Psychology Practice Policies
The Board of Mental Health Practice regulations, including the Mental Health Bill of Rights, require all licensed mental health professionals to provide clients certain basic information. You will find basic information below as well as additional information about my practice for your review. Please read it carefully and let me know if you have any questions.
Practice Policies and Procedures
I. License and Code of Ethics
I have been a licensed psychologist since 1992, governed by the Code of Ethics of the American Psychological Association. The code of ethics for Psychologists is available at http://www.apa.org/ethics/code/. I currently hold malpractice insurance with the American Professional Agency.
If you must cancel your appointment, please contact me as soon as possible. You will be charged the full fee for appointments that are scheduled and missed or cancelled with less than 24 hours’ notice unless we both agree that your situation was fully beyond your ability to predict or control. It is possible that we can reschedule your appointment during that same week and, if so, payment made will apply to the newly rescheduled session. Please note that payment for missed appointments is not reimbursed by your insurance provider.
III. Mode of Sessions
Until further notice, all sessions will be held on my Zoom platform (or FaceTime or Skype if Zoom is unavailable). You will be given a link to access my Zoom platform when a session is scheduled.
I can record all sessions, but only with your permission. A link to these recordings will be sent to your email address after each session.
I have a current Business Associate Agreement with Zoom verifying that the Zoom platform is HIPPA compliant.
By starting therapy using Zoom you are giving consent to me to use telehealth. I am certified by PSYPACT Commission to use telehealth. All of my credentials are up-to-date and I have met all requirements for the Authority to Practice Interjurisdictional Telepsychology (APIT).
According to ethical guidelines for Psychologists, communications between clients and a licensed Psychologist are privileged and confidential and may not be disclosed without the specific authorization of the client except under specific, limited circumstances.
In most situations, I can only release information about your treatment to others (teachers, primary care doctors, other professionals working with you) if you sign a written Authorization form. You will have the option to either give or decline consent.
There are 4 specific situations covered separately by your signature on this Agreement:
- Periodic consultation with mental health colleagues, all of whom are legally bound to maintain confidentiality.
- Communication with your insurance company, at your request. The information I submit pursuant to your claims will become part of the insurance company’s files, which I have no control over.
- Communication for protection. If you threaten to harm yourself, I may be obligated to contact family members or others who can help provide protection.
There are some situations where I am permitted or required to disclose information without your consent:
- Court order. If you are involved in a court proceeding and a request is made for information concerning your treatment, I will not disclose that information without your consent, unless there is a court order to do so.
- Legal complaint. If you file a complaint or lawsuit against me, I may disclose relevant information to defend myself.
- It is important that we discuss any questions or concerns you may have about confidentiality. Please feel free to bring these up with me.
Payment is due in full the day of the session. You may pay through PayPal by sending to firstname.lastname@example.org. Or, you can pay by credit card, if requested.
Therapy hour (50-60 minutes)
- $150 (see above)
Phone calls >15 minutes
- $150 (prorated/hour))
VI. Insurance Reimbursement
I am not in-network with any insurance providers and I do not personally file claims for insurance reimbursement.
However, if you wish to file a claim for insurance reimbursement, I will send a monthly invoice which includes a diagnosis, date of service, and fees assessed. It is your responsibility to determine the limits of your insurance and to secure whatever authorizations might be needed.
Please notify the insurance company, when you submit a claim, that the fee has already been paid by you and you wish to be paid directly for the reimbursement. Otherwise, they will send the reimbursement check directly to me.
VII. Phone, Email and Text Communication
When issues arise or a crisis occurs it is sometimes necessary to have telephone contact between sessions. Please keep telephone contacts brief, if possible, and address treatment issues during your regularly scheduled therapy session. Telephone calls exceeding 15 minutes will be prorated according to the regular session fee. Note that this charge is not reimbursed by your insurance provider.
If you choose to email me from your personal email account or by text, please limit the contents to issues such as cancellation or change in appointment time. Email and text messages are not guaranteed confidential. If you choose to communicate with me this way, please understand that I cannot guarantee that these modes of communication are confidential.
I do not create treatment notes during each session. However, I do keep records for no more than 7 years of basic information such as date and time of treatment, age, address, phone number, medications, and pertinent information. I also keep records of any other written or electronic information I received from or about you.
If the session is recorded, I will send you a copy and keep these recordings on file. I will provide a brief summary of your treatment history if required by court order or if you request this for other reasons. If you wish to see a copy of your records, I recommend that you review them with me so that we can discuss the content.
IX. Conflict of Interest
From time to time, actual or potential conflict of interest may arise. If I become aware of a conflict of interest in providing treatment to you, I may be required to refer you to another therapist. Regardless of the existence of conflict of interest, you can be assured that any information will remain confidential.
X. Concerns or Complaints
If you have any concerns or complaints, please do not hesitate to raise them with me. I am open to all concerns and am happy to address any questions that you have.