This document contains important information about practice policies. Please contact me with any questions or concerns.
I am an independent practitioner and share office space with a colleague. We are not a group practice and therefore may have differences in policies, fees and insurance contracting.
SERVICES
In most cases I conduct an evaluation over 1-3 sessions. During this time we will both assess if I am the best professional to provide you care based upon treatment needs and goals. Psychotherapy requires active participation on your part, often requiring the client to work on skills and goals between sessions. Following the assessment I will make a recommendation regarding length, format, and frequency of sessions.
It is my policy that once an appointment is scheduled a change or cancellation must be made more than 24 hours in advance. If not, the client is responsible for the full session fee. This cannot be billed to any third party and will be billed directly to the client. I am aware that emergent circumstances arise and am willing to consider these on a case-by case basis. Contact should be made by phone at (847) 754-3933.
PROFESSIONAL FEES
My current fee is $200 for an initial session; $160 for a family/marital/couples session; $160 for an individual session lasting 55 minutes; and $125 for an individual session lasting 45 minutes. Marital therapy is private pay and not billed to a third party carrier. Additionally this fee strucutre is used for other related professional services related to your care. Fees are prorated in 15 minute increments. Services may include disability report writing, scheduled telephone conversations lasting more than 15 minutes, attendance at a meeting or consultation with other professionals which you have requested, preparation of records or treatment summaries, or any other mutual agreed upon service within the scope of my practice. Depositions and testimony time are billed at double my regular fee due to the preparation required.
Fees are altered in the case of contractual agreements with in-network insurance carriers and are subject to change.
BILLING & PAYMENT
When determining treatment goals it is important that you evaluate the financial resources you have available to pay for treatment. I am willing to discuss the limits of your insurance coverage, such as deductibles, co-payments, etc and will help you plan accordingly. I will submit claim forms upon your behalf.
It is my preference that any co-payments, co-insurance or full fee payment be made at the time of service by electronic payment, check, credit card, or cash. When you receive a bill payment is expected within 14 days. Any past due balances in excess of 90 days will be considered past due and considered for collections.
It is imperative that you contact your health insurance carrier and know the limits of your policy.
CONFIDENTIALITY
Generally speaking, the privacy of our communication is protected by law and I can only release information with your written consent. There are a few expections of which you should be aware:
In most legal proceedings you have a right to prevent me from providing information about your treatment. In some proceedings involving child custody and those in which your emotional health is an important issue a judge may order my testimony if they determine it is warranted.
I am a mandated reporter by law, which means in certain circumstances I am legally bound to protect others from harm, even if I need to reveal some information about a client's treatment. For example, if I believe a child, older or vulnerable adult is being abused physically or financially I must file a report with the appropriate agency or authorities.
If I believe a client is threatening serious bodily harm to himself/herself/themselves or another individual I am required to take protective action to ensure safety. This may include notifying a potential victim, contacting the police, or seeking hospitalization for the client. I may need to contact family members or emergency contact persons should a client be suicidal to provide safety and protection. Should a situation arise during your care I will make every effort to discuss it with you fullly prior to taking action.
I also occasionally consult with colleagues regarding cases. This is done without disclosure of identity of the client and the consultant is legally bound to confidentiality.
CONTACTING ME
Generally I am not immediately available. I am reachable by phone, e-mail and text. It is encouraged that you do not share clinical information via these formats and use is for scheduling purposes only. These forms of technology are not encrypted and not guaranteed to be private.
I try to answer messages within 24 business hours.
To protect your privacy I will not accept requests to connect via social media such as LinkedIn or Facebook.
Audio recording of sessions without prior consent of both the client and myself is strictly prohibited and in violation of Illinois law.
EMERGENCIES
Any emergent situation should be managed by calling 911, contacting a treating physician, or going to a local emergency room.
OFFICE CONTACT INFO
4811 Emerson Ave. Suite 101 Palatine, IL 60067
(847) 754-3933 (voicemail and text)
e-mail:anne@annegwalker.com
www.annegwalker.com
I certify that I have read these policies and consent to their contents.