PRACTICE RULES, CONTRACT & CONSENT FOR TREATMENT
IT IS IMPORTANT THAT YOU READ THIS ENTIRE DOCUMENT VERY CAREFULLY AND THAT YOU UNDERSTAND IT.
By law, everything discussed during therapy is strictly confidential, including written records. Only with your written authorization can information be disclosed to others, except in situations detailed in the U.S. Department of Health and Human Services' HIPAA Health Information Privacy Rules.
All appointments are $180. Sessions are 45-50-minutes. If you arrive late, you will have a shorter session, but the full fee will apply. Payment is due at the time of service. Cash, check, debit or credit cards are accepted. It is your responsibility to verify the details of your insurance coverage. You remain ultimately responsible for the payment of your bill, even if you are using your insurance.
The services provided by Dr. Crous are not covered by any managed care networks (e.g., HMOs) and we do not bill insurance companies. However, many PPO insurance plans provide coverage for mental health services provided by licensed professionals. If you are using a PPO, you may choose to submit your therapy receipts to your insurance company for reimbursement. As the client it is your responsibility to be informed about your insurance coverage. If you plan to use your insurance, contact your insurance carrier prior to your first session to ask about your benefits for psychotherapy. The following are questions you may want to address:
- Your coverage for psychotherapy
- Your coverage for an out-of-network provider
- Whether a mental health diagnosis is required for reimbursement
- The amount of your deductible
- Number of visits per calendar year
24-Hour Cancellation Policy
Once an appointment is made, you will be charged the full session fee of $180, unless you provide 24-hours advance notice of cancellation.
Given the unique business aspect of private psychotherapy practice, there can be no exceptions to this policy, even though I completely understand that unforeseen circumstances may arise.
Alcohol & Substance Use:
If substance use causes or contributes to your difficulties, or interferes with your therapy progress, you will need to address the issue in a structured recovery program, in order to continue with therapy. To benefit from therapy you need to be clean and sober, or actively involved in a recovery program.
(1) For life-threatening emergencies call 911 or go to the nearest hospital ER;
(2) For non life-threatening situations call or email me. I will get back within reasonable time.
Telephone calls of 15 minutes or longer will be incrementally charged at my full professional fee.
Ethics codes prohibit dual relationships between therapists and clients like business, social activities or online social networking
Notice to consumers:
The Department of Consumer Affairs' Board of Psychology receives and responds to questions and complaints regarding the practice of psychology. If you have questions or complaints, you may contact the board by visiting their web site, calling 1-866-503-3221, or writing to the following address: Board of Psychology, 1422 Howe Avenue, Suite 22, Sacramento, CA 95825-3236.