Sessions are $145 and 50 minutes in length. Payment is accepted at the beginning of each session. Because the therapy time slot can not be used for another client, clients who miss a scheduled appointment will be automatically charged the full fee of $145. If you need to reschedule your appointment, please give 24 hours notice so that I can make that time available for another client. If you request to reschedule and fail to give at least 24 hours notice, then you will be charged a late notice fee of 100 dollars. I am an in-network provider with Highmark and Aetna, but out-of-network for all other plans (including Medicare.) If you have non-network behavioral health benefits with your insurance and would like me to provide you with a monthly receipt/superbill, please alert me and I would be glad to do so. If an account is delinquent, attorneys and collection agencies may be given minimum identifying information to recover funds.
The information you disclose in psychotherapy (including your clinical records) is
confidential and will not be released to any third party without your written authorization, except
when required or permitted by law. All clients are expected to read and sign The HIPAA Notice of Privacy
Policies accessed through their client portal so they can understand the legal requirements.
Exceptions to Confidentiality
By law, I am required to disclose confidential information in certain circumstances. These situations include, but
are not limited to: (1) If the client presents imminent danger to self or others; (2) If
there is any suspicion of child, dependent, or elder abuse or neglect; (3) Contact with a relative or
friend in the event that you experience a medical emergency; (4) A subpoena or court order to disclose information.
Additionally, I may share parts of your case (but not any identifying information) with other trusted clinicians who provide consultation to ensure that I provide high quality service, or who may provide coverage when I am unavailable. These professionals are also obligated to protect your privacy.
If you need to speak with me between sessions you can call me at 484-557-6470 or e mail me at firstname.lastname@example.org. Contact between
sessions should be reserved for scheduling or other administrative matters, as clients should address
treatment issues during therapy appointments. Telephone calls exceeding 20 minutes will incur costs
and will be prorated according to the regular session fee. Please note that this charge is not eligible for out-of-network reimbursement by your insurance provider. I am often not immediately available by telephone during business hours. If your call is not answered directly, please leave a message and make sure to indicate several times when I can call you back.
E mail Communication
Please be aware that email is not considered completely confidential. Therefore, any email
communication should be used for administrative purposes only, such as setting or changing
appointments. Please do not include any clinical information in emails because this creates a risk to
your privacy. If you do feel the need to provide clinical information in your e mail, you are demonstrating that you are aware of the risks. Also, please note that any email communication between us becomes part of your
Records and Documentation
Both the law and standards of my profession require that I keep treatment records. If you have
concerns regarding your treatment records, please discuss them with me. As a client, you have the
right to review or receive a summary of your records at any time, except in limited legal or
emergency circumstances or when I assess that releasing such information might be harmful in any
way. In such a case, I will provide the records to an appropriate and legitimate mental health
professional of your choice.
Ethics and Dual Relationships
Your care and confidentiality are my primary obligations. As I am an active member of the local community, it is possible that you may inadvertently see me outside of the therapy office. Because of HIPPA privacy guidelines, I will not approach you and initiate conversation about your care. Additionally, our therapy relationship takes priority once treatment has begun. Sometimes clients are referred to me who are friends of friends, or have met me in another context. Please understand that once a therapeutic relationship begins, I will not engage in any other personal or outside business relationship with you. I also do not accept invitations on social media from clients or former clients. If a connection on social media has accidentally occurred, I will terminate it as soon as I am made aware. (Clients will be asked to read and sign my Social Media Policy through their client portal, which goes into more detail on this topic.) For your well-being and protection, I will not engage in any dual relationships that could blur boundaries and negatively impact your care.