Professional Fee
All fees will be set at the start of treatment. Payment is expected at the time services are rendered. Reduced fee is available on a limited basis if financial circumstances are warranted. Cash, check, and credit card are accepted forms of payment at the time of service. Psychotherapy sessions typically occur on a weekly basis; however, frequency will be determined based on your needs.
Insurance
I am an out-of-network insurance provider. While I am not an in-network provider with health insurance or employee benefit plans, most insurance companies will provide partial or full coverage for services rendered by a licensed psychologist. Additionally, psychotherapy is an allowable expense for your Health Spending Account (HSA) or Flexible Spending Account (FSA). Many of my clients utilize these benefits by paying for their therapy services out of pocket and then submitting a claim to their insurance provider or HSA/FSA to receive reimbursement for out-of-network coverage. Many plans offer about 60-90% reimbursement, but you must check with your insurance company for specific benefits applicable to your plan. I will provide an itemized bill that you can submit to your insurance company or HSA/FSA flexible for your entitled reimbursement.
You may want to ask the following questions of your insurance provider:
• Do I have mental health insurance benefits?
• What is my deductible and has it been met?
• How many sessions per year does my health insurance cover?
• What is the coverage amount per therapy session?
• How much will I be reimbursed (%) if I pay out of pocket?
• Is approval required from my primary care physician?
• How do I request reimbursement?
Why have I decided not to participate in most insurance plans as an in-network provider?
As an in-network provider, I have a contract with the insurance company wherein I am essentially a company employee. As an out-of network provider, I work directly (and privately) for you. There is a greater degree of privacy and confidentiality, since I am not required to share a great deal of your personal information with the insurance companies. Our sessions are not pre-set and our treatment plan is not overseen by the insurance company to control their costs. We are better able to work collaboratively to determine your needs and length of treatment.
Confidentiality
The law protects the confidentiality of communications between a client and a psychologist, and information cannot be disclosed without prior written permission from the client. However, there are some exceptions required by law to this rule.
These include:
• When there is suspected child abuse or dependent adult or elder abuse. I am required to report this to the appropriate authorities.
• If a client is threatening serious bodily harm to another person(s), I am required to notify the police and the intended victim.
• If a client intends to harm him or herself, I will make every effort to work with the individual to ensure his/her safety. However, if an individual does not cooperate, I will take further measures without his or her permission that are provided to me by law in order to ensure the client’s safety.
On June 13, 2018, New Jersey’s Duty to Warn Statute that applies to mental health providers, including Psychologists, was updated and now provides:
The New Jersey Duty to Warn Law for all Mental Health Professionals has been changed. These amendments went into effect immediately. The New Jersey Duty to Warn Law The New Jersey Duty to Warn Law, (9P.L.1991, Chapter 270, passed in 1991) requires mental health practitioners to take at least one of five actions if they incur a “duty to warn”: that is “(1) The patient has communicated to that practitioner a threat of imminent, serious physical violence against a readily identifiable individual or against himself and the circumstances are such that a reasonable professional in the practitioner’s area of expertise would believe the patient intended to carry out the threat; or (2) The circumstances are such that a reasonable professional in the practitioner’s area of expertise would believe the patient intended to carry out an act of imminent, serious physical violence against a readily identifiable individual or against himself.” These courses of action are: “(1) Arranging for the patient to be admitted voluntarily to a psychiatric unit of a general hospital, a short-term care facility, a special psychiatric hospital or a psychiatric facility, under the provisions of P.L.1987, c.116 (C.30:4-27.1 et seq.); (2) Initiating procedures for involuntary commitment of the patient to a short-term care facility, a special psychiatric hospital or a psychiatric facility, under the provisions of P.L.1987, c.116 (C.30:4-27.1 et seq.); (3) Advising a local law enforcement authority of the patient’s threat and the identity of the intended victim; (4) Warning the intended victim of the threat, or, in the case of an intended victim who is under the age of 18, warning the parent or guardian of the intended victim; or (5) If the patient is under the age of 18 and threatens to commit suicide or bodily injury upon himself, warning the parent or guardian of the patient.”
The practitioner who does disclose this confidential information is immune from civil liability in regard to that disclosure. What has changed? The new amendment, originating from bill A1181, signed by Governor Phil Murphy (along with 5 other gun control bills) on June 13, 2018, adds to the existing duty to warn law by requiring that a licensed practitioner notify the chief law enforcement officer in the municipality/township where the patient resides, or the Superintendent of State Police if the patient resides in a municipality that does not have a full time police department, that a duty to warn and protect has been incurred with respect to the patient and shall provide to the chief law enforcement officer or superintendent, as appropriate, the patient’s name and other nonclinical identifying information. Only patient contact information needs to be given, not clinical information. The police will then take action with the courts to determine whether to revoke any firearms permit and seek to collect any firearms owned by the patient or that they have access to. There is a process for the patient to seek to reverse these actions once the “duty to warn” situation has passed through a clinical assessment. The practitioner who does disclose this confidential information is immune from civil liability in regard to that disclosure.
NEW JERSEY’S DUTY TO WARN STATUTE
2A:62A-16. Health, mental health, and marriage and family therapy professionals; immunity from liability; duty to warn; disclosure of privileged communications
Duty To Warn (References)
N.J. Stat. Ann. § 2A:62A-16.
Tarasoff v. Regents of the University of California, 17 Cal.3d 425, 131 Cal.Rptr. 14, 551 P.2d 334 (1976)(California Supreme Court’s landmark 1979 ruling on duty to warn).
McIntosh v. Milano, 168 N.J.Super. 466, 489, 403 A.2d 500 (Law Div.1979)(An early New Jersey case imposing a duty to warn potential victims of a dangerous patient).
Marshall v. Klebanov, 188 N.J. 23, 36, 902 A.2d 873, 881 (2006)(Reviewing the immunity provisions of N.J.S.A. 2A:62A–16 in the context of medical malpractice when a psychiatrist was sued for allegedly abandoning a seriously depressed patient who committed suicide)
REFERENCES FOR PSYCHOLOGIST/PATIENT PRIVILEGE:
N.J. Stat. Ann. § 45:14B-28.
NEW JERSEY RULES OF EVIDENCE, N.J.R.E. 505.
State v. Smith, 307 N.J. Super. 1, 12 (App. Div. 1997), certif. denied, 153 N.J. 216 (1998)(“Whether viewed in the context of the physician-patient privilege or the psychologist-patient privilege, we fully acknowledge that public policy requires protection of the confidentiality of communications made to a therapist in the course of treatment.”).
Arena v. Saphier, 201 N.J. Super. 79, 86 (App. Div. 1985) (In order for counseling to be effective “full disclosure to the therapist of the patient’s most intimate emotions, fears and fantasies is required.”)
Taylor v. United States, 222 F. 2d 398, 401 (D.C. Cir. 1955). (The need for trust is especially important in providing mental health treatment, a counselor “must have his patient’s confidence or he cannot help him.”)