Policies:
FEES:
My fee is $100 per visit. The first visit will last 60 – 90 minutes depending on clients’ specific needs. All follow up visits are 60 minutes, unless other arrangements are made, and the fee will be adjusted accordingly. Payment is expected at the time services are rendered, and cash or personal check are accepted as payment.
INSURANCE:
Clients are expected to pay me directly and submit claims to insurance companies as appropriate. Currently, I am not a network provider for any insurance companies, including Medicare. Some insurance companies provide coverage for “Out of Network Physical Therapy”, usually at a percentage of billed services. It is the client’s responsibility to check with their insurance company to see if any of the treatment will be covered and the process for receiving benefits. This will usually require a claim form to be completed, and I would be happy to assist you in this process as needed.
BILLING:
Clients will receive a statement from me at the end of each month upon request.
CANCELLATION:
I would appreciate significant notice in the event that a session needs to be cancelled. Notice of less than twenty-four (24) hours will mean that half payment is due for the session, and notice of less than four (4) hours or “no show” will require full payment for the missed session. Insurance cannot be billed for missed sessions, so this payment will be the client’s sole responsibility.
CONFIDENTIALITY
All information discussed, as well as all physical findings and treatments performed, during sessions is confidential unless I have written permission from a client stating otherwise. This includes medical history and any other personal information you may share with me during our sessions. One exception to this is that I am a mandated reporter by law for any situations of suspected/alleged child or elder abuse.
I have consultants with whom I discuss my work. No identifying information is given about my clients during this consultation.
PHONE CALLS
My voice mail is on 24 hours a day and I am the only one who picks up messages. I try to return calls as soon as I get them, however evening calls will usually be returned the next day. I do not charge for phone call consultation, though it is my expectation that calls will be brief.
Each client is asked to sign a copy of this policy statement at the initial visit.
Thank you – please let me know if you have any questions regarding these policies.
Revised: September 6, 2011
