TERMS & CONDITIONS

attendance policy

Regular attendance is an essential part of successful and effective therapy. Most clients are seen weekly or every other week. Regular attendance can assist you in reaching goals and maintaining gains in treatment. The following details the attendance policy of my practice:

• Cancellations must be made by you via the online scheduler 24 hours prior to the scheduled starting time of your session. This gives me adequate time to offer that time to another client (I often have a waiting list of clients who need appointments). Email messages will not constitute a cancellation. Appointments cancelled less than 24 hours in advance will be charged to you in full.

• All “no shows” will be charged to you in full.

• Should you fail to schedule and attend an appointment for four consecutive weeks, unless other arrangements have been made in advance, for legal and ethical reasons we must consider the professional relationship discontinued and my therapeutic responsibility to you terminated. Should you choose to resume therapy you are welcome to contact me to discuss options and availability. At your request I will provide you with referrals if I am not able to accommodate your needs or if you prefer to continue your work with another therapist.

• If there is consistently pattern of poor attendance, we will review your individual circumstance and clinical needs. All options will be considered including continuing treatment, termination from services or referral to a more appropriate setting.

• It is helpful to inform me if you are planning to leave or take a break from therapy and your reason for doing so. The termination process can be beneficial to both therapist and client.

  Please discuss with me any questions or concerns that you might have regarding the Attendance Policy.

PAYMENT

Stripe, Venmo, HSA’a, check and all major credit cards accepted for payment at the time of service. *Payment by credit card and HSA card will incur a 2.9% service charge - this partially covers the fee charged to me for processing.

A 10% late fee will be charged on fees outstanding after 30 days.

INSURANCE

I do not participate as a provider in any health insurance or managed care plan. My services are, however, covered by some health insurance policies which allow for participants to choose out-of-network mental health providers. Please consult with your insurance company if you plan on submitting therapy statements for reimbursement.

I do not participate in-network for hypnotherapy services. Hypnotherapy is covered by some health insurance policies. I will provide an invoice for you to submit for reimbursement.

It is your responsibility to understand your insurance policy. Services rendered that are not covered by your insurance policy are your responsibility.

CONFIDENTIALITY

All aspects of your treatment are confidential. Important exceptions include if there is risk that you might do harm to yourself or someone else. I am a mandated reporter for child and elder abuse.

The following is my policy regarding your health information:

• I create a record of the care and services you receive from me. The record consists of session dates and times, location, fee, and psychotherapy notes as that term is defined in 45 CFR § 164.501. I need this record to provide you with quality care and to comply with certain legal requirements.

• I am required by law to make sure that protected health information (“PHI”) that identifies you is kept private.

• The following categories describe different ways that I may use and disclose health information:

  • Treatment, Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of another health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your person health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.

    Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

  • Lawsuits and Disputes: If you are involved in a lawsuit, I may be required to disclose health information in response to a court or administrative order. I will make efforts to tell you about the request in advance and/or to obtain an order protecting the information requested.

• Use and disclosure of your psychotherapy notes require your authorization unless the use or disclosure is:

  • For my use in treating you.

  • For my use in defending myself in legal proceedings instituted by you.

  • For use by the Secretary of Health and Human Services to verify my compliance with HIPAA.

  • When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

  • Required to help avert a serious threat to the health and safety of others.

  • For health oversight activities, including audits and investigations.

  • For law enforcement purposes, including reporting crimes occurring on my premises.

  • For workers' compensation purposes. Although my preference is to obtain an Authorization from you, I may be required to provide your PHI in order to comply with workers' compensation laws.

• Certain uses and disclosures require you to have the opportunity to object:

  • You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

  • Other than psychotherapy notes as defined in 45 CFR § 164.501, you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request. I reserve the right to charge a cost-based fee for doing so.

Social Media

Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.

minors

If you are a minor, your parents may be legally entitled to some information about your therapy. I will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential.