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Notice of Privacy Practices
and Practice Policies
Transitions: Counseling Services 507 S. Nelson St. Greenville, MI 48838 (616) 754.9420
PRACTICE POLICIES
APPOINTMENTS AND CANCELLATIONS. The standard meeting time
for psychotherapy is 50 minutes. If you are late, you may lose some of that session time.
Arriving more than 10 minutes late will be considered a cancellation (No Show). If you
cannot make a scheduled appointment, please notify us 48 hours in advance. With the
exception of Medicare and Medicaid, failure to do so will result in a fee of $75.
If you do not arrive for a scheduled appointment, without notice, your future appointments
may be canceled. If you No Show, or Cancel Late, your services at Transitions may be
suspended for six months.
Clients often schedule appointments for several weeks at a time to ensure that they
can hold the day and time that works for their schedules. If you fail to appear for an
appointment, you will lose all following scheduled appointments. All paperwork must be
completed prior to your first appointment; if not, time during your appointment will
be utilized to complete the paperwork.
PAYMENT. Payment is due at time of service; a Health Savings Account (HSA) Card,
Mastercard, Visa, Cash, or Check made payable to Transitions are accepted.
1. A $35 fee will be charged for any check returned for any reason.
2. If you are paying with insurance, contact your insurance company (via the information
on the back of your insurance card) prior to your appointment to inquire about any co-
pays, co-insurances, and/or deductibles.
Ask your insurance company if the therapist you are seeing accepts your insurance and will
be reimbursed.
Proof of insurance is due at your first appointment together with identification. You will be
responsible for any balance due if your current insurance is not updated when there is
change of insurance or insurance discontinues for any reason.
3. Co-pays, co-insurance, and/or deductibles are due at the time of service. If you have
Medicaid or Medicare insurance, items 4a and 4b do not apply.
4. We require a credit card or HSA number on file. If insurance does not pay in a month’s
time, your credit card or HSA will be charged for the sessions. If insurance pays later, you
will be reimbursed. If you do not have a credit card or HSA, we require $150 in cash or check at the first
appointment. If insurance does not pay in a month’s time, Transitions will use that $150 for
session fees. If insurance pays later, you will be reimbursed.
5. If we are subpoenaed to appear in court, we charge $200 per hour for document
preparation, discussions with court officers, travel time, and time waiting for the court
appearance (among others). A minimum fee of $500 will be charged for any part of a half
day in court.
6. All copies, documents, letters, reports and emails will be charged a $15 fee per 15
minutes units and a minimum fee of $15.00 will apply. This does not include general
scheduling with your therapist.
ACCOUNT BALANCES. After 60 days from the date of service, any account balances will
be charged to your card. If you do not have a card on file, we reserve the right to send your
account to a collection agency.
Parents/guardians are responsible for paying the co-pay or deductible for a minor. The bill
for these appointments will be given to the parent/guardian listed as the main contact for
the child.
If the balance is not paid in full in three months, services may be suspended.
If you do not agree to these terms and do not provide a means to meet your financial
obligation, services may be suspended.
MINORS. At the first intake session, we require demonstration of custodial rights. Proof
includes, but is not limited to, court orders, birth certificates, and affidavits of parenting
agreements. Parents/guardians may be legally entitled to some information about a minor’s therapy. We
will inform the minor and the parents/guardians of the information which may be provided
to parents/guardians and which issues are more appropriately kept confidential.
Parents/guardians will have an active credit card or HSA card on file in order to bill any
outstanding balances without involving the minor. If parents/guardians do not have a credit
card or HSA card a $250 credit must be maintained on file until the minor is no longer
receiving services post 90 days. The credit card or cash credit utilized balances accrue.
Any minors under the age of 15 must be accompanied on site by a parent/guardian for the
entire visit. Typically, the responsible adult(s) will not be physically present in the session,
but they must be in the waiting area or on the premises throughout the visit.
Parents/guardians, stepparents, custodial parents, and any other person responsible for a
minor’s welfare must be prepared to participate in the minor’s therapy with or without the
child present.
Parents/guardians must be present during the initial assessment, annual assessments, and
creation of the treatment plan.Parents/guardians who are unable to accompany a child to appointments must sign a
release form in advance allowing a non-custodial adult to bring the child. That adult must
remain on site for the duration of the appointment if the child is under 15. Parents/guardians are responsible for the behavior of any other children accompanying the client to an appointment. If children are not in treatment, please bring toys, books, I-pads, etc. to keep them entertained. Please do not leave children under 12 years of
age unattended.
TELEPHONE ACCESSIBILITY. Cell phone communications cannot be guaranteed
as confidential. HIPAA acknowledges only land-line phones hard wired from handset
to wall employed by both parties as secure. Cell phone users acknowledge and accept
the risks to confidentiality. If you need to contact us between sessions, please leave a message on the voice mail. Often,
we are not immediately available; however, we will attempt to return your call within 24
business hours. Conversations continuing longer than 10 minutes will be considered a
phone session and will be charged for a session. You may have a co-pay, co-insurance, or
deductible due on this phone session. Please note that face-to-face sessions are highly
preferable to phone sessions. However, in the event that you are out of town, sick, or in
need of additional support, phone sessions are available (paid out-of-pocket; not all
insurances will pay). In an emergency, call 911, Montcalm Care Network emergency
services (800) 377-0974, or go to any local emergency room.
TELEHEALTH.
We possess a HIPAA compliant video conferencing method should you not
be able to come to the office for your appointment. If you are using a cell phone, you must
first download the Simple Practice application. Your therapist will ensure that he or she is
in a secure, confidential location. It will be your responsibility to ensure your privacy when
using Telehealth. Note that not all insurance companies reimburse Telehealth sessions. It is
your responsibility to contact your insurance provider to see if this is an option for you.
In consideration of your confidentiality and health boundaries, texting will be utilized only
for appointment verification and cancellation.
be able to come to the office for your appointment. If you are using a cell phone, you must
first download the Simple Practice application. Your therapist will ensure that he or she is
in a secure, confidential location. It will be your responsibility to ensure your privacy when
using Telehealth. Note that not all insurance companies reimburse Telehealth sessions. It is
your responsibility to contact your insurance provider to see if this is an option for you.
In consideration of your confidentiality and health boundaries, texting will be utilized only
for appointment verification and cancellation.
COVID-19 AND VARIANTS FOR IN PERSON COUNSELING SESSIONS
1. All clinicians and contractors on-site are responsible for implementing and monitoring this plan.
2. If you have a cold or flu symptoms, do not enter the building.
3. Anyone 5 years or older must be fully vaccinated and present a vaccination card which will be copied and filed.
4. Maintain six-foot distancing when possible.
5. Face masks are required upon entry. During sessions, clinicians will decide if masking is still required. Transitions will make coverings available, but clinicians and clients may bring their own.
6. Clinicians will clean and disinfect their work areas twice daily, at a minimum—once at the start of a day and again midway through the day.
7. The lobby will not be used. Clients will remain in their vehicles until clinicians message them to enter the building.
8. Clinicians will wash their hands following each client appointment.
8. Clinicians will wash their hands following each client appointment.
9. Everyone in the building will use hand sanitizer regularly. Effective March 1, 2022
SOCIAL MEDIA AND TELECOMMUNICATION. Due to confidentiality and
the importance of minimizing dual relationships, we do not accept friend or contact
requests from current or former clients on any social networking site (Facebook, LinkedIn,
etc.). Adding clients as friends or contacts on these sites can compromise your
confidentiality and your privacy. It may also blur the boundaries of our therapeutic
relationship. If you have questions, please raise them when we meet.
ELECTRONIC COMMUNICATION. We 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, we will do so. Although we try to return messages in a timely manner, we
cannot guarantee an immediate response; therefore, we ask that you do not use
these methods of communication to discuss therapeutic content and/or to request assistance
for emergencies. If you email the therapist for anything other than scheduling purposes,
the email will be considered a session. Emails are highly discouraged in providing
therapeutic information for yourself or for someone else. Know that your insurance may
not cover this cost and it would then fall to you to pay for the email correspondence.
TERMINATION. Ending therapeutic relationships can be difficult. Therefore, we
propose a termination process to achieve some closure. The appropriate length of the
process parallels the length and intensity of the treatment. We may terminate treatment if
psychotherapy is not effective for you, or if you are in default on payment. We will
never terminate the therapeutic relationship without first discussing and exploring the
reasons and purpose of termination. If you request other treatment, we will provide you
with a list of qualified psychotherapists. You may also choose someone on your own or
from another referral source.
If an appointment is not scheduled for you in a six month time period, or you have not been
seen by your therapist for six months, we will close your file with the therapist providing
services. This means that your therapist is no longer your therapist. For legal and ethical
reasons, we will consider the professional relationship discontinued. You may contact
Transitions to see if you can become a client once again or seek a referral to another
therapist.
In the event the relationship has terminated due to a psychotherapist’s illness, death, or any
other form of incapacity, Transitions: Counseling Services, PLLC will arrange for
the appropriate distribution of all client personal health information.
Notice of Privacy Practices