Client Information and Office Practices
Seeking Shalom (4/1/2024)
Info on Our Practice. Info on Your Treatment.
This document describes important information about our practice
and what is involved in getting treatment. It should be read in
conjunction with our Privacy Policies, which also contain
important information. Please review it carefully.
SUMMARY
Offices and Contacts
- Where our
offices are located and how different offices are used
- Other ways of
contacting us (especially by phone or email) and response times
you can expect
- How we do and
do not use social media
Appointments
- What the timing
of appointments usually looks like
- How to schedule
appointments and deal with clinician* absences
- Processes for
lateness and cancellations
Financial Matters
- Issues to be
aware of regarding our fees, including what fees you can expect
- Insurance
matters as well as factors relating to other payments
Clinical Matters
- How you are
assigned a clinician and how this may be able to be changed
- How
confidentiality and emergencies are handled
- Disclosures
about the process of therapy*
- Description of
the flow of treatment and what termination looks like
Teaching Practice Processes
- How our
clinicians all engage in continuous quality improvement
- Issues related
to supervision and some opportunities this provides for you
- Considerations
around pre-licensed clinicians
Client Rights and Responsibilities
- The rights and
responsibilities that every client at Seeking Shalom have
Applicability of this Information & Changes to these
Practices
- A description
of the entities following these practices and their relationships
- How these
practices may be changed and the effect of any such changes
* throughout this document use of clinician includes therapist
and counselor
* similarly, throughout this document therapy and counseling
are used interchangeably
* additionally, Seeking Shalom refers to any and all of the
entities that comprise Seeking Shalom
OFFICES AND CONTACTS
Offices
Seeking Shalom maintains a number of offices:
- West Bronx
o 2345 University
Ave, Bronx, NY 10468
o Access is via
the Parish Office entrance, which is closed for lunch and supper.
- Midtown
o As arranged, in
the vicinity of Grand Central and Rockefeller Center.
o Access will be
disclosed if and when a Midtown location is being used.
- Other locations
(as announced)
- Group Locations
o These will be
announced when the group is announced.
- Indiana
o Program
locations will be announced to those attending a particular
program.
- "Home Visit"
o In most cases,
services are delivered by distant technology (such as video,
telephone, chat) on platforms that provide appropriate settings
for clinical services. Access information will be provided prior
to a telehealth session; however, these are normatively conducted
on a secure version of Zoom. There is a 1:1 video platform in the
client portal that may also be used, particularly if there is a
technical problem with Zoom.
Your clinician will practice in one or more of these locations.
If your clinician practices in more than one of these locations,
you and your clinician can discuss if you can see them at more
than one location.
Clinicians may have set schedules at different offices, but this
does not mean that they will always be there during those hours
or that they will be free at those times. Clients should not
attempt to "drop in" at a particular office location as there may
not be anyone available to see them.
Administrative Address (for all mailed correspondence)
Our administrative address is:
- P.O. Box 8233,
White Plains, NY 10602
We do not intend to receive mail at any of the other addresses,
besides our administrative address.
Telephone - Text - FAX
You may get in touch with us by telephone (with the understanding
of the type of telephone system we use, as outlined in our
Privacy Policies). You will have available to you one or more of
the following numbers:
- Main Office
Number (212-655-9605): this number can be used for general
purposes and may be answered in different locations. Calls will
be returned as quickly as possible, but you may expect that a
returned call may take up to four business days. This number also
provides options to speak to staff members about general help,
particular programs, and special services, as well as direct
connections to clinicians and staff members (or their voicemail
if they are not available).
- Business Line
Number (646-513-2866): similar to the main office number except
that it connects to our business office. It is primarily used for
contacts with other businesses and not with clients. Calls here
get lower priority than calls to the main office number.
- Answering
Service (646-513-2867): if your clinician is served by the
answering service (which most clinicians are not, so please check
with your clinician before using it), this number may provide a
24/7 way to get a message about needed clinical attention within
a few hours. You can expect a timelier response, usually within
one or two business days; some clinicians may also arrange to
have this number be able to be used by their clients for
assistance with symptom management and/or other specified
reasons. If there is a problem with the answering service, calls
will generally be routed to a special voicemail box.
- Calls to
particular programs (such as the Journey to Peace program) or
special services (such as those in a particular language) as well
as intake calls are routed to staff associated with these
particular programs or able to assist with this special service;
these calls will be returned as quickly as possible but may take
up to a week.
- Calls to
clinicians or staff members may be forwarded to them in different
locations and in different ways; such calls will be returned as
quickly as possible, but you may expect that a returned call may
take up to four business days or even a week if the person is
part-time.
Text Messaging is a common method of communication, however:
- generally,
clients are not able to reach clinicians or staff members by text
message, and if they are, the clinician is not able to respond by
text.
- we may reach
out to you by text to provide you with updates, but our ability
to do this is severely limited.
- some clinicians
use systems that provide you with a text reminder of your
appointments, generally twenty-four hours in advance; if you do
not want to receive these text messages, you may make that
request through your clinician, and you can control reminder
messages through the client portal.
- Clients may
send a text message to their clinician only in the case of quick
issues relating to an appointment occurring on the same day such
as needing access to the building or telehealth platform,
forgotten details of the location of the appointment, or running
late to the session. Unless your clinician provides another
number to use, texts should be sent to (646)513-2865 and may be
viewed by more than one clinician; as such, it is important that
you identify yourself in the message you are sending. This method
of communication should not be used for other matters and use is
waiving privacy of the communication. Be aware that a clinician
is not able to respond by text and may be unable to reply at all,
especially if doing so would be interrupting someone else's
session.
Faxes are no longer a common method of communication, but they
can be a secure way for some people to send us information. Our
fax numbers are:
- Our main FAX
(646-513-2860)
- Secure FAX
(646-513-2859): a separate fax line through which Seeking Shalom
can receive faxes securely; this is particularly appropriate when
the content involves protected health information
Personal Cell Phone Numbers of Clinicians or Staff Members
- Clients will
not be given the personal cell phone number of their clinician,
or other staff members; the above contact methods provide other
ways to reach them and are what should be used.
We have provided a number of ways of contacting us by phone but
please understand that we are not always available to be able to
talk to you between sessions and that non-administrative
conversations may be billed as clinical sessions even if they are
not pre-scheduled sessions. Also, please understand that your
ability to reach a clinician or staff member will be affected by
their schedule (which may be different than typical given that we
operate on a seven-day-a-week schedule and have hours ranging
from the morning through the evening). After hours, you should
generally not expect to reach a live person, with the possible
exception of staff at an answering service.
Email Communication
You may get in touch with us by email (with the understanding
that some types of email communication have privacy limitations).
You will have available different ways of using email:
- Your clinician
or staff person may have a direct email address that you can use
that will be provided to you. If you choose to use this email
address, be aware that email to and from it will be using
commercial email channels and should not be considered secure.
This includes the possibility of email carriers scanning the
content of the email and/or third parties reviewing the content
without disclosing that they are doing so. This method of email
communication is less preferred than the next method of sending
us a message.
- Clients will be
provided a secure method of communicating by email (such as the
secure messaging system in the client portal). These messages are
encrypted and require the sender and receiver to both use
passwords. We will choose this method to send emails to you
unless it is an automatic message from one of the tools we use
(like the client portal or Zoom) or you have contacted us first
using an email that is not secure.
- We have email
addresses established for particular purposes (such as reaching
the clinical director at ClinicalDirector@SeekingShalom.org or
the team of supervisors of interns and residents at
Supervisors@SeekingShalom.org) that may utilize regular or secure
email.
- The practice
maintains several regular email addresses that can be used for
general purposes including NewYork@SeekingShalom.org and
Indiana@SeekingShalom.org.
Other systems we use may also provide email notifications to you
including:
- email
notifications from the client portal for appointment reminders or
announcements (you can customize these)
- requested
receipts from credit card payments
Generally, these notifications cannot be responded to.
In the event that we contact you through an email list that we
maintain of current or former clients, you have the right to ask
us to remove you from that list and receive no further
communication sent to that list. This will not restrict our right
to use your email address to contact you individually about
matters that relate to you.
Web Presence
Seeking Shalom maintains a website at www.SeekingShalom.org. This
website contains information that may be of interest to potential
and current clients. We also use this website to provide
information updates that clients are encouraged to review
regularly.
Seeking Shalom is also present on other sites including
directories and sites offering information.
Information that we offer on the web, as with other written
documents, is general information. Clients should not consider it
to be specifically about them or applicable to their case without
discussing it with their clinician or another qualified
professional.
Patient Portal
Clients may be given access to a patient portal by their
clinician. This is password-protected access to parts of the
electronic health record maintained on the client. Additionally,
it may provide a number of features that the client may find
helpful, such as:
- Online Calendar
System: allows a client to make, change, and cancel appointments
(within certain time periods) as well as see the times of
available appointments with their clinician
- Secure
Messages: a secure email system that can be used between client
and clinician
- Ability to
Review Treatment Plans: when shared electronically by the
clinician
- Forms: clinical
forms that can be completed online to avoid the need to use paper
- Billing
Information: copies of invoices and payment receipts, make online
payments
- Settings
Preferences: the ability to change how the portal works,
including notifications received
- Journal: an
online journal, unlike the other parts, does not have to be
shared with the clinician.
Clients with any questions about the client portal should speak
with their clinician.
Involvement through Social Media
Social media has come to occupy an important place in many
people's lives and has become a popular way of trying to
communicate.
As social media has the possibility of blurring boundaries and to
avoid the possible complications of dual relationships, Seeking
Shalom has adopted a policy whereby our clinicians do not form
associations with clients through social media, including any
type of being linked or becoming friends. Such requests will
ordinarily be declined if they are made.
As part of our professional practice, Seeking Shalom does
maintain a presence on a number of social media platforms. We
would welcome clients to connect with our professional presence
by liking or following our content.
Reviews of Our Work
We understand that there are third parties that collect reviews
of the work of all sorts of service providers, and some of these
even focus on people who provide the types of services we offer.
Seeking Shalom and its clinicians never solicit your public
review of our work. We believe that to do so would not be right,
given the type of relationship that we have with you. We are also
concerned about the fact that you may not understand the full
impact of something that you say in a review, especially when
viewed by someone you had not considered as part of the readers
of that review. We are also concerned that someone else who reads
a review may feel concerned about how we might use their personal
information from a confidentiality standpoint.
Rather than posting a review, positive or negative, we would
appreciate it if you would have direct communication with us.
We may, at times, ask for your feedback because we understand
that you can play an important role in helping us understand how
we can better serve you and others and that you can provide
insight into what we are doing well. Clinicians may also provide
simple ways to provide ongoing feedback (such as a couple
question session review form in the client portal).
Your best review of our work is honest interaction with us and
personal recommendations. We would only want you to make personal
recommendations if you were comfortable and if you felt that the
other person might benefit from the types of services we offer.
APPOINTMENTS
Appointment Timing
Generally, appointments are scheduled on the hour or the half
hour. If your clinician's schedule is different, they will let
you know.
Our standard appointment block is an hour. The beginning of this
time is spent between you and the clinician. The last 5-15
minutes (depending on the type of appointment) of the appointment
is spent by the clinician alone for the clinician to write a
progress note and take care of other matters they need to attend
to before the next appointment block.
Administrative matters (such as payment, scheduling appointments,
or other matters that need to be addressed) may be handled during
the beginning or end of your time with the clinician, although
most of these can also be handled directly by you online through
the client portal.
When the situation warrants it, there are other time frames that
may be possible, for example:
- someone who is
also involved in group therapy may only need appointments based
on a half-hour block in order to have the opportunity to touch
base on individual matters
- some clinicians
in some programs may provide for a longer initial session
- a client coming
more for assessment than treatment may require longer sessions
- in some cases,
a couples or family session may be combined with an individual
session with the combined session occupying a ninety-minute block
instead of a two-hour block
Generally, sessions will initially occur on a weekly basis.
Depending on clinical need and practical considerations, the
frequency of sessions may increase or decrease. Generally, while
in active treatment clients should expect to have sessions no
less frequently than monthly and no less frequently than
quarterly if they are receiving therapeutic checkups. We may make
your case inactive or discharge you if you are coming less
frequently than this or if you stop regularly scheduling
sessions.
The frequency of appointments and any deviation from the standard
appointment block will be discussed with the client by their
clinician.
If a break in treatment is needed, such as when someone is going
on vacation, this should be discussed between the client and
their clinician. You will discuss any other type of contact that
will or may occur during that break. However, note that this will
be restricted because by law clinicians can only have contact
with clients when the client is in New York or another location
where the clinician is authorized to practice.
Appointment Scheduling
We believe that different clients have different scheduling needs
and should be in control of their schedule, within the
availability of their clinician. To this effect, please consider:
- Clinicians may
practice with fixed schedules relative to particular offices or
may operate entirely based upon negotiated appointments. If the
clinician is using an online calendar system (such as found in
the patient portal), available appointment slots may be reviewed
there.
- Appointment
slots are generally booked on a first come first served basis,
meaning that if you wait until the last minute to book an
appointment, you are less likely to get the one you desire.
- Appointments
may be made for individuals, couples, families (or specific parts
thereof), or other groups of connected individuals. The
presenting problem and the assessed treatment plan generally
drive this. Before a client schedules for a different
configuration, the client should discuss this with the clinician.
- Same day
appointments (and those less than 24 hours away) do not show up
in the online calendar system and may well not be available. If
one is available, it can only be booked directly with the
clinician.
- Clients are
expected to manage (make, change, and cancel) their own
appointments. The following methods may be available to you to do
this:
o the online
calendar system
o reaching your
clinician through their phone number
o making
appointments at the time of a previous session
- Clients may
book more than one advanced appointment (for example, if they
want to establish a regular appointment slot). However, this
opportunity may be restricted if the client has an excessive
number of cancellations, whether these are timely or late
cancellations.
- If no
appointments are available when you want them, your clinician
will let you know if a cancellation occurs if you request them to
do so. Calendar exceptions to schedule appointments outside
normal times can only be made by the clinician involved.
- If an
appointment is canceled and not rescheduled or if too long passes
between appointments, your clinician may attempt to contact you
(or your emergency contact) to determine what is going on. If
they are not able to reach you, the clinician may make your case
inactive or discharge you.
Dealing with Clinician's Absence
There will be occasions when a clinician will not be able to see
clients.
When a clinician has a planned absence of more than a day or two,
the clinician will attempt to inform you in advance. Together,
the client and clinician will discuss details of how things will
be covered during the absence. During planned absences, the gap
may be addressed in different ways, such as a gap between
sessions, conducting of session(s) by video or possibly
telephone, and/or another clinician providing coverage (for
emergency sessions and/or regular sessions).
There are times when a clinician will have an unplanned absence.
In these cases, we will attempt to contact affected clients as
soon as we know and are able to reach out. Most of these (such as
illness or transportation problems) only affect a small number of
days. In these cases, clients may elect to reschedule the missed
session or may choose to simply wait until the next scheduled
session.
In some cases, a clinician may be unavailable for an extended
period of time without this having been anticipated. In these
cases, the clinical director (or other clinicians) will work with
clients to make sure that continuity of care is able to be
provided.
Lateness Policy
Lateness can occur on the part of the client or the clinician,
especially in a city with as complex transportation issues as
ours. Similarly, technological issues (especially unplanned
updates of software) can also cause a delay. While they are
handled differently, similar grace exists behind each of the
responses.
Clients are responsible for coming to each session on time and at
the time scheduled. A time block has been reserved for that
client and that client only to be together with the clinician.
Respect for this aspect of our work together is appreciated.
- Elsewhere,
being late for a therapy appointment would result in talking for
the whole session about the lateness. It would be presumed that
there are therapeutic issues behind a client being late, such as
trying to avoid talking about particular topics. We will
generally not have these conversations unless a client's lateness
is or becomes habitual.
- When a client
is late, the clinician may elect to extend the client's
appointment beyond the end time, which may not always be possible
based on other people's appointments, your clinician's other
obligations, or other factors in the therapeutic relationship. As
a result, if you are late, you should expect that you will have a
shorter appointment and still plan for your appointment to end on
time.
- When a client
is seven minutes late, the clinician may consider this to be a
missed session (with an associated fee for a no-show, as
described below) and may offer any portion of the remaining time
to the same or another client for a session. For insurance
clients, it should be noted that shorter sessions are generally
reimbursed at a lower rate by the insurance company, even if the
client pays the same copay.
- Similarly, if a
client ends a session before its scheduled time, the clinician
may charge a Session Reservation Fee (as if the full session had
been canceled) and any client responsibility for the shorter
session that was conducted.
On the other hand, if a clinician is expecting to arrive late,
the clinician will attempt to contact clients, most likely by
email or phone, to let them know about this possibility. It is
not fair to the client for the client's appointment to be
shortened if the clinician is late. If a clinician is late, they
are expected to work with clients for the full session time while
pushing administrative and record-keeping time to later. In this
way, the clinician will be able to catch up on their schedule.
Cancellation Policy
Our work together is most effective when meeting times are
regular and consistent. There are people whose life schedule
requires them to have a less regular or consistent schedule of
appointments - we understand this and allow you to have
flexibility in the booking of your appointments. Regardless, once
you have scheduled an appointment, the time scheduled for your
appointment is assigned to you and you alone. As a result, it is
not available to anyone else who wants to get help, and your
clinician is not able to plan to work with other clients during
that time.
- Please give at
least 24-hour notice if you cannot attend your session if it is a
weekday daytime appointment.
- Please give at
least 36-hour notice if the appointment is after 5:00 pm or on
the weekend.
- Providing this
amount of notice allows us to contact someone who has told us
they would like to come at that time but were not able to get an
appointment.
- You will be
charged a Session Reservation Fee (otherwise called a Late Cancel
or Missed Appointment fee) for missed sessions or sessions that
are canceled without adequate notice. It should be noted that
these fees are generally not reimbursed by third party payers
like insurance companies. We use two tiers of Session Reservation
fees:
o canceling less
than three hours before the appointment or not showing up for an
appointment: $75
o canceling more
than three hours but less than 24/36 (see above) before the
appointment: $35
o for those in the
Journey to Peace program, these will be reduced to $30 and $15
respectively.
Naturally, should an unforeseen emergent situation arise, this
may be taken into account, but even in these situations these are
usually not waived. In any case, frequent true emergencies will
not be repeatedly taken into account.
FINANCIAL MATTERS
Fees
Seeking Shalom is primarily funded from client fees. Some clients
will have a portion of their fees paid by a third party (such as
an insurance company or an employee assistance program). However,
we believe that it is usually important for those who receive a
valued service to pay at least a portion of the cost of their
therapy.
Session Fees
Standard fees are determined for each service and vary based on
the type of clinician and the office location (the client's
primary office location or higher fees if seen in another
office). As a result, the standard fee charged for a session in
one office may be different than the same session conducted by a
different clinician in a different office. Additionally,
different services may have different fee structures. For
instance, in most cases the fee charged a participant for a group
session will be half or two thirds the fee charged for an
individual, couple or family session that lasts a similar amount
of time. Currently, the standard fees for regular sessions
(individual, couple, family) when such clinicians operate in
these offices are as follows:
- Clinical
Director: $225 ($200 in Indiana)
- Licensed
Clinician: $200
- Resident: $175
- Intern: $140
- Initial Intake
Sessions:
o the standard fee
shall be 50% higher than the normal session
o at times, as a
courtesy and gift to our clients, the initial intake session may
be charged the same fee as a regular session, as detailed above
Reduced Fees
Some clients may qualify for reduced fees:
Some clients have fees that are reduced as part of the way that
they came to Seeking Shalom:
- Clients who are
residents of the Bronx or northern Manhattan who pay their full
session fee at the time of service will be eligible for a $50
discount on their fee for that session.
- Some referral
sources (especially third-party payers such as insurance) may
have negotiated reduced fees. See below for more information
about using insurance.
- Some clients
may receive financial assistance for their fees from their
religious body or other referral source.
- Seeking Shalom
may offer a fee reduction (of up to 20%) to clients paying full
cash rates whose leaders of their faith group (partnered with
Seeking Shalom) referred them.
- A client may be
part of an external program their clinician participates in that
provides pro bono or reduced-fee sessions. These opportunities
will be limited and only apply to clients meeting specific
criteria.
- Other clients
may have a session fee that is temporarily reduced from standard
fees based on their proven life situation and established in
cooperation with their treating clinician (and the approval of
supervisory staff), usually as part of the intake process. If
your life situation should change after the initial session,
please feel free to discuss this with your clinician in one of
your sessions. The clinician may also raise this periodically as
part of the therapeutic process.
o Temporarily
reduced fees will be periodically reviewed, and documentation of
ongoing needs will have to be established for them to continue.
- Clients may be
part of Journey to Peace, a program we established in the Bronx.
It is the result of our commitment to be a part of quality mental
health care in Northern Manhattan and the Bronx, communities that
have traditionally been underserved in this regard. It also arose
out of our desire to help residents in these local areas overcome
the stigma of seeking care that can help them find wholeness in
their lives. Individuals without adequate health insurance (or
none) or without reasonable access to mental health care through
their own insurance who are from these communities qualify. The
program is designed to provide service through interns (or
residents) at a total fee that is comparable to many copays
(usually $30 for a session). If you believe you qualify, please
speak to your clinician who can help you apply.
- Clients may be
part of other special programs we operate that involve reduced
fees. These usually are in partnership with other community
groups or connected to the special passions of particular
clinicians.
- Clients who
have a reduced fee may be charged the full fee and will be liable
for that full fee until all payments associated with the reduced
fee are received, at which time the excess will be written off.
Even more important than the liability portion of this, clients
reviewing their accounts should be aware of the way these charges
are processed.
- In cases where
the reduced fee is based on external sources paying part of the
fee, the client would be responsible for the full cash fee if the
external source does not pay their portion of the fee or later
reverses its payment. Depending on the reason for this, Seeking
Shalom may only hold the client liable for what would have been
the negotiated reduced fees rather than the full cash fees
involved.
Insurance/Third Party Payers
For those who are considering using their insurance, there are a
number of factors that they need to think about and will affect
how this will relate to their care at Seeking Shalom.
- Do you want to
use your insurance?
o There are
financial benefits of doing this and they are benefits that you
or someone else has already paid for.
o There are
downsides to using insurance, including some loss of privacy
(information about your care is shared with the insurance
company) and possible consequences of the way this information
can be used in the future (a common concern is that insurance
requires a diagnosis, and depending on the diagnosis, this can be
a red flag when applying for certain things in the future).
o A more detailed
information sheet about the use of insurance is available on the
website.
- Will your
insurance cover the type of services you need and for the reasons
that you would need them?
o As mentioned
below, there are some fees that insurance will not assist with.
o Some insurance
companies do not provide reimbursement for some services, for
example, services provided through the use of technology outside
specific ones they conduct internally or couples/marital therapy
(as this is for two people and not just one person).
o Even when
covered, there may not be any benefits provided by the insurance
company unless you will be meeting your deductible (an amount
that can be quite significant for some) for the year.
- Will your
insurance company provide reimbursement for covered services if
they are provided here at Seeking Shalom?
o Generally, for a
covered service to be able to be reimbursed at Seeking Shalom,
you will need to see a clinician who is in the network for that
insurance company (or on that company's panel). Not all of our
clinicians are on insurance panels, and those who are may not be
on all of the panels that are listed on our website, so it is
important to check whether your clinician is on the panel of your
insurance company.
o The best source
for network participation is the insurance company itself.
However, a list of networks that some clinicians participate in
is available on our website. We also try to provide you with this
information for particular staff members on their staff page, but
participation can change and be dependent on your particular
plan.
o Even if the
clinician is in network with your insurance company, you should
check with your insurance company to make sure that your
clinician is in network for your particular plan and for the
types of services you are planning to get at Seeking Shalom.
- Can I still get
reimbursement from my insurance company if my clinician is not in
network with them?
o Some insurance
plans (although this is a declining number) will offer coverage
for services received out of network. You can check with your
insurance company to see if they do.
o If your
insurance company is one that your clinician is not in network
with, you would be expected to pay for your services and use the
bill we can provide to apply to your insurance company to be
reimbursed directly. You cannot do this if your clinician is in
network with your plan, whether you formally opted out of using
your coverage or failed to provide your insurance information to
us.
o A guide with
some questions to ask your insurance company about your coverage
is provided on the website.
- If I have more
than one insurance, can I choose which one I use to cover my
care?
o Insurance
companies determine which coverage is primary and the order in
which they are applied. Neither you nor Seeking Shalom can choose
who will cover your care.
o If you have
multiple insurance policies, the insurance companies can require
you to go through a process of coordination of care to determine
which order they will pay for your care.
o If a clinician
is in-network with some, but not all, of your insurances, this
can affect your coverage and limit or eliminate any payments that
you might otherwise have been entitled to.
o Failure to let
Seeking Shalom know of all of your insurance policies may result
in you becoming liable for the full fee for any session. We do
not retroactively apply insurance that you did not tell us about
before the session. Additionally, insurance companies limit the
amount of time that claims can be filed.
If you are using a third-party payer (including insurance), it is
the responsibility of the client to ensure that Seeking Shalom
and their clinician are in-network for them. Clients intending to
utilize in-network benefits must let their clinician know in the
first session or at least before they plan to use them. A form to
provide information about your coverage will need to be filled
out. If you do not fill this out and provide it to your
clinician, it is presumed that you will not be using insurance or
other third-party payment to cover the cost of your services. In
that case, you agree to pay the full fee, not to hold Seeking
Shalom liable for any refund associated with rates negotiated
with your third-party payment source, and for any payments that
your third-party payer requests from Seeking Shalom. Retroactive
use of third-party payment is generally not available. You also
agree that you will not submit claims directly to any insurance
company that your clinician is in network with.
Seeking Shalom will also cooperate with you in the filing of
claims to your insurance company. However, the services here may
be considered out‐of‐network, and we do not usually take the
assignment of insurance benefits. The only third parties that we
accept assignments from are companies for which we are in-network
providers or others for which we have specific agreements. When
we do accept assignments, you will still be responsible for your
copay and deductibles. You will also still be responsible for
paying the entire fee if your insurance (or other outside payment
source) fails to authorize units of service, if no units of
service are available to you, declines coverage based on the
specific service rendered, coverage is otherwise denied, or they
later decide to reverse the payment.
As long as amounts remain unpaid by third parties, the entire
charge (less the amount paid by the client) will remain on the
client's account balances. Offsets for any difference between the
full fee and a contracted rate will only be made when the third
party makes its payment. As a result, given that Seeking Shalom
does not necessarily bill immediately after service and that some
third parties can take months to pay, a client's account balance
may include fees connected to many sessions.
Other Fees
In addition to fees directly associated with sessions with
clinicians, there are a number of other fees that a client may be
charged, although many clients will never face any of these fees:
- Session
Reservation Fee: This is a fee for reserving a clinician's time
that is then not used for a clinical session. It is not charged
if the session is canceled or rescheduled in a timely fashion.
This fee is specified in the section above dealing with
cancellations.
- Copying Fee: A
fee of not less than fifteen cents per page is charged for copies
made from the client's record. If additional time is needed to
compile information, fees for report writing will also apply.
Fees for mailing copied documents will be no more than twice the
rate of postage or shipping.
- External
Documentation Fee: A fee may be charged to provide documentation
to external sources about services received, outcomes reached,
and/or client participation. Clients may have access to some
documentation through the communication methods provided without
charge. Fees for simple documentation will usually be around
$5-20. If additional documentation is required, copying fees or
report writing fees may be required.
- Report Writing
Fee: Time spent writing a report for or on behalf of a client
will be billed by the clinician at the same hourly rate as a
regular visit. All associated time will be billed, including that
for chart review, research, and writing, as well as the time of
other clinicians that may also be involved (which is usually
applicable if the clinician has a clinical supervisor), which
will usually be billed at that clinician's and supervisor's
regular rates.
- Fees for
Testifying and Appearances Related to the Client (including Court
Appearances): Clinicians appearing or testifying related to the
client are time-intensive activities that remove the clinician
from being available to help other clients. Depending on the
setting, they may also require a larger block of time to be
dedicated to the testimony or appearance than would initially
seem to be involved unless one is aware of how these formal
systems work.
o When a clinician
is scheduled for a deposition, to appear in court, or to be
otherwise involved in a legal or administrative matter, this fee
shall be based on a minimum of sixteen times the full hourly cash
fee of that clinician. Half of this fee shall be for preparation
(which is nonrefundable after making the request), and half shall
be for the availability of an appearance (which shall be 50%
refundable up until a week before the scheduled appearance). Each
day of continuance or rescheduled appearance shall incur an
additional availability of appearance fee at a minimum of ten
times the full hourly cash fee. Appearance availability on
special days (when the clinician is regularly scheduled for more
than six hours or is not normally scheduled) shall require a
supplemental fee equal to five times the relevant full hourly
cash fee. Excessive preparation, transportation costs (using
means determined by Seeking Shalom), and document copying and
preparation will be additional charges above the basic minimum
fee. Additionally, the usual hourly fees of cooperating or
supervising clinicians will be charged in the same manner in each
case, but in addition to the above.
o If a clinician
is scheduled to attend other types of meetings, the minimum fee
shall be three times the full hourly cash fee for preparation and
an availability of appearance fee for all scheduled hours (plus a
minimum of two hours for transportation, if the meeting is in
person) based on the full hourly cash fee. Refundability and
additional fees shall be as in the above bullet.
o Ordinarily, an
appearance will not be added to a clinician's calendar until all
fees (except those that will be vouchered after the appearance
for which an advance may be required) have been paid. In the case
where the client consists of multiple people (e.g. a couple),
each shall be individually liable for these fees until the fees
have been paid in full. The above fees will be charged to the
client whether the appearance is scheduled at the client's
request or as the result of the clinician being compelled to
appear. If, in the clinical judgment of the clinician, there is a
therapeutic value for the appearance in a particular case, the
clinical director may consider an alternate fee schedule, but
only if worked out in advance.
o In the above
detailing of fees, if the clinician is under supervision,
whenever the clinician's hourly cash fee is mentioned then this
shall be read to be the sum of the clinician's hourly cash fee
and the clinician's supervisor's hourly cash fee. This is
necessary as the supervisor's involvement also has to be taken
into account.
- Emergency
Contacts Fee: These fees are for sessions that are of an emergent
nature (including non-face-to-face crisis interventions and most
sessions scheduled within twenty-four hours of the appointment).
They are usually double the normal rate. They will be billed in
quarter-hour increments with a half-hour minimum. Coaching calls
done when a client faces a particular situation may be considered
emergent calls or may be considered regular sessions; please
consult with your clinician.
It should be noted that many or all of these other fees may not
be covered by third-party payers (such as insurance) and will be
the responsibility of the client.
Payments Made by Clients
We ask that you make payment at each session. No sessions can be
scheduled beyond the second visit without payment unless special
arrangements are made. Payment may be made in cash or in other
agreed-upon forms.
In-person payments may be made using cash, check (payable to
"Seeking Shalom"), or credit or debit card (through the portal).
Online payments may be made by credit or debit card through the
client portal. If a payment form is reversed, declined, or
returned as unable to be paid, the client will be responsible for
providing payment immediately to cover the amount that was not
collected, as well as any resulting fees that this created. Even
if a clinician or location regularly accepts a particular form of
payment, we reserve the right not to accept that form from a
particular client, especially if there have been problems with
collection in the past.
If your clinician accepts credit or debit cards at your location,
this is done as a convenience for you (and at our cost). You
should be aware that there are limitations on your
confidentiality and privacy that can come from using a
third-party processing system. Clients should especially be aware
that some systems automatically send electronic receipts and may
send them to an address on file with that processor, and as such,
Seeking Shalom does not control where that information may go.
We may offer you the availability of having your financial
responsibility settled to a credit or debit card automatically.
Similarly, we require clients to provide authorization for us to
charge a credit or debit card on file if a balance remains
unpaid. A card may be placed on file by the client using the
client portal (which will store the credit card details in a way
that we do not have access to all the information) or, if that is
not possible, a client may provide card information on a form we
will provide.
Should a balance accrue and no payment be received, we reserve
the right to seek remuneration by any means legally possible
including, but not limited to, the retention of a collection
agency and/or seeking legal action against you. It is our desire
that this situation not be allowed to develop.
Payments are usually made during the clinical session (or within
24 hours before or after the session). In some programs
(particularly groups that have a fixed length), participants may
pay for the entire program upfront. The online client portal or
the website might also provide a way to make an electronic
payment (and we may send automatic invoices to clients who have
balances they may be responsible for).
Additionally, clients may mail payments to the
administrative/billing address in the contact section. In any
case, payment should be made at or before the time of service.
Clinical Matters
Assigned Clinician
Each client will be assigned to a primary clinician who will be
responsible for their care and the overall treatment plan. A
client may have additional clinicians, especially if more than
one type of therapy is being pursued or multiple issues are being
addressed. In certain cases, we may also assign a co-therapist to
work alongside your primary therapist; this most often occurs in
cases where a supervisor is also involved or where there is
extreme complexity in a relational situation.
The clinician initially assigned as the primary clinician may or
may not be the same as the clinician seen in the intake session.
The decision for the initial assignment will be made based on the
specialties of different clinicians, what would be best for the
client, comparative schedules and availability of the clinician
and client, and other relevant factors.
If a client feels that a particular primary or additional
clinician is not a good fit for them, they should discuss this
with the clinical director (usually after discussing it with the
clinician). When appropriate and feasible, a change may be made
at the decision of the clinical director. Similarly, the clinical
director may make a change without the prompting of the client
based on factors that the client may not even be aware of. There
are times when changes are required based on a conflict of
interest that cannot be discussed with the client.
Confidentiality
Your relationship with your clinician and to the center is a
personal and private matter. On occasion, your therapy may be
assisted by requesting information from other professionals with
whom you have had contact. No contact will be made with any
outside person and/or agency without your written permission,
except in the event of danger to self or others or if in one of
the situations discussed in our Notice of Privacy Practices.
When therapy is focused on a couple (married or otherwise) or a
family unit, one person may be formally designated as the client
(especially with a third-party payer), but the couple/family will
be considered as a clinical unit. Everyone involved in a clinical
unit needs to consent to their involvement in treatment, and the
clinician may see or communicate with one or more people without
everyone being present. When this occurs, it is assumed that
anything revealed when everyone is not present may be shared with
those who were not present, effectively providing a release of
information to the other party, unless an explicit agreement is
reached that confidentiality will be maintained and the
information will not be shared. Even if one or both individuals
are seen individually, a common file will normally be maintained
for the couple/family. As a result, normally all parties will
have to consent or assent to a voluntary release of information.
Emergencies
Clinicians will attempt to be available between sessions if a
client has a clinical emergency. Still, we are not set up to
provide around-the-clock availability for care on a 24/7 basis.
You may try to reach your clinician by the contact methods above
but know that your clinician may not have access to your full
records when they speak with you. Note that when you reach out
through a general method, you may be helped by another clinician
who may not have access to any of your records.
If the situation is critical and/or life-threatening, please call
911 and/or seek assistance at your local emergency room. The
Suicide Prevention Lifeline (988) can also be called. Seeking
help is especially important if you are at a risky or unsafe
place in your feelings, or if you have a desire to hurt yourself
or someone else. If you need outside help, we will cooperate with
outside services so that you can get the help you need.
The Process of Therapy
There are several aspects of the process of therapy that a client
may want to be aware of:
- Working Towards
Benefits
o Participation in
therapy can result in a number of benefits to you, including
interpersonal relationships and resolution of the specific
concerns that led you to seek therapy. However, such outcomes are
not guaranteed.
o Working towards
the possible benefits, however, requires effort on your part.
o Psychotherapy
requires your very active involvement, honesty, and openness in
order to change your thoughts, feelings, and/or behavior. Your
clinician will ask for your feedback and views on your therapy,
its progress, and other aspects of the therapy and will expect
you to respond openly and honestly.
o During therapy,
remembering or talking about unpleasant events, feelings, or
thoughts can result in you experiencing considerable discomfort
or strong feelings of anger, sadness, worry, fear, etc.
o You may also
experience anxiety, depression, insomnia, etc. Your clinician may
challenge some of your assumptions or perceptions or propose
different ways of looking at, thinking about, or handling
situations that can cause you to feel upset, angry, challenged,
depressed, or disappointed.
o Because you are
dealing with things you previously chose to avoid, the beginning
of therapy can be tricky. In fact, some, but not all, clients
experience that things get worse before they get better, in part
because of facing these feelings before healing begins. This is a
normal part of the process. Change will sometimes be easy and
swift, but more often it will be slow and frustrating. There is
no guarantee that psychotherapy will yield positive or intended
results.
- Unexpected
Consequences
o Attempting to
resolve issues that initially brought you into therapy (such as
personal or interpersonal relationships) may result in changes
that were not originally intended and may reveal other issues to
be addressed in therapy. Psychotherapy may result in decisions
about changing behaviors, employment, schooling, substance use,
housing, or relationships. Sometimes a decision that is viewed as
positive by one family member may be viewed quite negatively by
another.
o There are no
guarantees with therapy, so we cannot tell you that a particular
outcome will be the result of going through therapy.
- Alternative
Treatment
o Sometimes more
than one approach can be helpful in dealing with a certain
situation. During the course of therapy, your clinician may draw
on a variety of psychological approaches which he or she is
qualified to utilize. These approaches will be selected based, in
part, on what is being treated and their assessment of what will
be of benefit to you. Their approaches may include but are not
limited to behavioral, cognitive, psychodynamic, systems/family,
developmental, and/or psycho-educational techniques. There may be
times when the situation and/or technique indicates that the
clinician will suggest the inclusion of another person in the
therapeutic session. The clinician may also suggest or require
that you consult with someone else for a portion of your
treatment (such as an expert in one piece of your situation,
someone to evaluate possible physical causes, or someone to
consider prescribing medications).
Treatment Process
There is a general flow of treatment that most clients progress
through. These stages include:
- Coming t
