Important Information
The Answers You Need
Welcome to The Counseling Office of Debbie E. Dickson Counseling, Inc. The federal law requires us to give you a copy of this notice. It is a Notice of Privacy Practices. With this notice is an acknowledgment the federal law requires you must sign confirming that you received/reviewed a copy of the Notice. This document will help you understand how and when
your medical information is used of disclosed by this practice.
Financial Policy
Basic policy: Payment in full is due at the time service is provided unless prior arrangements have been made. Co-payments are due at the time of service. Cash is the preferred payment for services. A receipt will be given to you that may be submitted for you to file with your insurance provider.
Clients with Insurance-Medicare-Medicaid
Coverage must be provided to initiate services under your provider contract. Please contact your company to confirm that this office is in-network. We will bill most carriers when we are in-network. It is the client’s responsibility to be informed about your coverage plan and what it covers. We will bill most secondary insurance. We will not bill third party insurances. Copays, co-insurance, deductibles are due at the time of service. If there is an issue with your claim, please contact your coverage company for an explanation. If your carrier has not paid within 60 days of billing.
Collections of Fees
If it becomes necessary to bill you more than once for your share of services, a $7.50 per month fee may be charged to your account until paid in full. If your account is brought to collections/court action the prevailing party shall be entitled to recover from the other party the costs and fees as determined. All waived fees will be reinstated to your account.
Credit Cards
Credit Cards may be placed on file to be charged as fees are due.
Fees
• 53-60 minute hour = $225.00/ • 38-52 minute hour = $200.00/ • 16-37 minute hour = $175.00
Late cancel/late reschedule/no show minimum charge = $75.00. It is up to your counselor to waive fees per your request.
The account must also be in a positive status to apply for waivers. If your account goes into collection status
all waived fees are reinstated.
Court- Portal to Portal = $500 per hour. Fees are due prior to court.
Form completion = $10 per page.
Billing fee for charges due at time of service = $7.50
If you are paying out of pocket for services and not using insurance or employee assistance programs, fees may be negotiated with your chosen counselor if you choose. Counselors may choose to assist the client with a sliding fee scale.
Limits on Confidentiality: Information can be shared with your consent in writing only or by local, state, federal mandates,
and or in case of a lawsuit with a clinician and client for defense purposes. By signing the intake documents,
information is consented for treatment and billing purposes.
We are mandated reporters of child abuse, elder abuse, or when there is a threat to yourself or others.
Phone messages
If you reach us after hours, please leave a detailed message and we will be in touch with you as soon as possible.
In the event of a mental health emergency, please visit your local hospital Emergency Room rather than leave phone messages.
Emergencies: Mental Health
Emergencies: Weather
If you have a mental health emergency, visit your nearest hospital Emergency Room.
In the event of a weather emergency, office hours may be interrupted. Please listen to local radio stations for information on closures.
Missed appointments, late or cancelling
A 24-hour notice is required to cancel an appointment.
Office hours & holidays
Appointments are scheduled by appointment. Call the office to schedule. We observe all major holidays and are closed.