OFFICE POLICIES

PROFESSIONAL COUNSELING:

Professional counseling is the process of building a relationship through which therapeutic principles and strategies are applied to address social, emotional, and behavioral difficulties. There are many different methods I may use to deal with the problems that you hope to address though my approach is generally client-centered and cognitive-behavioral.

Counseling is not like a medical doctor visit. Instead it calls for a very active effort on your part. In order for the therapy to be most successful, you will have to work on things we talk about both during our sessions and at home. Our first few sessions often involve an evaluation of your needs. By the end of the evaluation, some initial impressions will be offered to you of what our work will include and a treatment plan to follow, if you decide to continue with therapy.

You should evaluate this information along with your own opinions of whether you feel comfortable working with me. Therapy involves a large commitment of time, money, and energy, so you should be very careful about the therapist you select. If you have any questions about procedures, please discuss them with me as they arise. If necessary, I will gladly help you meet with another mental health professional for a second opinion.

We will usually schedule one 55-minute session per week at a time we agree on, although some sessions may be longer or more frequent. The frequency and duration of sessions depends on the issue and surrounding circumstances. Once an appointment hour is scheduled, you will be expected to pay for it unless you provide advance notice of cancellation (unless we both agree that you were unable to attend due to circumstances beyond your control). All efforts will be made to find another time to reschedule the appointment as soon as possible.

Two (2) “no show” sessions (failing to attend and not calling to cancel appointment) may result in termination of services. Because I see clients throughout the day, I am not immediately available by phone. If I am not available, you will reach my confidential voice mail. I make every effort to return calls the same day, with the exception of weekends and holidays. I do not provide 24-hour emergency care. If you are having a crisis situation and are in need of immediate assistance, contact your family physician or the nearest emergency room and ask for the psychologist/psychiatrist on call.

RISKS/BENEFITS:

Psychotherapy can have risks and benefits. Since therapy often involves discussing unpleasant aspects of your life, you may experience uncomfortable feelings like sadness, anger, guilt, frustration, or hopelessness. On the other hand, psychotherapy also has been shown to have many benefits for people who go through it, like reduced distress, solutions to problems, and better relationships. There are no guarantees of what you will experience, but all efforts will be made to maximize benefits.

LIMITS ON CONFIDENTIALITY:

The law protects the privacy of all communications between a patient and a counselor. 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. There are other situations that require only that you provide written, advanced consent. I may occasionally find it helpful to consult other health and mental health professionals about your case, making every effort to avoid revealing your identity. The other professionals are also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. All consultations will be noted in your Clinical Record (which is called “PHI” in your HIPAA Notice Form).

In most cases, I need to share protected information with the other individuals employed by this office for both clinical and administrative purposes, such as scheduling, billing and quality assurance. All of the mental health professionals are bound by the same rules of confidentiality. All staff members have been given training about protecting your privacy and have agreed not to release any information outside of the practice without consent.
If a patient seriously threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her, or to contact family members or others who can help provide protection. Arkansas law provides that a professional may disclose confidential information only to medical or law enforcement personnel if I determine that there is a probability of imminent physical injury by the patient to the patient or others, or there is a probability of immediate mental or emotional injury to the patient.

If a patient discloses that he/she has a disease commonly known to be both communicable and life threatening, counselors may be justified in disclosing information to identifiable third parties, if they are known to be at demonstrable and high risk of contracting the disease.

There are some situations where I am permitted or required to disclose information WITHOUT either your consent or Authorization:

If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the confidential privilege law. I cannot provide any information without your (or your legal representative’s) written authorization, or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order your therapist to disclose information.

If a government agency is performing health oversight activities for which information is required to be provided.

If a patient files a complaint or lawsuit against his/her therapist, I may disclose relevant information regarding that patient in order to defend myself.

If a patient files a worker’s compensation claim, I must, upon appropriate request, provide records relating to treatment or hospitalization for which compensation is being sought.

There are some situations in which I am legally obligated to take action, which I believe are necessary to attempt to protect others from harm and I may have to reveal some information about a patient’s treatment. These situations are unusual in my practice and include:

Suspected child abuse/neglect/maltreatment (for all person under age 18), including sexual contact or conduct

Suspicion that an elderly or disabled person is in a state of abuse, neglect or exploitation

Probability that the patient will inflict imminent physical injury on another or imminent physical, mental, or emotional harm upon him/herself or others.

In these cases, I am required by law to take protective action by disclosing information to medical or law enforcement personnel, or making a report to the appropriate governmental agency. If such a situation arises, I will make every effort to fully discuss it with you before taking any action and will limit disclosure to what is necessary. While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have now or in the future. The laws governing confidentiality can be quite complex, and I am not an attorney. In situations where specific advice is required, formal legal advice may be needed.

PROFESSIONAL RECORDS:

You should be aware that, pursuant to HIPAA, I keep Protected Health Information about you in two sets of professional records. One set constitutes your Clinical Record. It includes information about your reasons for seeking therapy, a description of the ways in which your problem impacts on your life, your diagnosis, the goals that we set for treatment, your progress towards those goals, your medical and social history, your treatment history, any past treatment records that have been received from other providers, reports of any professional consultations, your billing records, and any reports that have been sent to anyone, including reports to your insurance carrier. Except in unusual circumstances that involve danger to yourself and others, you may examine and/or receive a copy of your Clinical Record if you request it in writing. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. For this reason, it is recommended that you initially review them in the presence of your therapist, or have them forwarded to another mental health professional so you can discuss the contents.

If you make a request for records, there is a processing fee of $75 per request. Payment is required before record requests will be processed. If your therapist refuses your request for access to your Clinical Record, you have a right of a review, which will be discussed with you upon your request. Please note that your file will be considered “closed” six months after our last scheduled therapy session however, it can be re-opened through consultation with the therapist. In addition, I will also keep a set of Psychotherapy Notes. These Notes are for the therapist’s use and are designed to assist the therapist in providing you with the best treatment. While the contents of Psychotherapy Notes vary from client to client, they can include the contents of our conversations, my analysis of those conversations, and how they impact on your therapy. They also contain particularly sensitive information that you may reveal that is not required to be included in your Clinical Record. These Psychotherapy Notes are kept separate from your Clinical Record. While insurance companies can request and receive a copy of your Clinical Record, they cannot receive a copy of your Psychotherapy Notes without your signed, written Authorization. Insurance companies cannot require your Authorization as a condition of coverage nor penalize you in any way for your refusal. You may examine and/or receive a copy of your Psychotherapy Notes unless your therapist determines that release would be harmful to your physical, mental or emotional health.

PATIENT RIGHTS:

HIPAA provides you with several new or expanded rights with regard to your Clinical Record and disclosures of protected health information. These rights include: requesting that your therapist amend your record; requesting restrictions on what information from your Clinical Record is disclosed to others; requesting an accounting of most disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about my policies and procedures recorded in your records; and the right to a paper copy of the Informed Consent/Service Agreement and my privacy policies and procedures when you come in for your initial intake evaluation.

MINORS & PARENTS: Patients under 18 years of age who are not emancipated and their parents should be aware that the law may allow parents to examine their child’s treatment records. However, if the treatment is for suicide prevention, chemical addiction or dependency, or sexual, physical or emotional abuse, the law provides that parents may not access their child’s records. For children between 16 and 18, because privacy in psychotherapy is often crucial to successful progress, particularly with teenagers, it is our policy to request an agreement from the patient and his/her parents that the parents consent to give up their access to their child’s records. If they agree, during treatment, they will be provided with only general information about the progress of the child’s treatment, and his/her attendance at scheduled sessions. Parents will also be provided with a summary of their child’s treatment when it is complete. Any other communication will require authorization, unless I feel that the child is in danger or is a danger to someone else, in which case, parents will be notified of the concern. Before giving parents any information, I will discuss the matter with the child, if possible, and do my best to handle any objections he/she may have.

PROFESSIONAL FEES:

The psychotherapy/counseling hourly fee is $165.00. In addition to counseling sessions, this charge MAY apply for other professional needs (with the hourly cost broken down for periods less than one hour), such as report writing, preparation of records and treatment summaries, consulting with other professionals you have authorized, and time spent performing other services you have requested. If you become involved in legal proceedings that require my participation, you will be expected to pay for my professional time even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge $400.00 per hour for preparation and attendance at any legal proceeding. Please refer to the Court Actions and Legals Fees tab for further information.

MISSED APPOINTMENTS:

Unless waived by mutual agreement on a case-by-case basis, No-Shows and Cancellations WILL BE CHARGED FOR unless you cancel at least 24 hours in advance of the appointment time. The fee for late cancellations and for No-Shows is the full hourly fee. I adhere to this policy very strictly! Patients arriving 15 minutes or more late to the appointment will be considered a No-Show and must be rescheduled unless other arrangements are made with the Therapist. Authorization is given, where applicable, to charge credit/debit cards for late or No-Show appointment fees when incurred. Patient understands the appointment policies of the office and assumes responsibility for payment of fees related to late cancellations or No-Show appointments. Such charges are payable immediately and will be automatically deducted, where applicable, and are not normally reimbursable by insurance.

BILLING AND PAYMENTS:

You will be expected to pay for each session at the time it is held, unless we agree otherwise. Payment schedules for other professional services will be agreed to when they are requested. If necessary, fee adjustments or payment installment plan may be arranged.

If your account has not been paid for more than 30 days and arrangements for payment have not been agreed upon, I have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court which may require me to disclose otherwise confidential information. In most collection situations, the only information that is released regarding a patient’s treatment is his/her name, the nature of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim.

INSURANCE REIMBURSEMENT:

Because I am private pay, it is important to evaluate what resources you have available to pay for your treatment. If you have a health insurance policy, it will usually provide some coverage for mental health treatment. I will provide you with a receipt for services rendered that provide a diagnosis code, my tax ID number, and the required CPT code for you to file with your insurance company. In most cases, once you meet your annual deductible, your insurance company will reimburse you directly.

It is very important that you find out exactly what mental health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services. If you have questions about the coverage, call your plan administrator.

COMPLAINTS:

Complaints must be submitted to the Texas Behavioral Health Executive Council on an approved complaint form, which may be downloaded from the Forms and Publications webpage or by clicking on the link below. Alternatively, you may call or write and request the complaint form be mailed to you.

BHEC Complaint Form

It is important to realize that by signing the complaint form, you are waiving confidentiality as it is necessary for the Enforcement Division to review your complaint.

NOTE: The Council may accept, but is not obligated to investigate, a complaint that lacks sufficient information to identify the source or the name of the person who filed the complaint.

Generally speaking, complaints must be filed within five years of the date of the termination of services to be considered timely. However, complaints alleging sexual misconduct may be filed within seven years after the date of termination of services or within five years of the patient/client turning 18, whichever is later.