clinical questions are not answered by phone in lieu of a portal message or scheduled visit.
Email and text are not used for clinical content. Email or text may be used for non-clinical practice updates and administrative items and notices. You have the ability to opt out of these communications.
Clinical questions (anything related to your health status, interventions, or treatment) belong in Practice Better secure messaging. Administrative requests like scheduling changes may be sent by text or by phone call to the office number, (503) 656-1415. Practice text notifications (appointment reminders and similar updates) are sent through the practice's communication platforms and may appear from a different number.
Your preferred contact information is captured at intake. Clinical content is always handled through Practice Better secure messaging regardless of contact preference.
Response Time
Dr. Stefanie responds to portal messages within two business days.
The portal is not monitored in real time and is not a substitute for scheduled clinical care.
During extended absences (vacation, conferences, planned time away), the portal autoresponder will reflect Dr. Stefanie's expected return date and any coverage instructions.
What Portal Messaging Is For
Portal messaging is designed to handle:
- Quick logistical questions (scheduling, portal navigation, confirming visit details)
- Administrative questions (invoices, paperwork, forms)
- Brief updates between visits for patients actively enrolled in a program
What Portal Messaging Is Not For
The following require a scheduled visit so Dr. Stefanie can apply clinical judgment with full context:
- Interpretation of lab results
- New, changing, or worsening symptoms
- Clinical questions about treatment or progress
- Supplement or protocol adjustments
- Recommendations that require review of history, records, or examination
- Questions that cannot be answered in a brief, factual reply
This is a clinical standard. Dr. Stefanie does not provide clinical recommendations through chat without adequate context because doing so is not responsible care.
Program Member Messaging Benefits
Patients actively enrolled in Align & Ascend or another Sustainable Alignment program may have defined messaging benefits included as part of the program fee. These are described in the enrollment agreement for each program. Program messaging does not replace scheduled visits for new clinical concerns, lab interpretation, or protocol changes.
Between-Visit Clinical Consultation Fee
For patients not enrolled in an active program, and for any request that falls outside the messaging benefits included in a program fee, clinical consultation outside of a scheduled visit is billed as follows:
- Rate: $40 per 15-minute increment, rounded up to the next full increment. The rate reflects the practice's standard clinical hourly value of $160 per hour.
- Minimum bill: one 15-minute increment ($40). Time required to review your chart, respond, and document is included.
- Advance notice and authorization: Before any clinical work is performed, Dr. Stefanie will send you a brief message describing the request, the anticipated time required, and the anticipated fee. You must confirm authorization before the work is performed. If you prefer, you may decline and schedule a visit instead.
- Payment: charged to your card on file per the Financial Responsibility & Payment Policy.
- If actual time exceeds the estimate by more than one 15-minute increment, Dr. Stefanie will note the reason in her reply.
Clinical consultation includes any communication where Dr. Stefanie is asked to apply clinical judgment. Examples: reviewing lab results, making recommendations, interpreting symptoms, adjusting supplements or protocols, providing opinions on health decisions, reviewing records from outside providers.
Administrative communication is never billed. Examples: scheduling, billing questions, paperwork, portal navigation, insurance documentation.
Urgent and Emergency Situations
Portal messaging is not monitored in real time and is not appropriate for urgent or emergency concerns.
- For medical emergencies, call 911.
- For urgent concerns, go to the nearest emergency room or urgent care facility.
- If you are uncertain whether a situation is urgent, err on the side of seeking in-person care.
The portal autoresponder reinforces this guidance on every incoming message.
Updates to This Policy
This policy may be updated periodically. Material changes (significant changes in communication channels, response time commitment, fee structure, or authorization model) will require a new signed acknowledgment before continuing care. Routine adjustments do not require re-acknowledgment.