Colleen Desmond Counseling - Secure Client Area

Policies and Practice Information

Welcome to my practice!

This document provides important information about the services I offer. Please read through it carefully and make note of any questions you have so that we can discuss them when we meet. I realize this is a lot of information to digest, and I appreciate your efforts to read through it and understand it fully.

You will have permanent access to this document through the Secure Client Portal.

PSYCHOTHERAPY SERVICES
I provide psychotherapy to children, adolescents, and adults. The services I offer include individual therapy, family therapy, parent consultations and case management. Depending on the needs of the client, I often work in collaboration with a variety of other health and educational professionals.

My therapeutic style stems primarily from cognitive-behavioral therapy (CBT), which emphasizes how thoughts, feelings and behaviors influence each other. In addition to CBT, I incorporate a variety of other methods, including techniques from Dialectical Behavior Therapy (DBT), especially when working with teens. I embrace a collaborative, solution-focused approach that capitalizes on my client's existing strengths while developing valuable new skills. Sessions typically involve active conversation, engaging activities, and humor when appropriate. I sometimes provide "homework" for the client to complete to monitor progress and reinforce skills learned in the therapy session. You are likely to experience the most benefit if you and/or your child devote meaningful effort to the process, both during and outside of your sessions. I cannot guarantee any particular result, but I will do my best to help you achieve the positive changes you desire.



INTAKE PROCESS
Effective psychotherapy requires a good fit between client and therapist. During the intake process I will answer questions about my practice, gather background information about you and/or your family, and discuss your concerns and goals. The intake phase will help us determine whether I am a good match for your needs. If you or I decide that I am not a good fit, I will happily refer you to a therapist who can better meet your needs.


PROFESSIONAL FEES
My fee is $170 for a 45-50 minute session. Intake and family sessions are $190 for approximately 60-minutes. Sliding scale fees are available on a limited basis. We can discuss the possibility of a sliding scale fee if finances are a concern.

In addition to weekly appointments, you may be charged for other professional services such as attendance at meetings, preparation of records or treatment summaries. The fee for these services is based on the time involved, at a rate of $80/hr. 

The charge for phone sessions is $2.00 per minute.  You will not be charged for brief phone calls regarding session cancellation or rescheduling.

BILLING AND PAYMENT
Payment is due at the time of service and may be paid using a major credit card, cash, check or Venmo. Credit card payments are made through the secure client portal. I am happy to provide details about the system's security and encryption process upon request. Many clients prefer to keep their credit card on file so that I can automatically bill for services at the time they are rendered.

You must cancel appointments at least 24 hours in advance to avoid being charged for the session. The late cancellation charge may be waived if we are able to reschedule your missed session for another time within the same week, but I cannot guarantee my availability. You will not be charged for late cancellations related to personal emergencies, unexpected illness or inclement weather.

If a check of yours is returned by the bank for insufficient funds, you will be responsible for reimbursing any bank fees charged to my account for your returned check. If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, I have the option of hiring a collection agency or an attorney to secure the payment. If such legal action should become necessary, its costs would be included in the claim. In addition, this process would require me to disclose otherwise confidential information. In most collection situations, the only information I release is the clients name, the nature of services provided, and the amount due.

INSURANCE
I am considered an out-of-network provider for insurance purposes. If you would like to submit to your insurance company, I will provide you with a "superbill" containing all of the required information to submit for out-of-network reimbursement. You can submit this bill to your insurance company and receive directly any reimbursements for which you might qualify. However, a superbill is not a guarantee of reimbursement. By signing this agreement, you are indicating that (1) you agree to pay for all services at the time they are rendered, (2) you understand that you may or may not be eligible to receive insurance reimbursement, (3) I have no knowledge regarding your reimbursement eligibility, and (4) any attempt to seek reimbursement is solely your responsibility.

Please be aware that if you choose to provide this superbill receipt for services to your insurance company, it must include a psychiatric diagnosis. In that event, I will inform you about the diagnosis that I plan to render before it is given. Any diagnosis that is made will become part of your permanent insurance records. Note that even if you do not pursue reimbursement through your insurance company, a superbill may be useful for tax purposes or for utilizing funds set aside in an employer-based health savings account.

You should also be aware that your contract with your health insurance company requires that I provide them with information relevant to the services that I provide to you if you submit claims. Maryland permits me to send some information without your consent in order to file appropriate claims. I am required to provide them with a clinical diagnosis and treatment information typically limited to the Uniform Treatment Plan. Sometimes I am required to provide additional clinical information such as treatment plans or summaries, or copies of your entire Clinical Record. In such situations, I will make every effort to release only the minimum information about you that is necessary for the purpose requested. Maryland law prevents insurers from making unreasonable demands for information, but there are no specific guidelines about what unreasonable includes. If I believe that your health insurance company is requesting an unreasonable amount of information, I will call it to your attention. You can instruct me not to send the requested information, but this could result in claims not being paid and an additional financial burden being placed on you. Once the insurance company has your claim information, it will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it once it is in their hands. In some cases, they may share the information with a national medical information databank. I will provide you with a copy of any report I submit, if you request it. By signing this Agreement, you agree that I can provide requested information to your insurance carrier.

HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that mandates privacy requirements and client rights pertaining to the use and disclosure of your Protected Health Information (PHI) in connection with treatment, payment and health care operations. HIPAA requires me to provide you with a Notice of Privacy Practices (the Notice), which is attached to this agreement and explains HIPAA and its application to your personal health information in detail. The law requires that at the end of the first session I obtain your signature acknowledging that I have provided you with this information. Although these documents are long and sometimes complex, they contain important information about your rights and I ask that you review them carefully. We can discuss any questions you have about the procedures. When you sign this document, it will represent an agreement between us. You may revoke this Agreement in writing at any time. That revocation will be binding on me unless I have taken action in reliance on it; or unless there are obligations imposed on me by your health insurer in order to process or substantiate claims made under your policy; or unless you have not satisfied any financial obligations you have incurred.

CLIENT RIGHTS INCLUDING CONFIDENTIALITY
At any time you may ask questions about the process and the course of therapy and/or refuse therapeutic or diagnostic procedures or methods. I expect that questions about the methods, effectiveness, and duration of therapy will be raised by both of us at regular intervals during the course of treatment in order to evaluate progress, make adjustments, and decide when to end your therapy. You are encouraged to discuss these topics and are reminded that you may end treatment at any time. You may also seek a second opinion if you wish to do so.

I treat the information you share with me with the greatest respect. The confidentiality of our conversations and my records are protected by standards for professional practice established by the American Counseling Association and by specific Maryland state law governing privilege and confidentiality.

In most situations, I can only release information about your treatment to others if you sign a written Authorization form. However, there are some circumstances in which no authorization is required. Federal Law (HIPAA) specifies these circumstances. As you will see below, the Federal requirements are aimed at protecting the rights of clients and counselors, and in some cases, the community at large. Most of them reflect the legal and ethical responsibility of a counselor to take action to protect endangered individuals from harm when such a danger exists. Fortunately, such situations are rare. If a crisis of this sort should occur, it is my policy to discuss these matters fully with you before taking any action, unless in my professional judgment there is a compelling reason not to do so. Confidentiality will be respected in all cases, except as noted below:

* I may occasionally find it helpful to consult other health and mental health professionals. During a consultation, I make every effort to avoid revealing the identity of my client. The other professionals are also legally bound to keep the information confidential. Unless you object, I will not tell you about these consultations unless I feel that it is important to our work together. I will note all formal consultations in your Clinical Record.
* If you are involved in a court proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the counselor-client privilege law. I cannot provide any information without your written authorization, or a court order. If you are involved in or are contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
* If a government agency is requesting the information for health oversight activities, I may be required to provide it for them.
* If a client files a complaint or lawsuit against me, I may disclose relevant information regarding that client in order to defend myself.
* If health insurers require disclosures or it is necessary to collect overdue fees, I may disclose relevant information as specified elsewhere in this Agreement.

There are some situations in which I am legally obligated to take actions that I believe are necessary to attempt to protect others from harm. In such situations, it may be necessary to reveal some information about a clients treatment. Again, these situations are unusual in my practice.
* If I have reason to believe that a child or vulnerable adult has been subjected to abuse or neglect, or that a vulnerable adult has been subjected to self-neglect, or exploitation, the law requires that I file a report with the appropriate government agency, usually the local office of the Department of Social Services. Once a report is filed, I may be required to provide additional information.
* If I know that a client has a propensity for violence and the client indicates that s/he has the intent to inflict imminent physical injury upon a specified victim(s), I may be required to take protective actions. These actions may include establishing and undertaking a treatment plan that is calculated to eliminate the possibility that the client will carry out the threat such as seeking hospitalization of the client and/or informing the potential victim or the police about the threat.
* If I believe that there is an imminent risk that a client will inflict serious physical harm or death on him/herself, or that immediate disclosure is required to provide for the clients emergency health care needs, I may be required to take appropriate protective actions, including initiating hospitalization and/or notifying family members or others who can protect the client.

If such a situation arises, I will make every effort to discuss it with you before taking any action and I will limit my disclosure to what is necessary. With the exception of situations in which I am legally required to breach confidentiality, you agree that I may use my professional judgment to determine what is and what is not shared with parents of child/minor clients. This allows minors (particularly adolescents) to participate in therapy without feeling at risk of having their personal information shared with parents. This creates a private, therapeutic environment, and offers a respectful attitude toward my minor clients. I welcome any questions or concerns about this aspect of my practice.

While this written summary of exceptions to confidentiality should help to inform you about potential problems, it is important that we discuss any questions or concerns that you may have now or in the future. The laws governing confidentiality can be quite complex; in situations where specific advice is required, formal legal advice may be needed.

PROFESSIONAL RECORDS
You should be aware that, pursuant to HIPAA, I may keep Protected Health Information about you in two sets of professional records. One set constitutes your Clinical Record. It includes information about your reasons for seeking therapy, a description of the ways in which your treatment issues impact your life, your diagnosis, the goals that we set for treatment, your progress towards those goals, your medical and social history, your treatment history, any past treatment records that I receive from other providers, reports of any professional consultations, your billing records, and any reports that have been sent to anyone, including reports to your insurance carrier. Except in unusual circumstances in which disclosure is reasonably likely to endanger the life or physical safety of you or another person, you may examine and/or receive a copy of your Clinical Record if you request it in writing. However, because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. For this reason, I recommend that you initially review them in my presence, or have them forwarded to another mental health professional so that you can discuss the contents with that professional. In most circumstances, I am allowed to charge a copying fee (and certain other expenses). The exceptions to this policy are contained in the attached Notice Form. If I refuse your request for access to your Clinical Records, you have a right of review, which I will discuss with you upon request. In addition, I may keep a set of Psychotherapy Notes. These Notes are for my own use and are designed to assist me in providing you with the best treatment. While the contents of Psychotherapy Notes vary, they may include sensitive information that is not required to be included in your Clinical Record, such as the content of our conversations, the analysis of those conversations, and how they impact your therapy. These Psychotherapy Notes are kept separate from your Clinical Record. While insurance companies can request and receive a copy of your Clinical Record, they cannot receive a copy of your Psychotherapy Notes without your signed, written Authorization. Insurance companies cannot require your Authorization as a condition of coverage nor penalize you in any way for your refusal.

Clients under 18 years of age who are not emancipated and their parents should be aware that the law may allow parents to examine their childs treatment records. While privacy in psychotherapy is very important, particularly with teenagers, parental involvement is often essential to successful treatment. You agree that I may use my professional judgment to determine what is and what is not shared with parents of child/minor clients. I will provide parents with a summary of their childs treatment if requested. If I feel that the child is in danger or is a danger to someone else, I will notify the parents of my concerns. Before giving parents any information, I will attempt to discuss the matter with the child, if possible, and do my best to handle any objections he/she may have.

COMMUNICATION AND EMERGENCIES
I can be reached by phone at (301) 760-4151 or by e-mail through the secure client portal: https://colleendesmond.SecurePatientArea.com. E-mail exchanges through the portal are confidential and HIPAA-compliant. If necessary, you may also reach me at Colleen@DesmondCounseling.com, but the privacy of e-mails to that address cannot be guaranteed.
In order for me to maintain comprehensive documentation of your/your child's treatment, it is very helpful for our e-mail communications to take place within the CounSol system whenever possible. It is important that you respond promptly whenever you receive a notification that a message is waiting for you. I appreciate your willingness to take the extra step to log into the system to retrieve and send e-mails.

 *E-mail can be used to discuss scheduling, to give brief reports about your progress, or to ask simple questions that can be answered concisely. However, I am unable to provide any form of treatment or therapeutic advice via e-mail.
 *Phone calls are answered by voicemail if I am not available. Please leave a message and I will call you back at my earliest convenience, typically within 24 hours.
 * When I am away and cannot be reached, I will provide you with the name and number of a colleague who will provide coverage in my absence.
 * If you are having an urgent crisis and need immediate assistance, please call 911 or go to your nearest emergency room.

CONSENT TO TREAT
I consent to my/my child's participation in psychotherapy services with Colleen E. Desmond, LCPC, and I agree to the policies of her practice as detailed in the above paragraphs. I understand that services will be rendered in a professional manner, consistent with accepted ethical standards. I am aware that if psychotherapy services are not rendered in a professional and ethical manner, I may file a complaint with the Maryland State Board of Counselors and Therapists. I have read this agreement and agree to its terms and I have been provided a copy of this agreement and the Notice of Policies and Practices to Protect the Privacy of Your Health Information (also found on the secure client portal). The contents of these documents have been satisfactorily explained to me, and I have had the opportunity to ask questions and clarify my understanding of these policies.

Whenever possible, I prefer to have both parents signatures in the case of minor clients. Both parents must sign their consent to treatment of a minor if parents are in the process of separating, or are separated/divorced and have joint legal custody.


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Colleen Desmond, LCPC 
Licensed Clinical Professional Counselor

11904-F Darnestown Rd., Gaithersburg, MD 20878 

301-760-4151
Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

Your health record contains personal information about you and your health. This information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to you as Protected Health Information ("PHI"). This Notice of Privacy Practices describes how I may use and disclose your PHI in accordance with applicable law, ACA Code of Ethics and The American Psychological Association Code of Ethics. It also describes your rights regarding how you may gain access to and control your PHI.

I am required by law to maintain the privacy of PHI and to provide you with notice of my legal duties and privacy practices with respect to PHI. I am required to abide by the terms of this Notice of Privacy Practices.

HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

For Treatment. Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members. I may disclose PHI to any other consultant only with your authorization.

For Payment. I may use and disclose PHI so that I can provide the necessary information for your insurance carrier, explaining the treatment services you received. This will only be done with your authorization. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities.

For Communication with you. When I need to contact you by telephone I will use the phone numbers you have given me on the signature form to do this.

Required by Law. Under the law, I must make disclosures of your PHI to you upon request. In addition, I must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining my compliance with the requirements of the Privacy Rule.

Without Authorization. Applicable law and ethical standards permit me to disclose information about you without your authorization only in a limited number of other situations. The types of uses and disclosures that may be made without your authorization are those that are:
-Required by Law, such as the mandatory reporting of child abuse or neglect or mandatory government agency audits or investigations (such as the counselor licensing board or the health department.)
-Required by Court Order
-Necessary to prevent or lessen a serious imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

Verbal Permission. I may use or disclose your information to family members that are directly involved in your treatment with verbal permission.

With Authorization. Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization, which may be revoked. Your treatment will not be affected if you choose to not sign an authorization.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding the PHI I maintain about you. To exercise any of these rights, please submit your request in writing to me.

-Right of Access to Inspect and Copy. You have the right, which may be restricted only in exceptional circumstances, to inspect and copy your PHI that may be used to make decisions about your care. Your right to inspect and copy your PHI will be restricted only in those situations where there is compelling evidence that access would cause serious harm to you.

-Right to Amend. If you feel that the PHI I have about you is incorrect or incomplete, you may ask me to amend the information although I am not required to agree to the amendment.

-Right to an Accounting of Disclosures. You have the right to request an accounting of certain of the disclosures that I make in your PHI.

-Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. I am not required to agree to your request.

-Right to Request Confidential Communication. You have the right to request that I communicate with you about medical matters in a certain way or at a certain location.

-Right to a Copy of this Notice. You have the right to a copy of this notice.

COMPLAINTS

If you believe that I have violated your privacy rights, you have the right to file a complaint in writing to me or with the Department of Health and Mental Hygiene, Baltimore, Maryland.