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Steen Psychotherapy, PLLC
J. Harley Steen, MA, LPC
Phone: (512) 766-6866
3001 North Lamar Blvd, Suite 305
Austin, Texas 78705
Welcome to my practice. I am grateful to have the opportunity to serve you and hope that this document will provide information helpful in making an informed decision concerning my services. If you have any questions or concerns about these policies or any other aspect of my practice, please feel free to discuss them with me at any time.
FEES: My basic fee is $130 per 50-minute individual session and $150 per 50-minute couple session. Longer or shorter sessions are prorated from this basic fee.
PAYMENT FOR SERVICE: Clients are expected to pay for services at the time they are provided unless other arrangements have been made. Payment may be made by check, cash, or credit card. All credit card payments are subject to a processing fee of 2.95% + $.30 per charge. Clients are responsible for payment of all fees at the time of service unless another arrangement has been agreed upon.
APPOINTMENTS AND CANCELLATIONS: Your time is reserved for you. A minimum of 48 hours is required for all rescheduling or cancellation of a scheduled appointment. Cancellations and re-scheduled sessions will be subject to a full charge if NOT RECEIVED AT LEAST 24 HOURS IN ADVANCE. A 50% fee will be charged with less than 48 hours notice. This is necessary because a time commitment is made to you and is held exclusively for you. All appointments require a credit card on file.
The standard meeting time for psychotherapy is 50 minutes. It is up to you, however, to determine the length of time of your sessions. Requests to change the 50-minute session needs to be discussed with the therapist in order for time to be scheduled in advance.
A service charge of up to $25.00 will be charged for any checks returned for any reason for special handling.
If you are late for a session, you may lose some of that session time.
INSURANCE: I am not currently in-network with any insurance providers. Alternatively, I am able to offer a Superbill (essentially a bill-of-sale for paid services) that you may submit to your insurance for possible reimbursement. Superbills are automatically generated on a monthly basis for the previous month’s sessions and may be delivered to your email address on or around the 5th of the month at your request.
I cannot guarantee insurance reimbursement and I have no way of knowing if your insurance will issue reimbursement. Due to HIPAA restrictions, I am unable to contact your insurance provider on your behalf. I will not contact your insurance provider with administrative questions. If your Superbill is denied on the basis of a coding issue, it is your responsibility to clarify that issue with your provider. In order for me to amend your Superbill, you must inform me of the specific code modification(s) requested.
COURT APPEARANCES & LEGAL CONSULTATION: Court appearances are outside the scope of my practice and will incur a base fee of $1,800. Consultation with your legal team will incur an hourly fee of $500. Any additional fees will be determined on a case by case basis.
TELEPHONE ACCESSIBILITY If you need to contact me between sessions, please leave a message on my voice mail at: (512)766-6866. I am often not immediately available; however, I will attempt to return your call within 24 business hours (messages left on non-business days may take up to 48 hours to be received and therefore may not receive a reply for up to 72 hours). Please note that face-to-face or video sessions are highly preferable to phone sessions. However, in the event that you are out of town, sick or need additional support, phone sessions are available. If a true emergency situation arises, please call 911 or any local emergency room.
EMERGENCIES: In the event of an urgent psychotherapeutic matter, please contact me at (512) 766-6866. If you need to speak with someone immediately, please make use of the emergency services listed below:
24-Hour Crisis Hotline 512-472-4357
Seton Shoal Creek Psychiatric Hospital 512-324-2000
General Emergency Number 911
SOCIAL MEDIA AND TELECOMMUNICATION: Due to the importance of your confidentiality and the importance of minimizing dual relationships, I do not accept friend or contact requests from current or former clients on any social networking site (Facebook, LinkedIn, etc). I believe that adding clients as friends or contacts on these sites can compromise your confidentiality and our respective privacy. It may also blur the boundaries of our therapeutic relationship. If you have questions about this, please bring them up when we meet and we can talk more about it.
ELECTRONIC COMMUNICATION: I cannot ensure the confidentiality of any form of communication through electronic media, including text messages. If you prefer to communicate via email or text messaging for issues regarding scheduling or cancellations, I will do so. While I may try to return messages in a timely manner, I 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.
Services by electronic means, including but not limited to telephone communication, the Internet, facsimile machines, and e-mail is considered telemedicine by the State of California. Under the California Telemedicine Act of 1996, telemedicine is broadly defined as the use of information technology to deliver medical services and information from one location to another. If you and your therapist chose to use information technology for some or all of your treatment, you need to understand that:
(1) 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.
(2) All existing confidentiality protections are equally applicable.
(3) Your access to all medical information transmitted during a telemedicine consultation is guaranteed, and copies of this information are available for a reasonable fee.
(4) Dissemination of any of your identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.
(5) 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
INDEPENDENT PRACTICE: I am an independent practitioner practicing as a Licensed Professional Counselor – LPC # 79480
CONFIDENTIALITY: The privacy and confidentiality of our sessions are extremely important to me. To the degree allowed by law, information about your contact with me and my office will not be disclosed to any person or organization unless you give me a specific, written release to do so. While you are free to discuss anything that occurs in our sessions with anyone, I am required not to discuss such matters without your written authorization. In all aspects of my practice, communication between my clients and me (or between me and those whom my clients have authorized me to contact) are protected by confidentiality regulations as stipulated by federal and state laws, and by professional standards and ethics.
There are, however, some situations written into law that deny me complete control over confidentiality of communication as follows:
1. I am legally required to report any situation of suspected child abuse or neglect to the proper authorities. I am also legally required to report suspected abuse, neglect, or exploitation of an elderly or disabled person.
2. In some circumstances, my records may be subject to a subpoena issued by the court. In particular, confidentiality may be waived with regard to any suit affecting the parent-child relationship.
3. If I believe a client may harm her/himself or another individual, I am permitted by law to break confidentiality by contacting law enforcement officials and/or medical authorities who may then take protective actions.
4. If I am contacted by an insurance company or an auditor, I may be required to release client information as dictated by law. The law also permits me to release information to a collection agency in order to collect on an overdue account.
5. If a client discloses to me the identity of a mental health professional who engaged in sexual contact with him or her during the process of treatment, state law requires me to report that professional to the appropriate district attorney. In this situation, I am not permitted to disclose the identity of the client if he or she does not wish to be identified.
6. Confidentiality does not extend to criminal proceedings in Texas.
This list is not exhaustive, but these are the most common circumstances which may occur. The situations outlined above are out of the ordinary and have no impact on the large majority of people seeking professional mental health services. I share this information with you so that you can be fully informed and your questions and concerns can be addressed
Designated Privacy and Security Officer for this Practice:
Harley Steen, MA, LPC is the designated Security Officer for this practice.
Harley Steen, MA, LPC is the designated Privacy Officer for this practice.
All privacy and security questions, requests, and concerns should be directed to me, and I will be responsible for handing them. Policy effective date: 11/01/2018
Harley Steen, MA, LPC
Psychotherapist | Professional Individual & Couples Counseling
Steen Psychotherapy PLLC