PRACTICE POLICIES

APPOINTMENTS AND CANCELLATIONS

• Intake Appointments: You can cancel free of charge within 24 hours of making your intake appointment. Additionally, you can cancel 48 hours prior to the appointment free of charge. If there is a need to cancel the intake appointments within 48 hours of the appointment time, there is a $100 cancellation fee and will be charged to the credit card on file.
• Ongoing Appointments: If you are unable to attend your session, please cancel or reschedule your appointment 48 hours in advance. You will be responsible for the entire fee if cancellation is less than 48 hours or if you fail to show up to your session. One cancellation without the 48-hour notice is excused. Subsequent ones are charged as mentioned. This fee will be billed to your credit card on file. This is necessary because a time commitment is made to you and is held exclusively for you. If you are late for a session, you will lose that session time. The appointment is considered a “no show” after 15 minutes past your appointment start time. After two missed appointments or excessive cancellations, your therapist might terminate your case. 
• Family Session After the Fourth Session: A family session without the minor client is available after the fourth visit. This is a time to review what has been learned thus far with regards to tools given and the framework we want the client and family to use to tackle the presenting problem. This session is typically 30 minutes and can be done virtually or in person. If you have Blue Cross Blue Shield it is covered based upon your policy. If you are self pay you will be charged $95 for a half hour appointment.  Family sessions may run over the allotted 30 minutes, if that is the case, the appointment will be charged the full fee. 
• Phone calls: Phone calls serve the purpose of providing brief updates or addressing urgent matters that cannot wait until the next scheduled session. It’s important to note that these calls should be limited to a duration of 10 minutes. If a call extends beyond this duration, there will be additional charges. These charges are calculated based on our current self-pay rate of $190 per hour, billed in 15-minute increments, which amounts to $47.50 for every extra 15 minutes. 
• Session Duration: The standard session for psychotherapy is 53 minutes. However, session length can be adjusted upon agreement with your therapist. This agreement will be reviewed on an individual basis. 
• Unattended Appointments: Unattended appointments for over 60 days can lead to case termination. Clients must be proactive in maintaining their active status. After 60 days of inactivity, L & B Counseling will attempt to contact about needing to schedule an appointment in order to remain an active client. If an appointment is not scheduled after two weeks of this notification, L & B Counseling will move forward with discharging. However, discharged clients can return based on availability and fit.

FEE SCHEDULE

I agree to compensate L & B Counseling, PLLC for providing professional services, which include but are not limited to sessions, assessments, report writing, extended phone calls, meetings with other professionals, record preparations, and any additional services you request or the therapist deems necessary.

RATES:

• Self-Pay/OON: Intake Assessment at $200/hour, Ongoing Appointments at $190/hour.
• Professional Services: Individual, couples, family sessions, etc. at $190/hour, Group therapy at $75.00/group.
• Legal Proceedings: $200/hour.
• Administrative Paperwork (e.g., Treatment Summaries, IEP/504 Letters): Billed in 15-minute increments at the self-pay rate of $190/hour. 
• In-network Insurance: In the case of in network insurance, I agree to pay the remaining member’s expense or co-pay as stated in the explanation of benefits by my insurance company.
• Out-of-network (OON) Insurance: Out of network clients need to file their claims. L&B Counseling, PLLC won’t file claims for services related to legal proceedings or ones not typically covered by insurance. You’re liable for any balance if insurance doesn’t cover invoiced amounts.
• CBHA/Medcost: CBHA recently made changes with behavioral health claims.  They are now processing them first and then sending them to Medcost for further processing and payment. Claims are now taking up to 4 months to be processed and the impact this has on a small business is huge. In order to continue serving clients with CBHA insurance while also keeping our accounting up to date, we have enacted a new policy: 
  • All clients with CBHA insurance will be responsible for paying the full contracted rate of each appointment on the day of service
  • Intakes – $133 with fully licensed clinicians and $128 associate licensed clinicians
  • Ongoing Appointments – $127 with fully licensed clinicians and  $122 associate licensed clinicians
• We will continue to file your claims for you and when CBHA processes and pays the claim, any  overpayment made by you will be credited to your account, which will be used towards any future payments or refunded to your card on file.

If you have coverage under BCBS or CBHA, there are additional fees for appointments scheduled before 8:00 am or after 5:00 pm, on federal holidays, or on Saturdays and Sundays. For those with standard BCBS plans – $13.47, BCBS state plans – $26.94, and CBHA – $10-12.00. These extra charges will be applied to your regular copay and will count towards your annual deductible. By scheduling an after-hours appointment, you acknowledge and accept these additional fees.

It is my responsibility to understand my policy and therefore my financial obligation. If insurance is changed, canceled, or if the insurance company fails to pay any portion of the estimated insurance, the remaining balance becomes the responsibility of the financially responsible party. I understand that my card on file in Simple Practice will automatically be charged for any payment due. WE DO NOT CARRY BALANCES.

PAYMENT

Note: All credit card charges will appear as “L & B COUNSELING” on your statement.

• Primary Payment Method: The credit card you put on file in Simple Practice will be the card used to process payments. If you are using a HSA or FSA card, another method of payment must also be provided as a back up. In the event that funds are not available on your HSA or FSA card at the time of processing, your secondary card will be automatically charged. Invoices and billing statements are available through the Simple Practice client portal. 
• Service Charge: There is a 3% service charge to use your credit/debit card. You may pay with a check at time of service to avoid the service charge. If payment is not made at the time of service, the card on file will be charged. We cannot accept partial or cash payments.
• Late Payment Fee: A late payment fee of $15.00 will be charged to any account that has an outstanding balance beyond the due date specified in the invoice. Continued failure to pay the outstanding balance after 10 calendar days past the invoiced date, including the late fee, may result in further action, including but not limited to, suspension of services, referral to the collection agency George Brown Associates, or legal action.
• Ongoing Appointments: For ongoing appointments, your card on file will automatically be charged on the day of service. If you reach your deductible (or have a decrease in the amount you owe), your account will be credited with the overpayment once we receive the EOB from your insurance provider, which will be used towards future co-pay amounts or refunded to your card on file.
• Intakes: For intakes, once we receive the EOB from your insurance provider, we will automatically charge your card on file for the amount indicated (“client responsibility”) on your EOB. Please familiarize yourself with your benefits and deductible information so this charge is not a surprise. Until your annual deductible is met, you may be responsible for the full cost of your appointment. It’s essential to be aware of this to prevent unexpected charges. To determine the exact amount you’ll be charged for an appointment please contact your insurance provider and inquire about their reimbursement rates for the following CPT codes: 90791- Intake appointment, 90837 – Ongoing appointments, 99051 – After-hours services. By checking in advance, you can ensure clarity on the costs associated with your care. 
• Insurance Policy Termination: Should my insurance policy end or be terminated, including the discontinuation of Medicaid, I understand and agree that I will be responsible for the full self-pay rate for any appointments affected by this termination. All fees are payable at the beginning of each session.
• Returned Checks: Any check returned to us due to insufficient funds will incur a returned check fee of $15. The issuer of the bounced check will be required to provide an alternative payment method going forward. 

TELEPHONE ACCESSIBILITY

To contact your therapist between sessions, please leave a voicemail. They may be in session and will strive to return your call within 24 hours. Should you face an emergency, dial 911 or visit your nearest emergency room. Our typical availability is from 9AM-5PM. We prefer communication through email. Please use text messages solely for scheduling purposes. Be advised that texting is not a confidential form of communication. For emergencies, please refer to your crisis plan or consult the plan on our website.

SOCIAL MEDIA AND TELECOMMUNICATION

We do not accept friend or contact requests on personal social media pages from current or former clients on social networking sites (e.g., Facebook, LinkedIn) to maintain confidentiality and avoid dual relationships. Adding clients on a therapist’s personal social media page can compromise confidentiality and blur the boundaries of the therapeutic relationship. We encourage clients to engage via our social media pages.  

ELECTRONIC COMMUNICATION

Confidentiality cannot be guaranteed for any form of electronic communication, including text messages. If you opt for communication via email or text concerning scheduling or cancellations, we will accommodate this. While we try to return messages in a timely manner, we cannot guarantee immediate response and request that you do not use these methods of communication to discuss therapeutic content and/or request assistance for emergencies.

TELEMEDICINE

Using information technology for treatment, such as telephone communication, internet, fax, and email, falls under telemedicine. Please be aware that:

• You retain the option to withhold or withdraw consent at any time without affecting the right to future care or treatment or risking the loss or withdrawal of any program benefits to which you would otherwise be entitled.

• All existing confidentiality protections are equally applicable.

• Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.

• Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.

• There are potential risks, consequences, and benefits of telemedicine. Potential benefits include, but are not limited to improved communication capabilities, providing convenient access to up-to-date information, consultations, support, reduced costs, improved quality, change in the conditions of practice, improved access to therapy, better continuity of care, and reduction of lost work time and travel costs. Effective therapy is often facilitated when the therapist gathers a multitude of observations, information, and experiences about the client. Therapists may make clinical assessments, diagnoses, and interventions based not only on direct verbal or auditory communications, written reports, and third person consultations, but also from direct visual and olfactory observations.
• Not all insurance plans cover telemedicine. Please contact your insurance provider to ensure you have telemedicine benefit coverage.

MINORS

If you are a minor, your parents may be legally entitled to some information about your therapy. We will discuss with you and your parents what information is appropriate for them to receive and which issues are more appropriately kept confidential. Minors’ consent law (GS 90-21.5 (a). This allows health care providers to accept an unemancipated minors’ own consent for medical health services for prevention, diagnosis, or treatment of the following conditions: abuse of controlled substances or alcohol or emotional disturbance. There is no age limit established in the law. To give effective consent to health care, a person of any age must have both legal capacity and decisional capacity. Even when a minor’s parent or other responsible adult provides the legal consent for treatment, a provider may still choose to seek the minor’s assent to the treatment. Assent is not identical to consent, but it does involve consultation with the minor, with developmentally appropriate explanations and an opportunity for the minor to express his or her wishes regarding the treatment.

DISCHARGE FROM A HIGHER LEVEL OF CARE

To ensure seamless and informed care, our therapists may request discharge paperwork from previous higher-level care facilities as clients transition to our outpatient services. This documentation aids in tailoring our approach to meet the specific needs of each client. Therapists will use their discretion to determine when these documents are necessary for enhancing treatment continuity and effectiveness.

TERMINATION

Terminating a therapeutic relationship can be challenging, necessitating a structured termination process to ensure closure. The duration and method of this process often correlate with the therapy’s length and intensity. If a therapist discerns that the therapy isn’t benefiting the client or if there’s a default in payment, termination may be considered. However, before making such a decision, the therapist will thoroughly discuss and evaluate the reasons for termination with the client. If the relationship ends or the client seeks a different therapist, we will provide a list of qualified alternatives. The client also retains the right to select a therapist from another source.

DATA BREACH

In the event of a data breach you will be contacted immediately. L & B Counseling puts your PHI at the highest priority and takes every available step to make sure your PHI is protected. We use encryption and HIPAA technology with all forms of communication.

THIRD PARTY EMPLOYMENT

At times, we will employ third parties, who are not affiliated with L & B Counseling, to help us perform our services or administrative duties. We may share your health information with them so that they can perform their function. They are required to protect your health information and keep it confidential.

LEGAL PROCEEDINGS, COURT APPEARANCES, AND RECORD REQUEST

Our responsibility to your child may require involvement in conflicts between the parents and other parties. You agree that our involvement will be strictly limited to that which will benefit your child as determined by the therapist. This includes, but is not limited to, keeping anything said by any person during a therapy session as strictly confidential. You further agree that you will not attempt to gain an advantage in any legal proceeding with any other person as a result of our involvement and treatment with your child or children. Furthermore, you specifically agree that you will not, either personally or through a third party including an attorney, require that any therapist treating your child is asked (by verbal request, subpoena, or court order) to testify in court, provide treatment records of any kind, or complete an affidavit. You also agree to instruct your attorneys not to subpoena any therapist or to refer in any court filing to anything our therapists have said or done. If one of our therapists is required to testify, we are ethically bound not to give an opinion about custody or visitation suitability and we will not make any recommendations about a final decision on custody and visitation. If the court appoints a custody evaluator, guardian ad litem, or parenting coordinator we can provide information only if the appropriate releases are signed or there is a specific court order. If you require, by any means, that any therapist from L & B Counseling must appear or participate in any way with a legal proceeding, you agree to reimburse us at a rate of $200.00 per hour for all time devoted to that request. This includes, but is not limited to, traveling, preparing reports, testifying, being in attendance, and any other case-related costs. If there is a court order for custody please provide this in writing in the event that the other party contacts us. 

Additionally, requests for medical records must be made in writing, either by mail, email, or fax. The maximum fee for each request shall be 75¢ per page for the first 25 pages, 50¢ per page for pages 26 through 100, and 25¢ for each page in excess of 100 pages, provided that L&B Counseling may impose a minimum fee of up to $10.00, inclusive of copying costs. If a records request is being made for a minor with divorced or separated parents, a custody agreement will be required to be provided to the therapist to determine parental rights. In cases where the release of medical records may pose a risk to the client’s safety or well-being, the request may be denied or the information may be redacted to protect the client’s privacy and confidentiality.

EMERGENCIES

In the event of a mental health emergency, please refer to the crisis plan on the landbcounseling.net homepage or the L & B Counseling app. For immediate crises, dial 911, reach out to your local mental health emergency room, or visit the nearest emergency department. For non-emergencies requiring prompt assistance, we strive to accommodate clients by scheduling them within 48 hours.

DUAL RELATIONSHIPS

The counseling relationship is a psychologically intimate but professional one. Our contact will be strictly limited to our sessions together and necessary phone contact. Please do not offer gifts or ask any therapist to engage in any social activities with you, including, but not limited to social media interaction.

DESTRUCTION OF PROPERTY

If a client or a member of the client’s family is destructive towards property on the premises, it will be grounds for discharge. A recommendation will be made upon discharge.

CONDUCT POLICY

We acknowledge that strong emotions may arise during individual, couples, and family therapy sessions. However, it is important to maintain a respectful and constructive atmosphere. The following policy addresses appropriate conduct:

• Respectful Communication: Engage in respectful and constructive communication with all participants during therapy sessions. Speak honestly and openly, but avoid using offensive, disrespectful, or derogatory language. This includes refraining from personal attacks or insults towards any individual present.
• Conflict Resolution: If conflicts arise during therapy, we encourage clients to express their concerns and disagreements respectfully and listen actively to other participants’ viewpoints. Therapists will mediate and guide the process of conflict resolution to ensure a constructive outcome.
• No Physical Violence: Under no circumstances is physical violence tolerated during therapy sessions. This includes any form of aggressive behavior, such as hitting, pushing, or any other actions that may cause harm to others.
• Therapist’s Intervention: In the event of a verbal, physical altercation or the use of inappropriate language, the therapist may intervene to redirect the conversation, provide guidance, and ensure that the therapy session remains safe and focused on therapeutic goals. Failure to comply with this conduct policy may result in consequences, including, but not limited to, a verbal warning, termination of therapy services, or referral to appropriate authorities if necessary.

GRIEVANCES

If you are dissatisfied with any aspect of our work, please discuss it with your therapist or with the owner of L & B Counseling, Trent Morrow. If you believe you have been treated unfairly or unethically, and we cannot resolve the problem, you can contact the respected board of your therapist. 

• North Carolina Social Work Certification and Licensure Board, PO Box 1043, Asheboro, NC 27204
• North Carolina Board of Licensed Clinical Mental Health Counselors, 7 D Terrace Way, Greensboro, NC 27403
• North Carolina Marriage and Family Therapy Licensure Board, 1046 Washington St, Raleigh, NC 27605
• North Carolina Addictions Specialist Professional Practice Board, 1046 Washington St, Raleigh, NC 27605

Additionally, for clarification of clients’ rights or to lodge a complaint or contact NC Disability Rights 877-235-4210, North Carolina Bar Association Lawyer Referral Service 1-800-662-7660, and Pro Bono Project of the North Carolina Bar Association 1-800-662-7407. A copy will be returned to you and L & B Counseling will retain a copy for their confidential files.

Disclaimer: Please note that this Practice Policies Consent Form was last updated on Friday, October 27th 2023. In the event of any changes to our practice policies, we will notify you via email at the email address we have in your client portal. It is your responsibility to ensure that we have your current email address and to periodically check your email for any updates or communications from us.