Practice Policies

APPOINTMENTS & FEES

We will usually schedule one 45- 53 minute session per week or every other week at a time we agree on,although duration and frequency of sessions can vary based on need.

For new clients, you will interact with our referral coordinator who will assess how we can best support you,gather your insurance information and ID. We will then verify your insurance (which can take time but wedo endeavor to be as quick as possible). Once we get the verification, the referral coordinator will share theinformation with you for informed consent. Once you agree to services with us, our paperwork will be sentto you via the client portal.

You must fill out and sign all the following paperwork before we can schedule you with your clinician:

• Notice of Privacy Practices
• Informed Consent for Psychotherapy
• Practice Policies
• Payment & Cancellation Policies
• Demographics/Credit card 
• selection for self pay (if this one is applicable).

• Current Insurance card (front and back)
• Valid ID
• Working Credit or Debit Card
• Current address and phone number

Once your appointment hour is scheduled, you will be expected to pay for the allotted time(copay/deductible) at the start of the session unless you provide 24 hours advance notice of cancellation[See payment and cancelation policies form]. On occasion, your clinician will be out due to vacation,professional development, or have to cancel an appointment due to an emergency, or illness. We will makeevery effort to notify you as early as possible and to reschedule with you to a date and time that isconvenient for you.

The fee for sessions is $125 (45 min) or $150 (53-55 min) unless otherwise agreed upon with your clinician. In addition to therapy session related appointments, we charge for other professional services you mayneed. For phone calls lasting over 15 minutes, this is $37.50 per 15 min increments (which we can charge toyour insurance when necessary-like in a crisis call situation). These fees are subject to increases of no morethan 10% annually.

If you request any letters, paperwork, etc, we charge an upfront $50 fee for the 1st 20 minutes of work.After that, it is $2.78 per minute for any work over 20 minutes. This must be paid in full, as well as any otherbalance on your account, before we hand over the paperwork/letter. You are welcome to discuss a paymentplan with your clinician and make the appropriate arrangements. If you fail to meet the terms of thisarrangement or the described above, you are still ultimately responsible for paying your bill. Any paymentplans are subject to approval of the director.
If for some reason your insurance does not cover sessions or is refusing to pay, the client is responsible forthe balance. Phases Therapy, Inc. is open to discussing payment plans when applicable. Any changes needto be discussed with Phases Therapy, Inc./your clinician and updated in writing. We are happy to printinvoices for you so you may submit them to your insurance company for reimbursement (if that is anoption). You are also allowed to elect to self-pay and will fill out a form waiving coverage. A $10.00 servicecharge will be charged for any checks returned for any reason for special handling.

If you become involved in legal proceedings that require your clinician’s participation, you will be expectedto pay for the professional time even if called to testify by another party. This additionally includes travel toand from, as well as any prep needed for the court time present. Because of the difficulty of legalinvolvement, we charge $300 per hour for preparation and attendance at any legal proceeding.

Any unpaid bills after 90 days that have not had arrangements made with your clinician may result in legalaction.