Counseling Services Psychotherapy calls for an active effort on your part. In order for counseling to be most successful you will have to work on the things we talk about during our session at home. In addition, your responsibilities are to provide relevant, accurate and complete information as to your history, symptoms, complaints, medication, and current status. Please make your best efforts to have relevant information (such as previous psychiatric evaluations, discharge summaries, school reports, etc.) ready at the time of your first session. As your therapist, I have the responsibility to ask you questions about you and your family’s history, as well as your feelings and actions. I also have the responsibility to provide you with direct information about treatment as well as my clinical recommendations. If you choose to terminate treatment, I can assist you in developing appropriate options, unless you choose otherwise. Individual and family sessions are 45 minutes in length. It is important for us to end on time, so I am able to document our session, review records and/or make collateral phone calls on your behalf. The frequency of sessions depends on clinical need and can be discussed at your first session and re-evaluated at subsequent sessions. My usual and customary fee for your first appointment, described as the “diagnostic assessment” or “intake” is $175.00. All other sessions (individual, family, collateral) are charged at $125.00 per session. Special evaluations/assessments (e.g. school/court related) are billed according to the breadth of the evaluation, duration of evaluation, and whether or not a formal report is required. Co-payments/session fees are due at the time of service. All payments for services are to be made by personal check, cash, or credit card. If your insurance company is being billed, I will make appropriate efforts to obtain payment; however, you as the client are responsible for any outstanding charges that are not covered. A service fee of $25.00 per month shall apply to any accounts for which there is an outstanding balance, including payments which are late, or if there has been no payment made by you or your insurance company on the balance within the past 30 days. If your account has not been paid for more than 60 days and arrangements for payments have not been agreed upon, I have the option of using legal means to secure payment. By signing this agreement, you understand that you are responsible for reasonable attorney and legal fees for accounts that go to collections. Any service requested by you the client (e.g., court testimony, written treatment summaries/recommendations, attendance at PPT meetings) is billable to you personally at the regular session rate of $125.00 per hour. If you have a brief, routine message please call and leave the message on my voice mail. If you are having a mental health emergency, or require urgent care, please call your local emergency services or proceed to your local emergency room. I check my voice mail twice per day and cannot guarantee that I will be readily available. I try to return messages within one business day. Phone calls are not to take place of a regular counseling session.
Tobacco Use Counseling and Intervention This plan covers smoking cessation programs when prescribed by a physician in accordance with R.I. General Law §27-20-53 and ACA guidelines. Smoking cessation programs include, but are not limited to, the following: • Smoking cessation counseling must be provided by a physician or upon his or her • Over-the-counter and FDA approved nicotine replacement therapy and/or smoking cessation prescription drugs, prescribed by a physician, and purchased at a pharmacy. See the Summary of Pharmacy Benefits for details on coverage. This plan covers adult and pediatric preventive vaccinations and immunizations in accordance with current guidelines. Our allowance includes the administration and the vaccine. If a covered immunization is provided as part of an office visit, the office visit copayment and deductible (if any) will apply. Travel immunizations are covered to the extent that such immunizations are recommended for adults and children by the Centers for Disease Control and Prevention (CDC). The recommendations are subject to change by the CDC. This plan covers preventive screenings based on the ACA guidelines noted above. Preventive screenings include but are not limited to: • mammograms; • pap smears; • prostate-specific antigen (PSA) tests; • flexible sigmoidoscopy; • double contrast barium enema; • fecal occult blood tests, screening for gestational diabetes, and human papillomavirus; and • genetic counseling for breast cancer susceptibility gene (BRCA). This plan covers colonoscopies in accordance with R.I. General Laws § 27-18-58. Covered healthcare services include an initial colonoscopy or other medical tests or procedures for colorectal cancer screening and a follow-up colonoscopy if the results of the initial test are abnormal. This plan covers the following contraceptive services: • FDA approved contraceptive drugs and devices requiring a prescription; • barrier method (cervical cap, diaphragm, or implantable) fitted and supplied during an office visit; and • surgical and sterilization services for women with reproductive capacity, including but not limited to tubal ligation. This plan covers lactation (breastfeeding) support and counseling during the pregnancy or postpartum period when provided by a licensed lactation counselor. This plan covers manual, electric, or battery operated breast pumps for a female member in conjunction with each birth event.
