Striving toward better emotional, relational, and organizational health
What Should I Expect During a First session?
The first session will last about 60 minutes, and it is broken up into three basic components. In the first few minutes, it is important that we review information that is contained in the forms that we have asked you to sign. This includes reviewing confidentiality and its limitations, your therapist’s background, and information about some important logistics of our practice. This is also a time for you to ask questions. Next, we will spend the bulk of the session in conversation about what it is that has brought you to treatment. In addition to asking you some clarifying questions about the problems that you are experiencing, we will begin to try to understand your concerns within the larger context of your life. As every one of our patients has heard us say at least once, “You are not just a ball of symptoms and problems, but a whole person who has strengths, positive and negative life experiences, and the like.” The last 10 minutes of the session is usually spent asking you some specific questions about some symptoms that may not have been discussed earlier. We are also interested to know what it was like for you to talk with us.
The length of treatment is very difficult to determine without knowing you. Some people consult us for very focused and specific concerns, such as resolving an occupational problem or talking through some relatively normal but stressful developmental challenge. Others experience themselves as “out of control” or having a life that is a “mess.” Still others appear successful in some parts of their lives but others leave them unfulfilled. Of course there are other possibilities, but the main message we want to convey is that you and your therapist will decide together what the right length of treatment should be. We ask that you consider committing to at least three months of weekly sessions in most circumstances, which that being discussed periodically throughout our work together.
Paperwork for the First session
The forms to the right must be filled out at the first appointment. We will have the paperwork available for you at the time of your first appointment, and thus you should arrive 15 minutes prior to the start of your session to have time to fill it out. However, we are making the forms available here in “portable document format” (PDF) so that you may download them and fill them out ahead of time if you wish. In order to accomplish this, you will need Adobe Acrobat Reader installed on your computer. It is available by clicking here.
Your therapist will likely ask you to at read over the Consent for Treatment form(s) and the Notice of Privacy Practices prior to your first session so that you can be ready with questions. As Dr. Hicks says regularly, no one comes to his office to talk about paperwork!
Information about Costs and Insurance
Our current fee structure for psychotherapeutic services is:
- Initial Consultation: $180 (60 minutes)
- Individual Psychotherapy: $140 (45 minutes) to $165 (55 minutes)
- Couple and Family Therapy: $140 (45-50 minutes)
- Other charges can be incurred for incidental activities requiring significant time (e.g., extensive phone contacts).
We accept Blue Cross/Blue Shield Preferred Provider Organization (PPO) Network and Medicare . Please note that we are NOT an in-network provider for Blue Cross/Blue Shield’s “Blue Choice PPO” plan. Blue Cross has created a separate network for this product that is offered on the Affordable Care Act Exchange, and we have at this time chosen not to participate.
Currently we accept check, cash, and credit card. You are responsible for payment or co-payment at the time services are rendered.
24-hour cancellation policy: Please note that it is expected that if you cannot use your appointment time, you should notify us as soon as possible. If you do so with less than 24 hours notice or you do not come to your appointment, we reserve the right to charge you a missed appointment fee. This can be up to the cost of an individual therapy session. However, we do consider extenuating circumstances and your attendance history in deciding whether or not to assess a fee.
Why can’t you waive my co-payment? When you choose to use your insurance, they expect you to pay a certain amount or certain percentage of what is billed or what is “allowable.” If we do not charge you the portion that they expect you to pay, then the company construes this as us telling them our fee is “X” when our fee is really “X minus your portion.” The company sees this as fraud.
Why don’t you participate on my HMO panel? We firmly believe that the best treatment that we can provide occurs when you and your therapist are able to decide together what is in your best interest. Unfortunately, many Health Management Organizations (HMO’s) insert themselves into this process in a way that we believe can be destructive and undermining of the therapy. Further, it is quite common for an HMO to require a lot of additional paperwork and extra time on the phone trying to get additional sessions authorized, appealing a decision that your treatment is not “medically necessary,” or attempting to correct a billing error. In addition to that being lost time that takes away from our ability to work with clients, we find the process frustrating.
I think I would like to come and see you, but you are not on my insurance panel. Is there something that we can work out? Typically. There are a few ways to view this. For example:
- If you want to use your insurance benefits, then you have to find out from them whether or not they will reimburse for “out of network” services. If they do, then you will want to find out how they calculate what is reimbursed and what you have to do in order to make a claim. In these cases, you pay for the service at the time it is rendered and we provide you with the paperwork you need to make a claim. The insurance company should reimburse you and not us (because you will have already paid).
- If your insurance company does not reimburse for out of network claims (or your insurance benefits are exhausted for the year, or you do not wish to use insurance), then we can negotiate a fee.
Therapy isn’t cheap! You are right, though these fees are about standard for in this area. There is so much to say about this. Below is a brief article written by Dr. Ivan Miller, a psychologist from Colorado. We believe he captures the value of psychotherapy extremely well.
Is Therapy a Wise Way to Spend Your Money?
© 2001 by Ivan J. Miller, Ph.D. (published with permission of the author)
When people have a need for therapy, they often gain so much financial benefit that therapy becomes a wise use of their time and money. Many research studies show that therapy can reduce future medical expenses. Because so many long-term health care expenses are a result of stress or untreated mental health conditions, proper mental health treatment greatly lowers the overall cost of health care. In fact, this “medical cost offset” is so large that when medical costs are measured over a period of three to five years after treatment, psychotherapy lowers overall health care costs so much that it would more than pay for the cost of the therapy.
Therapy can also improve a person’s performance on the job. Employers are becoming increasingly aware that mental health problems can increase the number of sick days, interfere with the quality of an employee’s work, and decrease an employee’s productivity. The financial benefits of treatment are so great that many employers have hired employee assistance programs to provide short-term therapy and identify employees who can benefit from longer-term therapy. Executives and some other people are now using a form of psychotherapy – coaching – to improve their effectiveness and performance. Moreover, psychotherapy helps many individuals succeed in gaining promotions or become ready to change to a better job.
Problems with relationships and family issues can be very expensive. There are enormous costs that can result from divorce, child adjustment problems, or other relationship problems. Individual and family therapy can go a long way in averting these costs.
So how should you decide if therapy is a wise use of your money? Of course, individuals are different and need to decide this for themselves by making some educated guesses. To figure this out for yourself, try to estimate the total cost of your therapy and compare it to the long-term benefits. You can ask your therapist to help by estimating how long it might take to accomplish the kind of changes that you hope to make in therapy. Use this information to estimate the cost of therapy.
To estimate the financial benefits, consider the changes that you are making in stress levels that may affect your long-term health care costs. Look at whether the therapy is helping you be a more productive employee or enabling you to earn more money through promotions or by changing jobs. Look at the relationship and family problems that you are working on in therapy and evaluate if the therapy is likely to avert expensive problems in the future.
When you estimate the cost/benefit ratio, remember your personal improvements may yield financial benefits over many years to come, and the therapy costs are usually spent up front. If you are like most people, as long as there is a need for treatment, you will find that the potential financial benefits probably justify the investment in psychotherapy even when insurance does not pay for the treatment. In addition, think about the possible intangible improvements in your quality of life that cannot be measured financially.