Office Policies & Fees Agreement
You may pay for counseling services directly or use your private insurance.
Therapy for individuals ~ $100 (50 minute session)
Therapy for couples or families ~ $100 (50 minute session)
Therapy in your home ~ $150 (50 minute session)
Hypnotherapy (please see "Hypnosis" page for detailed information)
Court Appearance on behalf of a client ~ $200 per hour, minimum three-hour charge
(court appearance is not a service covered by insurance)
Any services I provide beyond the therapy session, or beyond what your insurance company has authorized are charged to you directly at my hourly rate of $100 (charged in 15-minute increments). This includes telephone calls exceeding 5 minutes and requests for written reports or forms required by an outside organization, such as (but not limited to) employers, Child Protective Services, Probation / Parole Officers, attorneys, etc. This service is not covered by insurance; therefore, you will be charged as "self-pay" for the time I spend on your documentation.
Payment for sessions are due at the time of service unless other arrangements have been made. Sessions may be paid in cash, check, or credit card. If your financial circumstances necessitate a special payment plan, I will work with you. You are responsible for payment of services not covered by your insurance carrier.
If you are using insurance, you will usually have a copay or need to meet your deductible.
Unless cancelled 24 hours in advance, my policy is to charge $50.00 for missed appointments. You may leave a voice mail. Emergency cancellations (less than 24 hours) are handled on an individual basis. Clients will be billed directly and responsible for any missed appointments without 24 hours notice. If your appointment is on Monday, notice of cancellation is expected no later than the Friday prior to your appointment.
Regarding insurance: Please note that whenever insurance is used, personal information such as your diagnosis becomes available to your insurance company and at times to employers. Managed care organizations often ask for detailed information about patients in order to make payment decisions. Paying for therapy directly assures that confidentiality is not compromised and that insurance companies are not influencing your therapy. If I am a provider for your insurance company or Employee Assistance Program (EAP), I will be pleased to accept your insurance and file your claims for you, in which case you authorize payment be made directly to me. Your plan may require diagnostic and treatment plan information to be released to them before they will authorize payment. If you request that I accept your insurance or EAP benefits, I
am obligated to comply with their requests for information. If your insurance company or EAP happens to be one with which I am not contracted, known as “out-of-network”, I will provide receipts so you can submit claims to them. Please understand that you may or may not receive reimbursement. This practice belongs to many (but not all) managed care and preferred provider health plans.
I do not take clients who I do not think I can help. Therefore, I will enter our relationship with hope and an eagerness to work with you. As a professional I will use my best knowledge and skills to help you. I am licensed and trained to practice counseling – not law, medicine, or any other profession. I am not able to give you advice from these other professional viewpoints. I am required to keep what you tell me confidential except in a certain limited situations (outlined in the confidentiality brochure). I ask you not to disclose the name or identity of any other client you may see in this office, as you appreciate the same respect.
Doing psychotherapy by telephone is not ideal, and needing to talk to me between sessions may indicate that you need extra support. If this is the case, you and I will need to explore adding sessions or developing other resources you have available to help you. Telephone calls that exceed 5 minutes in duration will be billed at $2 per minute. I do not encourage therapy via email or texting.
I do not take calls when I am with a client. I will return the call as soon as I am able. In an emergency, call your personal physician or go to the nearest emergency room. If I become concerned about your personal safety, or the possibility of you injuring someone else, I am morally and legally obligated to contact the person you identified on your intake information.
If you are dissatisfied with any aspect of your counseling, please raise your concerns with me immediately. It is my desire to treat you ethically and fairly.
In my professional practice, I do not discriminate in accepting and treating clients on any of these bases: age, gender, marital status, race, color, religious beliefs or creed, belief, ancestry, nationality or ethnicity, location of residence, physical or mental disability or handicap, veteran status, sexual orientation, or health status. This is both a personal commitment and is made in accordance with federal, state and local laws and regulations. If you believe you have been discriminated against, please bring this matter to my attention immediately.
I truly appreciate the opportunity you have given me to be of professional service to you and I am eager to receive your questions, comments, suggestions or concerns at any time. I look forward to a successful and beneficial relationship with you. If, as we proceed, you are fully satisfied with my services, I would appreciate your referring other people to me who might also benefit from counseling.
