January 21, 2018

Fees & Policies

Thank you for choosing me for counseling. These pages contain important information about my office policies.  Attached is a detailed explanation of the Health Insurance Portability and Accountability Act (HIPAA), which provides you with certain rights and protections.  The law requires that I obtain your signature acknowledging that I have provided you with this information. Please note any questions you have about these policies so we can discuss them. When you sign this document, it represents an agreement between us.

My Approach

I work collaboratively with clients, developing a treatment plan that fits each client’s unique requirements. If you have questions about my approach, we should discuss them whenever they arise. Psychotherapy can have benefits and risks. It often results in solutions to specific problems, better relationships as you define them significant reductions in symptoms and resolution of troubling experiences . However, since therapy often involves discussing difficult aspects of your life, you may experience uncomfortable feelings like sadness, shame, anger, loneliness, and helplessness and there are no guarantees what you will experience. At the end of treatment, I will give you a written survey to provide me with feedback about your experience, but I welcome your feedback at any time.

Meetings

Unless other arrangements have been made, couple sessions are 1 hour in length; individual sessions are 50 minutes. Beginning with new couples, I normally conduct one evaluation session for individuals and up to 3 sessions for couples. During this time, we can both decide if I am the best person to provide the services you need. As part of the evaluation process, I may ask you to sign an authorization to allow me to communicate with past and/or current practitioners.  If we decide I am not the appropriate practitioner to work with you, I will refer you to several practitioners who may be more suitable. 

Fees                                                         Individual               Couple

  • Initial Evaluation:                                       $175 (60 min.)                  $270.00 (90 min.)
  • Second and additional sessions:               $160 (50 min.)                 $180.00 (60 min.)

Payment for each session is expected at the time of service, unless we make other arrangements. I accept cash, checks or bank transfer.  In the event of a fee increase, I will provide two months advance notice.

Once an appointment hour is scheduled, you will be expected to pay for it unless you provide at least 24 hours advance notice of cancellation. Insurance companies do not provide reimbursement for missed/late cancelled sessions.

Insurance Reimbursement

I am not a network provider for any insurance plans, so your visits with me will be considered ‘out of network’. Your insurance company or its representative can provide you with details regarding your out of network benefits. If you are planning to use insurance, I find out before the first session exactly what services are covered, including marital or couple counseling (sometimes referred to as ‘family counseling’) if you are seeing me as a couple. If your plan requires pre-authorization for outpatient services it is your responsibility to call your insurance company and obtain it.

I will complete reasonable forms provided and required by your insurance company in support of you insurance claims. If you wish to utilize insurance benefits, I will also assist you by providing a detailed statement that you may submit to your insurance company. However, you – not your insurance company – are ultimately responsible for full payment of my fees.

Nondiscrimination

I do not discriminate on the basis of race, ethnicity, national origin, disability, age, gender, sexual orientation, or religious beliefs.

Limits on Confidentiality

The law and professional code of ethics protect the privacy of all communications between a client and clinical social worker. In most situations, I can only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA and Illinois law.  There are some unusual situations where I am permitted, or even required, to disclose information without your authorization. Here is a brief summary of situations in which I may be obligated even without your permission:

  • In a lawsuit if I have been served with a valid subpoena.
  • If I believe you pose a danger to yourself or to others.
  • If I have reason to believe that a child under the age of 18 years or a vulnerable adult has been abused or neglected or if I believe there are circumstances that would reasonably result in abuse, abandonment or neglect.

Please feel free to discuss any concerns you have about confidentiality.

I will ask you to sign a copy of my Office Policies agreement at our initial meeting. Again, tell me at that time or in advance if you have concerns regarding those policies.