payment policy

 


At this time, I do not participate in any insurance panels as an in-network provider, although most plans provide some reimbursement for out-of-network clinicians. Since I am not an in-network provider, I do not  bill  insurance companies directly, I bill patients directly and ask for payment at the time of service by cash, check or credit card. Since I am not involved with the insurance companies, the arrangements we make are between us, without third-party monitoring which compromises both our confidentiality and our ability to structure the treatment to meet your needs.   I will provide you with a claim form to submit to your insurance company for reimbursement if you wish, and can guide you through the claims submission process. Majority of my clients are able to get reimbursed by their health insurance providers.

 

forms

  • Prior to the first meeting please print, fill out and sign relevant forms below
  • Consent to Treatment (Adult)
  • Consent to Treatment (Child/Adolescent)
  • HIPAA Guidelines
  • Intake Form (Adult)
  • Intake Form (Child)
  • Authorization Form

sessions & fees

Sessions

There are four types of sessions: intake/consultation 50-90 min, individual session 45-55 min, group therapy session 60-90min, phone session 30-55min.

 

Fees

Session fees are dependent on the type of session. Please refer to the consent form for sessions fees.

*Sliding scale fees are available for families who demonstrate significant financial difficulties.

value. quality care. convenience.