Payment

Policies and practices regarding payment for services

Fees

My basic fee is $130 for a 90 minute psychotherapy session. This assumes that 75 minutes of this time will be allocated to client services, and the remaining time to paperwork (case notes, billing, etc.). While I do, on occasion, work with clients in 60 minute time intervals (for which my fee is $100), I most often meet with individuals and couples for a 90-minute session, due to the complexity of the type of clients I usually see and the superior economics of this time interval (see below).

Ninety minute sessions are simply more cost-effective. For any session I have with a client, they have transportation costs (time and vehicle-related). We both take time to get the session started, and to do a wrap-up at the end. In the middle of this is time we have for psychotherapy. By extending that time, while holding constant the costs involved in beginning and ending the session, we get more work done without increasing these costs.

My approach to fees is flexible. I employ a sliding fee scale, and have always done a significant amount of pro bono work. Any client experiencing financial difficulty should discuss their situation with me rather than drop out of psychotherapy; we can usually work out a mutually satisfactory arrangement.

Payment expectations

Payment is expected at time of service, unless other arrangements have been made in advance.

A check or cash is the usual mode of payment. Clients referred from government agencies (including those associated with Tribal governments) are usually paid for by the referring agency, which I will bill. Clients with insurance or managed care contracts are expected to pay at time of service as well.

Insurance billing

In my experience, virtually all insurance or managed care plans will reimburse their clients for my services. I will assist you in making your reimbursement claim, if you need this assistance.

It is important to be aware, however, that my communications with your contracted company/plan is a courtesy only. The contract being serviced is between the individuals I treat and their companies. You have primary responsibility for managing your insurance company/managed care provider.

I do not have a contractual relationship with any insurance or managed care company, by choice. The overhead involved is objectionable, and merely adds to the cost of my services. In addition, a number of studies have shown that involvement of such companies does not lower the cost of service. Instead, it merely redistributes the monies paid for care. There are also some real questions about the degree of information sharing sometimes required by such companies. Most people think it best if their personal information is not distributed between too many people, company databases, filing systems, etc. I agree!

Medicare, Medicaid, Social Security Disability

I am not a reimbursable provider for such health care funding sources.

Cancellations, missed appointments, “no-shows”

For a cancellation, 24-hour notice is required if the matter is not to be considered a missed appointment.

Missed appointments (last minute non-emergency cancellations, and no-shows) are billed at $35 per appointment.