MEETINGS
Meetings consist of' 45-minute sessions at a frequency determined by the both of us. Once an appointment hour is scheduled, you will be expected to pay a No-Show fee of $100.00 dollars, unless you provide 24 hours advance notice of cancellation. lf it is possible, I will try to find another time to reschedule the appointment.  Because I have more requests for services than I have available times, appointments are at a premium.  Thus, clients who cancel sessions on a frequent basis may be asked to consider withdrawing from treatment until their schedule allows them to make appointments.

CONTACTING ME
I am often not immediately available by telephone.  While I am usually available between 9:00AM and 7:00PM, I probably will not answer the phone when I am with a patient.  When I am unavailable, my telephone is answered by an answering machine or voice mail that I monitor frequently.  I will make every effort to return your call on the same day you make it, with the exception of weekends and holidays when I will respond to emergencies only.  If you are difficult to reach, please inform me of some times when you will be available.  lf you are unable to reach me and feel that you can't wait for me to return your call, contact your family physician or the nearest emergency room.  If I am unavailable for an extended time period, I will discuss with you options for emergency contacts and, if necessary, provide you with the name of a colleague to contact.

PROFESSIONAL FEES FOR SERVICES
If you are not using health insurance to pay for treatment fees, it is expected that payment will be received at time of the session at the current rate for services, $150.00. Contact your insurance provider for procedures on insurance reimbursement.

In addition to weekly appointments, I charge for other professional services you may need, though I will break down the hourly cost if I work for periods of less than one hour.  Other services include report writing, telephone conversations lasting longer than 15 minutes, attendance at meetings with other professionals you have authorized, preparation of records or treatment summaries (separate from those necessary for insurance reimbursement), and the time spent performing any other service that you may request of me.

If you become involved in legal proceedings that require my participation, you will be expected to pay for my professional time even if I am called to testify by another party.  Because of the difficulty of legal involvement, there is a special rate for preparation and attendance at any legal proceedings.  Treatment that is mandated by the court or another agency will require individualized contracts between all parties involved.

In an effort to provide better treatment and financial accessibility, Now Me is now accepting insurances. We are currently accepting Cigna, Aetna, Optum and Centerstone Solutions. We will notify you as we add additional insurances. Insurance companies cover 45 minutes duration sessions as a standard. 60 minutes sessions are covered for emergency sessions. If the duration of the session goes above 10 minutes of the allotted time, clients will be charged $50 every 30 minutes. You will be responsible for this additional fee. 

Now Me Counseling Services accepts all major credit cards for your convenience. Due to increased credit card fees we will be charging a $4.50 fee per transaction. To avoid this fee, we suggest, utilizing alternative payment methods such as cash, checks and Zelle. The office will waive the fee if you pay your sessions in bundles. Each client will require a credit card on file. This card will be charged for late cancellations fee and no shows. 

DELINQUENT ACC0UNNTS
If your account has not been paid for more than 60 days and arrangements for payment haven't been agreed upon, I have the option of using legal means to secure the payment.  This may involve hiring a collection agency or going through small claims court.  If such legal action is necessary, its costs will be included in the claim.  In most collection situations, the only information I release regarding a patient's treatment is his/her name, the nature of services provided, and the amount due.

ADDENDUM 08.21.2024

DUE TO INCREASE DIFFICULTIES WITH COLLECTING PAYMENTS ON THE DAY OF THE SESSION, THE OFFICE WILL NOW CHARGE YOUR METHOD OF PAYMENT THE DAY BEFORE YOUR APPOINTMENT, TO ENSURE SUFFICIENT FUNDS ARE AVAILABLE. WE KINDLY ASK THAT YOU VERIFY YOUR PAYMENT METHOD 2 DAYS BEFORE YOUR SCHEDULED APPOINTMENT AND UPDATE ANY EXPIRED CARDS. IF YOU WOULD LKE TO AVOID THE CONVENIENCE CREDIT CARD FEE OF $4.50, PLEASE ADVISE THE OFFICE YOU WILL BE SENDING PYMENT VIA ZELLE OR PAYING IN CASH OR WITH A CHECK AT THE TIME OF YOUR APPOITMENT. 

I am committed to keeping everything you share completely confidential.  Whatever you speak about will not be shared with anyone else without your written permission.  However, there are certain limits to this confidentiality that I would like you to know about.

1)  If you have been referred by the court or any agency of the court, I may be required to furnish

Information to them.

2)  If you are involved in certain kinds of litigation, such as worker's compensation, and inform the

Court of the services you have received from us, you may be waiving your right to have your records remain confidential.  This would need to be clarified with your attorney.

3)  If you threaten to harm yourself or someone else, I am obligated to inform potential helpers or victims.  Information would be divulged only if I perceive that there is imminent danger to a readily identifiable victim, yourself, or the public.  I am obligated to warn and protect if I believe you intend to carry out serious violence, even if you have not made a specific verbal threat.

4)  If I have reason to suspect there is child abuse or neglect, I am obligated by law to report this to the appropriate state agency.

5)  If I reasonably believe that a vulnerable adult is being abused, neglected, or exploited, I may report

this information to the county adult protective services provider.

6)  If you are a minor, your parents or guardians will be informed of your progress, if they ask.

However, I will not reveal specific details of our conversations without your permission unless I

determine that your safety is at risk.

7)   Your health care insurance may require information to process claims or to authorize benefits.

8)  If the New Jersey/Pennsylvania State Board of Psychological Examiners issues a subpoena, I may be compelled to testify before the Board and produce your relevant records and papers.

If you are concerned about some of your information, you have the right to ask me not to use or share it for treatment, payment, or administrative purposes.  You will have to tell me what you want in writing. Although I will try to respect your wishes, I may not be able to agree to these limitations.  However, if I do agree, I promise to comply with your wishes.  You will be told if your information is shared per the privacy limitations listed above.

You have the right to request to receive confidential communication by alternative means and at

alternative locations.  For example, you could request that bills/statements be sent to a different address if you didn't want a family member to know about them.

You can request to inspect, obtain a copy of, or amend information about yourself in our mental health

or billing records.  Under certain circumstances, your request may be denied, but you may be able to have this decision reviewed.

If you have questions about this notice, disagree with a decision I make about access to your records, or

have other concerns about your privacy rights, please discuss them with me.  You can also send a written complaint to the Secretary of the US Department of Health and Human Services.

After you have signed this consent, you have the right to revoke it (by writing a letter telling me you no longer consent), and I will comply with your wishes about using or sharing your information from that time on. However, if I have already used or shared some of your information, I cannot change that.  Please sign and date this sheet to acknowledge that you have read and understood this notice of privacy policies.   This form complies with federal regulations (HIPAA).

Agreement for Payment

I agree to pay the provider, Rissy C Batista, MA, LPC, NCC, (Now Me Counseling Services, PLLC) in full for services rendered at the time of the appointment, $150.00 a session. I am aware that I am responsible for a No-Show fee of $100.00 dollars if the appointment is canceled with less than 24 hours' notice. If I need a payment arrangement, it must be made and authorized by Rissy C Batista, MA, LPC, NCC, (Now Me Counseling Services PLLC) prior to services starting.

Waiver of Confidentiality

If I fail to pay the provider in full, I am aware that my name may be submitted to a collection agency, and might appear on a credit report.  My signature below attests to the fact that in such an instance, I waive my right to confidentiality and am aware that

the credit report will indicate that I have an outstanding balance for services rendered by a mental health professional.

Patient Responsibility if Courtesy Extended for Assignment of Benefits

If the provider agrees to the assignment of benefits, I agree that reimbursement from the insurance company or other outside agent responsible for the bill will go to Rissy C Batista, MA, LPC, NCC.  I agree to pay any co-payment at the time of the appointment.  I agree that should the insurance company send the payment for these services directly to me (the patient or responsible party); I will bring the entire payment from the insurance company to the provider within 10 days of the date postmarked on the envelope.   I agree that I will not cash the check and view it as my own money.  I understand that were I to do so, that could constitute conversion of money owed to the provider.

I have chosen to receive psychological treatment from Now Me Counseling Services, PLLC for myself and/or my minor child. My choice has been voluntary and I understand that I may terminate therapy at any time.

Because psychotherapy is a joint effort between my therapist, and myself I will work with my therapist in a cooperative manner to resolve my difficulties.  I understand there is no assurance that I will feel better.

I understand that during the course of my treatment, material may be discussed which will be upsetting in nature and this may be necessary to help me resolve my problems.

I understand that confidentiality of records of information collected about me will be held or released in accordance with state and/or federal laws regarding confidentiality of such records and information.

I understand that state laws require that my therapist report all cases of abuse or neglect of minors or of the elderly.

I understand that state laws require that my therapist take mandated steps where there exists a danger to self or others.

I understand that there may be other circumstances in which the law requires my therapist to disclose confidential information and I will be informed of such circumstances prior to the disclosure.

I give my therapist permission to disclose information and records necessary for continuation of treatment and processing of medical claims under current limits of state and federal law.  I give permission for my therapist to file insurance forms on my behalf if requested, including electronic forms.

I understand that I can revoke my consent at any time except to the extent that treatment has already been rendered or that action has been taken in reliance on this consent, and that if I do not revoke this consent, it will expire automatically one (1) year after all claims for treatment have been paid or treatment has been terminated, whichever is latest.

My signature attests that I have read and understood the above.