The following information will help to clarify confidentiality, cancellation policies, insurance reimbursement and fees. After reading over the information, if you have additional questions, please do not hesitate to contact us.
Confidentiality between client and counselor is a cornerstone of psychological treatment. It is crucial that you feel free to disclose and discuss all personal material without fear that this information will be revealed to others. No information related during our sessions will be disclosed to third parties without your explicit consent. There are a few exceptions to this rule. A critical exception is that if the counselor believes your safety is in jeopardy, he/she will take whatever measures are necessary to protect you. An attempt to inform you of the safety plan will be made. If someone else is in danger because of your actions, your counselor is obligated to warn that person or notify the authorities, even without your consent. Confidentiality is also limited if you disclose that a child under the age of 18 (including yourself) or a vulnerable adult has been or is being abused; and if you have been abused by a healthcare provider. These procedures are required by law to prevent future harm from occurring.
Many insurance companies require the submission of a treatment plan to document service. Treatment plans contain a psychiatric diagnosis, symptoms, reasons for treatment, treatment goals and progress in treatment. Your insurance company will store this information in an electronic data base that can be accessed by other insurance companies. Once this information is disclosed to your insurance company, we can not guarantee confidentiality of that information. If you are using health insurance and they require a treatment plan we will provide this information to your insurance company.
Confidentiality is an essential element of the mediation process as it builds trust, supports full disclosure of information and protects the participants and the mediator from retribution. The mediator will not share any information related to or disclosed during the mediation sessions with anyone outside the mediation sessions. Participants agree not to call the mediator or anyone working for the mediator as a witness in court for the purpose of disclosing information obtained as part of the mediation. The participants are also prohibited from requiring the mediator to provide records or documents that were part of the mediation for the court. Participants agree not telephone the mediator for purposes other than changing appointment times.
We are committed to providing excellent service and highly skilled professionals for assisting you in meeting your goals. As part of this, a financial contract indicating the agreed fees for service is signed. Fees are due at the time of service. We accept cash, personal checks and major credit cards. Any returned check fees will be the responsibility of the client. We understand that financial hardships can occur. If this happens, please discuss this with us so that we can address it together.
We request at least 48 hours cancellation prior to a scheduled counseling appointment and three days prior cancellation for mediation sessions. Missed appointments or late cancellations will be billed at half the agreed rate unless rescheduled within the same week. Fees can be paid at the next appointment or by mail. Exceptions to this policy are made in the event of an emergency, illness, accident or extreme weather.
billing and insurance
Payment is due at the time of service according to the financial arrangements discussed prior to or during the first session.
Written Reports such as psychological evaluations, treatment summaries for health insurance, other healthcare providers, school guidance counselors and attorneys are billed at the agreed hourly rate.
I am available by phone to all counseling clients between scheduled appointments for supportive intervention and emergencies. Infrequent, brief conversations are free of charge. Telephone support that occurs more than one time a week, or for more than 10 minutes will be billed at the contracted hourly rate.
While not encouraged, E-mail support and sessions for clients who are not able to meet face to face, or who cannot come to counseling on a regular schedule can be arranged if discussed and arranged in advance. These sessions are billed at the agreed fee and are not covered by health insurance.
An invoice of services is provided which you must submit to your insurance company for reimbursement. Your insurance company will reimburse you directly. If you have any questions regarding reimbursement, please contact your insurance company. If you have questions regarding the invoice from our office, you may call or send an email.
Payment is due at the time of service in accordance with the contract to mediate which is discussed and signed at the first meeting, the orientation session.
Memorandum of Understanding:
This is the document that outlines the mediated agreements, and is paid for via retainer to cover time involved in writing the agreement. Any unused portion of the retainer will be reimbursed.
Phone calls to schedule, confirm or change appointments are not billed and will be limited to scheduling appointments only.
E-mail may be used by the mediator to send information to educate clients about mediation services, to schedule mediation sessions and to deliver drafts of the Memorandum of Understandings. E-mail exchanges among participants should be sent to all involved in a mediation to support full disclosure, transparency and trust. E-mails sent by participants should be limited to scheduling sessions and revisions on the memorandum or understanding.