“It took many years of vomiting up all the filth I’d been taughtabout myself, and half-believed, before I was able to walk on the earth as though I had a right to be here.” - James Baldwin
I N S U R A N C E
I N S U R A N C E
I am an out of network provider, and as such may, as a courtesy, offer you a “Superbill” receipt each month for you to submit to your insurance company for potential reimbursement of the fees you have paid for that (and each) month prior to submission.
Insurance companies have specific guidelines from which they make their decision to POTENTIALLY reimburse their clients, fully, partially or not at all.
Therefore on my Superbills, you will have all of the information required by your insurance, so that they may make their most informed decision. Anything I can do to help that process along to your benefit, I’m happy to do.
The stipulations however are as follows:
- Client agrees to pay the FULL FEE for psychological services UP FRONT at the time of each week's session.
- Weekly sessions are the minimal amount at the start of the therapeutic process. Any changes will be made collaboratively with myself and clinical reasonings will always take precedent when these decisions are made.
- Obviously finances (the client's actual ability to pay) must be taken in consideration, however this too is considered a clinical issue and (as with ANY subject matter pertaining to client's treatment), it is my hope that a frank and direct discussion between therapist and potential client be made before therapist agrees to provide client with the curiosity of a Superbill.
- It is, of course, the final decision of the potential client to work with therapist or not based on the established fee. Should this become the ultimate decision, therapist agrees to provide potential client(s) with at least three (3) referrals who are within the budget of the potential client.
My Full Fee is as listed:
- Adults, Teens or Children = $200 per 50 min session
- Couples - $250 per 90 min session
- Families (3 or more) - $300 for 90 min sessions
Sliding Scale Fee
Sliding Scale Fee
What Is Sliding Scale Therapy?
A sliding scale is a type of fee structure therapists sometimes use to give people with fewer resources a lower fee. In fact, the sliding scale fee is commonly used in many types of industries including legal service or dental care. Affordable sliding-scale therapy is not a "sale" or a "discount" that can change over time. The amount you pay for affordable sliding-scale therapy is calculated by your income. The less income you bring in each month, the less you pay for your therapy sessions.
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SLIDING SCALE CONSIDERATIONS
There are limited time slots of which I've placed aside for Sliding Scaled fees. Please talk with me to see if there are any sliding scale fee time slots currently available. IF there are, here are the stipulations and expectations for sliding scale fees :
ALL SLIDING SCALE TIME SLOTS ARE WEEKDAYS BEFORE 5PM
. . .
EACH PERSON WILL SIGN A SLIDING SCALE AGREEMENT WHICH WILL STATE THE FOLLOWING:
- I, certify that I do not have or am choosing not to pay through health insurance (or certify that I will not / cannot utilize any health insurance for therapeutic services rendered by Timothy Rogers, M.A., Licensed Marriage & Family Therapist. Due to my current financial situation, I cannot afford the full fee rate of $200 per 50 min individual session/$250 per couples 90 min session/$300 per Family (3 or more) 90 min session. I therefore, request that my fee be adjusted.
- My current monthly income is currently insufficient to cover my monthly expenses and therapy at the rate of $200 per 50 min individual session/$250 per couples 90 min session/$300 per Family (3 or more) 90 min session.
- This is also true of my total household income, if living with a partner. Therefore, I understand that the fee for services with Timothy Rogers, MA, LMFT mfc101500 will be agreed upon by all parties which will be reviewed every 3 months and this agreement will not exceed 2 years.
- I further understand that I will not be charged for any appointments that are cancelled at least 24 hours in advance. I understand that appointments not cancelled at least 24 hours in advance are subject to a “Late Cancellation” or “No Show” charge of my contracted rate above. I understand that I am solely responsible for all these charges as they apply, as well as, the costs associated with collecting these charges.
- I agree to notify Timothy Rogers, M.A., LMFT of any substantive changes in my financial situation (e.g., 10% increase or decrease in income) within 30 days of the change, and understand the fee may change according to my updated financial situation.
- I further acknowledge that my therapist will periodically verbally review my financial status with me, approximately in three months time in order to reassess eligibility. A continuance of Sliding Scale benefits is not guaranteed and is subject to modification and/or elimination at the sole discretion of Timothy Rogers, M.A., LMFT but also in discussion with me and/or my third party payer.
- Client acknowledges that he/she/they has/have reviewed and fully understands the terms and conditions of this Agreement. Client has discussed such terms and conditions with Therapist, and has had any questions with regard to its terms and conditions answered to Client’s satisfaction.
- Client agrees to abide by the terms and conditions of this Agreement and consents to participate in psychotherapy with Therapist. Moreover, Client agrees to hold Therapist free and harmless from any claims, demands, or suits for damages from any injury or complications whatsoever, save negligence, that may result from such treatment.