Office Policies

Welcome to my practice. Below you will find important information about my professional services and office policies, including questions clients often ask about psychotherapy.

PSYCHOTHERAPY

Psychotherapy varies depending on the treatment approach(es) of the psychologist, as well as on the personality, preferences, and needs of each client. In all instances, psychotherapy calls for an active effort on your part. The process can have both benefits and risks. Since therapy often involves discussing unpleasant aspects of your life and/or functioning, uncomfortable feelings may arise. Psychotherapy also has been shown to have benefits, such as improving relationships or work satisfaction, finding solutions to specific problems, and reducing feelings of distress and symptoms of various psychological conditions.

It also is necessary to understand that a positive therapeutic relationship is helpful to the course of treatment, and so finding a “good fit” between you and your psychologist is important.

MEETINGS AND CANCELLATION POLICY

My usual practice is to conduct an initial evaluation that will last from one to four sessions. By the end of this period, I will be able to offer you some initial impressions and treatment recommendations, and we can both decide whether I am the best person to provide you with the services to meet your treatment needs and objectives. Subsequent meetings usually consist of one 45-minute session per week, although sometimes sessions will be longer or more frequent.

Once an appointment is scheduled, that time is reserved for you and will not be used for anything else. You will be expected to attend unless you provide 24 hours advanced notice of cancellation. Please be advised that insurance providers do not reimburse for missed appointments. I recognize that there occasionally may be unforeseen circumstances that make it impossible to provide 24 hours advanced notice of cancellation. Therefore each client will be permitted one “late cancellation/missed” session per calendar year without charge. For each additional late cancellation or missed appointment, you will be charged a missed appointment fee of $50.

CONTACTING ME OUTSIDE OF SCHEDULED APPOINTMENTS

I am often not immediately available by telephone. While I am usually available between 9AM and 6PM, I do not answer the phone when I am with clients. When I am unavailable, my telephone is answered by a voice mail that I monitor frequently. I will make every effort to return your call that same day, with the exception of weekends and holidays. If I am unavailable for an extended time period, I will discuss with you options for emergency contacts and/or provide you with the name and contact information of a trusted colleague. Please note that e-mail is generally not considered to be a secure means of communication, and I do not communicate with patients via this method.

In the event of a mental health emergency, such as that involving a client’s safety, clients and families should do what they deem necessary to ensure the safety of the client first. lf you are unable to reach me and feel that you cannot wait for me to return your call, these steps might include contacting your family physician, calling 911 or Mobile Response and Stabilization Services (1-877-652-7624), or proceeding to your nearest crisis center or emergency room.

PROFESSIONAL FEES FOR SERVICE

Your fee or copayment shall be paid in full at the time of the visit. For this reason, I will not send you a bill. Fees are payable in cash or check made out to Cornerstone Psychological Services, LLC. You will receive a receipt for services rendered.

In addition to weekly appointments, it is my practice to charge my usual fee, on a prorated basis, for other professional services you may require. These might include report writing, telephone conversations lasting longer than 15 minutes, and preparation of records or treatment summaries (separate from those needed for insurance reimbursement), among others.

CONFIDENTIALITY

In general, the privacy of communications between a client and a psychologist is a hallmark of psychotherapy and also protected by law. This means that I can only release information about our work with written permission from the client or a parent/guardian. There are a few rare exceptions. When there is an imminent risk of harm to the client or others, I am required to take protective actions. This includes if I believe a child, elderly person, or disabled person is being abused; in this situation, I am legally required to file a report with the appropriate state agency.

PROFESSIONAL RECORDS

The laws and standards of my profession require that I keep treatment records. These records are not released to anyone without the consent of the client or parent/guardian. New Jersey state law indicates that the client or parent/guardian is entitled to receive a copy of their records, unless receipt of the information would adversely affect the client’s health or welfare.

NOTICE OF PRIVACY PRACTICES: LIMITS OF CONFIDENTIALITY & POLICIES AND PRACTICES TO PROTECT THE PRIVACY OF YOUR HEALTH INFORMATION

This Health Insurance Portability and Accountability Act (HIPAA) notice describes how psychological and medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.

Uses and Disclosures for Treatment, Payment, and Health Care Operations

I may use or disclose your protected health information (PHI) for treatment, payment, and health care operations with your consent. To help clarify these terms, here are some definitions:

  • “PHI” refers to information in your health record that could identify you.
  • “Treatment” is when I provide, coordinate, or manage your health care and other services related to your health care.
  • “Payment” is when I obtain reimbursement for your health care. Examples of payment are when I disclose your PHI to your health insurer to obtain reimbursement for your health care or to determine eligibility for coverage.
  • “Health Care Operations” are activities that relate to performance and operations of any practice. Examples include quality assessment and improvement activities, business-related matters such as billing and administrative services, and case management and care coordination.
  • “Use” refers only to activities within my office such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you.
  • “Disclosure” refers to activities outside of my office such as releasing, transferring, or providing access to information about you to other parties.

Except in some special circumstances, when I use your PHI in this office or disclose it to others, I share only the minimum necessary PHI needed for those others to do their jobs.

Uses and Disclosures Require Authorization

I may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances, when I am asked for information for purposes outside of treatment, payment, and health care operations, I will obtain authorization from you before releasing this information.

You may revoke all such authorizations at any time, provided each revocation is in writing. You may not revoke authorization to the extent that (1) I have relied on that authorization, or (2) if the authorization was given as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.

Uses and Disclosures with Neither Consent or Authorization

I may be obligated to use or disclose PHI without your consent or authorization in the following circumstances:

  • If I have reasonable cause to believe that a child has been subject to abuse or neglect, I must report this immediately to the NJ Division of Child Protection and Permanency.
  • If I have reasonable cause to believe that a vulnerable adult is the subject of abuse, neglect, or exploitation, I must report this immediately to the county adult protective services provider.
  • If the New Jersey Board of Psychological Examiners issues a subpoena, I may be compelled to testify before the Board and produce your relevant records and papers.
  • If you are involved in a court proceeding and a request is made for information about the professional services that I have provided you and/or the records thereof, such information is privileged under state law, and I must not release this information without written authorization or a court order.
  • If you communicate to me a threat of imminent serious physical violence against a readily identifiable victim or yourself, and I believe you intend to carry out that threat, I must take steps to warn and protect. I also must take such steps if I believe you intend to carry out such violence, even if you have not made a specific verbal threat. These steps may include arranging for a crisis evaluation in the psychiatric unit of a hospital or other health care facility, advising the police of your threat and the identity of the intended victim, warning the intended victim (or his/her parents if the victim is under 18 years old), or warning your parents if you are under 18 years old.

Patients’ Rights

  • You have the right to request restrictions on certain uses and disclosures of your protected health information. However, I am not required to agree to a restriction you request.
  • You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations.
  • You have the right to inspect and/or obtain a copy of your PHI and psychotherapy notes in my mental health and billing records used to make decisions about you for as long as the PHI is maintained in the record. I may deny your access to PHI under certain circumstances, but in some cases you may have the decision reviewed.
  • You have the right to request an amendment of PHI for as long as the PHI is maintained in the record. I may deny your request.
  • You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization (as described above in this Notice).
  • You have the right to obtain a paper copy of this Notice from me upon request.
  • You have the right to file a complaint if you feel your rights have been violated. Please let me know immediately if you believe your privacy rights have been violated so that I can make any necessary corrections. You also can file a complaint with the US Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or by visiting hhs.gov/ocr/privacy/hipaa/complaints/. I will in no way retaliate against you for filing a complaint.

Psychologists’ Duties

  • I am required by law to maintain the privacy of PHI and to provide you with a notice of my legal duties and privacy practices with response to PHI.
  • I reserve the right to change the privacy practices described in this Notice. Unless I notify you of such change, however, I am required to abide by the terms currently in effect.
  • If I revise my policies and procedures, I will notify all current clients.