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Jill Gaumer, LCSW
Counseling & Mediation

Office Policies and Procedures

SESSIONS AND FEES: My usual fee is $85 per session. Sessions normally last 50 minutes, but can be longer or shorter depending on the circumstances. Fees are paid at either the beginning or the end of the session.

TELEPHONE COVERAGE AND CONTACTING ME: I return calls as quickly as possible as I like to be available to clients. I do not, however, want to use the telephone for treatment issues. Please limit calls to information exchange or critical issues. You may also e-mail me at jill@jgcounseling.com

When I am out of town or on vacation, I will have another therapist on call for urgent needs

EMERGENCIES: CALL 911 or go to the nearest hospital emergency room.

CONFIDENTIALITY: A key aspect of counseling/psychotherapy is the development of a trusting relationship between the client and the therapist. Also, I am bound by the Clinical Social Work Federation and the licensing board to maintain client confidentiality. Therefore, information between the client and therapist is kept in strict confidence. You may review your record with your therapist upon written request.

Exceptions to confidentiality:

  1. If there is a suspicion of abuse or neglect of a child, whether current or past, there is a Duty to Report this to the Department of Social Services. This is true for both suspected victim and abuser.

  2. If a client threatens to do harm to another person, there is a Duty to Warn that potential victim.

  3. If a client is determined to be at high risk of harming him/herself, or of harming another person, the Duty to Protect takes precedence over confidentiality.

  4. If there is a suspicion of abuse or neglect of an elderly person, there is a Duty to Report this to the Department of Social Services.

  5. Court Orders override the rules of confidentiality.

  6. Health insurance companies generally require a diagnosis and can require a review of their case records.

PAYMENT AND RESPONSIBILITY: You may pay privately or you may choose to use your health insurance or your Employee Assistance Program (EAP). I accept many of the major plans.

If you are using your insurance coverage for psychotherapy is often very different than coverage for medical visits to a physician. To insure that you are aware of what type of coverage you have, I suggest that you verify your benefits for outpatient coverage by calling your insurance carrier. Here are some questions you should ask your insurance company.

  1. Is your coverage active at the time of your session?
  2. Do you have a deductible?
  3. Do you have a co-pay?
  4. What is the maximum amount they will pay in a year?
  5. What is the maximum number of sessions in a year?
  6. If you have your own coverage and are covered by a spouse’s insurance, how does this affect the payment?

It is the insurance company’s job to explain your benefits to you. Be aware that most insurance carriers do not pay the entire fee.

KEEPING APPOINTMENTS: It is important to keep your agreement to come to counseling on a regular schedule. I try to accommodate people’s work and home life schedules. However, last minute cancellations are disruptive to all. This time has been reserved for you. Additionally, insurance companies will not pay for any missed sessions.

Appointments cancelled with less than 24 hours notice and missed appointments are charged at $35. Payment must be made before additional sessions can be scheduled.

Please review the following and sign that you have read and agree:

I understand and agree that, regardless of my insurance status, I am personally responsible for any balance on this account. I understand that I will be responsible for any legal fees or other fees incurred in the collection of payment on this account. I have completed the above information and certify that this information is true and correct to the best of my knowledge.

 

                                                                                                
Signature Date
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