James Fitzgerald Therapy PLLC

James Fitzgerald Therapy, PLLC

My Private Practice Policies & Procedures

Download a PDF Version of my Policies & Procedures

INTRODUCTION

I have chosen to display my practice policies and procedures on this website. In some cases therapists are ethically or legally required to display their policies and procedures on a public-facing website for several important reasons related to transparency, informed consent, client empowerment, legal protection, and professional integrity.

First and foremost, publicly posting policies and procedures helps uphold the ethical principle of informed consent, which is foundational to all counseling and therapeutic relationships. Informed consent means that clients have a clear understanding of what to expect from therapy, including fees, cancellation policies, confidentiality limits, telehealth practices, emergency protocols, and how records are handled. By displaying these details publicly, the therapist ensures that prospective clients have access to this vital information before they engage in services. This empowers clients to make educated decisions about whether the provider aligns with their needs, values, and expectations.

In addition, providing accessible policies and procedures helps to build trust and credibility. It demonstrates the therapist’s commitment to transparency, professionalism, and accountability. This is especially important in a field where clients are vulnerable and may have had prior experiences of disempowerment, coercion, or institutional betrayal. When a therapist is clear and upfront about how they operate, it creates a safer container for the therapeutic work to unfold.

From a legal and risk management standpoint, public-facing policies can serve as a layer of protection for the therapist. Clearly communicated policies about fees, missed appointments, and confidentiality can reduce the likelihood of misunderstandings, disputes, or complaints. In the case of a grievance or legal challenge, having documented, consistently applied procedures can support the therapist in demonstrating that they provided appropriate notice and maintained ethical standards.

Therapists are also expected by many licensing boards, ethical codes (such as those from the American Counseling Association (ACA) or National Association of Social Workers (NASW)), and professional liability insurers to provide written documentation of practice policies. While not all boards require these policies to be public-facing, providing them online ensures accessibility and compliance, particularly in the age of telehealth, where clients may not meet in person or receive paper documents. In states that regulate informed consent or telehealth laws, having these disclosures readily available is often recommended or required.

Additionally, publicly posted policies can promote accessibility and inclusion. Individuals with disabilities, language barriers, or limited access to transportation may find it easier to review policies online at their own pace. This reduces barriers to care and demonstrates a commitment to equitable practice.

In a competitive digital landscape, clarity around policies can also enhance marketing and client attraction. Many clients now “shop” for therapists online and will gravitate toward providers who are clear, organized, and transparent. A professional, well-structured site that includes policies signals that the therapist is not only clinically skilled but also ethical, responsive, and trustworthy.

Finally, public transparency of procedures affirms the therapist’s values and philosophy of care. For therapists working from progressive, person-centered, trauma-informed, or social justice lenses, this transparency is a form of advocacy and empowerment in itself. It models integrity and relational accountability, which are central to healing and human flourishing.

In summary, displaying practice policies on a public website is not just a matter of formality—it’s a best practice that serves to protect both the therapist and the client, enhances ethical and legal compliance, promotes access and equity, and fosters trust. Whether through an FAQ section, downloadable informed consent document, or detailed practice guidelines, this kind of openness is a core expression of therapeutic professionalism and care in the modern era.

PROFESSIONAL RECORDS

Your therapist is required to keep appropriate records of the psychological services that they provide. Your electronic health records are maintained on this portal owned and operated by Therapy Notes, LLC and licensed for use to James Fitzgerald Therapy. The computer equipment is kept in a secure location in the office or always on my person in locked bag. Your therapist may keep brief records noting that you were here, your reasons for seeking therapy, the goals and progress we set for treatment, your diagnosis, topics we discussed, your medical, social, and treatment history, records received from other providers, copies of records sent to others, and your billing records. It is required that any physical records or copies of electronic records be kept in a locked storage cabinet in a secure locked office when not being handled or transported.

Except in unusual circumstances that involve danger to yourself, you have the right to a copy of your file. Because these are professional records, they may be misinterpreted and / or upsetting to untrained readers. For this reason, we recommend that you initially review them with your therapist, or have them forwarded to another mental health professional to discuss the contents. If your therapist refuses your request for access to your records, you have a right to have my decision reviewed by another mental health professional, which your therapist will discuss with you upon your request. You also have the right to request that a copy of your file be made available to any other health care provider at your written request. Upon my death, incapacity, or long-term disability, maintenance of your records will be transferred to an executor named by me. Please refer to my professional last will and testament for additional details.

MINORS AND PARENTS

Patients under 18 years of age, who are not emancipated, and their parents should be aware that the law allows parents to examine their child’s treatment records unless we believe that doing so would endanger the child or we (patient, therapist, and parents) agree to do otherwise. Because privacy in therapy is often crucial to successful progress, particularly with teenagers, it is sometimes our policy to request agreements from parents that they consent to give up their access to their child’s records.

If parents agree, during treatment we will provide them only with general information about the progress of the child’s treatment and his/her attendance at scheduled sessions. Any other communication will require the child’s authorization, unless we feel that the child is in danger or is a danger to someone else. If that is the case, the therapist will notify the parents of their concern.

Before giving parents any information, your counselor will discuss matters with the child. If possible, and do their best to handle any of their objections.

IN-PERSON VISITS & PUBLIC HEALTH MEASURES

When guidance from public health authorities allows and your Provider offers, you can meet in-person. If you attend therapy in-person, you understand the following conditions. You can only attend if you are symptom-free (For symptoms, see: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html). If you are experiencing symptoms, you can switch to a telehealth appointment or cancel. If you need to cancel, you will not be charged a late cancellation fee.

You must follow all safety protocols established by the practice, including:

Following the check-in procedure; washing or sanitizing your hands upon entering the practice; adhering to appropriate social distancing measures; and wearing a mask, if required or when following the guidance of the WHO, CDC, or VT Dept of Health; telling your Provider if you have a high risk of exposure to COVID-19, such as through school, work, or commuting; and telling your Provider if you or someone in your home tests positive for COVID-19.

Your Provider may be mandated to report to public health authorities if you have been in the office and have tested positive for infection. If so, your Provider may make the report without your permission, but will only share necessary information. Your Provider will never share details about your visit. Because the COVID-19 pandemic is ongoing, your ability to meet in person could change with minimal or no notice. By signing this Consent, you understand that you could be exposed to COVID-19 if you attend in-person sessions. If your provider or another provider in the building tests positive for COVID-19, you will be notified. If you have any questions, or if you want a copy of this policy, please ask.

NO SURPRISES ACT

If I have chosen to pay directly and not use health insurance benefits, I understand that I have the right to a good faith estimate of the cost of services, guaranteed by the No Surprises Act. Effective January 1, 2022, the No Surprises Act (NSA) established new federal protections against surprise medical bills and balance billing for services received from out-of-network providers. I understand that my therapist will provide me with the notice of a good faith estimate handout and fact sheet from the US government’s Centers for Medicaid Services, as part of this intake packet.

A Good Faith Estimate

If you don’t have health insurance or you plan to pay for health care bills yourself, generally, health care providers and facilities must give you an estimate of expected charges when you schedule an appointment for a health care item or service, or if you ask for an estimate. This is called a “good faith estimate.”

A good faith estimate isn’t a bill

The good faith estimate shows the list of expected charges for items or services from your provider or facility. Because the good faith estimate is based on information known at the time your provider or facility creates the estimate, it won’t include any unknown or unexpected costs that may be added during your treatment.

Generally, the good faith estimate must include expected charges for:

The primary item or service

Any other items or services you’re reasonably expected to get as part of the primary item or service for that period of care.

The estimate might not include every item or service you get from another provider or facility, even if some items or services may seem connected to the same service. For example, if you’re getting surgery, the good faith estimate could include the cost of the surgery, anesthesia, any lab services, or tests.

In some cases, items or services related to the surgery that are scheduled separately, like certain pre-surgery appointments or physical therapy in the weeks after the surgery, might not be included in the good faith estimate. You’ll get a separate good faith estimate when you schedule those items or services with the provider or facility, or if you ask for it.

Your right to a good faith estimate:

Providers and facilities must give you the good faith estimate:

  • After you schedule a health care item or service. If you schedule an item or service at least 3 business days before the date you’ll get the item or service, the provider must give you a good faith estimate no later than 1 business day after scheduling.
  • If you schedule the item or service OR ask for cost information about it at least 10 business days before the date you get the item or service, the provider or facility must give you a good faith estimate no later than 3 business days after you schedule or ask for the estimate.
  • That includes a list of each item or service (with the provider or facility), and specific details, like the health care service code.
  • In a way that’s accessible to you, like in large print, Braille, audio files, or other forms of communication.

Providers and facilities must also explain the good faith estimate to you over the phone or in person if you ask, then follow up with a written (paper or electronic) estimate, per your preferred form of communication. Keep the estimate in a safe place so you can compare it to any bills you get later. After you get a bill for the items or services, if the billed amount is $400 or more above the good faith estimate, you may be eligible to dispute the bill.

Your Good Faith Estimate:

My full rate for an individual, couples, or family, 55-minute psychotherapy session is $120.00. The session length is 55 minutes due to the nature of the session’s cognitive behavioral therapy informed format.

Due to insurance company contractual responsibilities, I am unable to offer a sliding scale for services. Payment is typically due for each session before the next session. My approach and therapeutic orientation work best in weekly sessions.

You should expect to attend therapy from between 6 to 12 months depending on the problems and goals unique to your individual circumstances. Each insurance company has different plans, and each employer offers different plans.

Please call your insurance company to determine your benefits, coverage, deductibles, copays, and coinsurance before your first session. You may need to asked to complete a coordination of benefits for some insurance companies and plans.

By signing this agreement and consent for services, you attest that you have carefully reviewed the information presented. You have read and understand your rights and responsibilities regarding the federal law No Surprises Act and your right to a good faith estimate.

THE MEDICARE ADVANCE BENEFICIARY NOTICE

Please be aware that if your Medicare Part B insurance does not cover sessions with a Licensed Clinical Mental Health Counselor (LCMHC), you will receive a Medicare Advance Beneficiary Notice (ABN). The ABN is a standard form that informs you when Medicare may not cover certain services, and it provides you with options to receive those services.

What This Means for You:

Notification: You will be given an ABN before your session, notifying you that Medicare might not cover the service provided by an LCMHC.

Options: The ABN will allow you to choose whether or not to receive the services, understanding that you might have to pay out-of-pocket if Medicare does not cover the session.

Costs: If you choose to proceed with the session, you will be responsible for paying the cost if Medicare does not cover it.

Purpose of the ABN:

The purpose of the ABN is to ensure you are fully informed about your potential financial responsibility before receiving services that may not be covered by Medicare. This transparency helps you make informed decisions about your treatment options.

Therapy Agreement and Informed Consent:

This notice is part of our therapy agreement and informed consent document. By signing the therapy agreement, you acknowledge understanding this policy and your options regarding sessions not covered by Medicare Part B.

I am committed to providing you with the best care and ensuring you are fully informed about all aspects of your treatment. If you have any questions or need further clarification about the ABN or your coverage, please do not hesitate to reach out to us.

By signing the agreement and consent for services, you attest that you have carefully reviewed the information presented. You have read and understand the information about the Advance Beneficiary Notice (ABN) from the Center for Medicare Services (CMS)

PROTECTED ELECTRONIC MEDICAL RECORDS (PATIENT CHARTS)

Your Provider is required to keep records about your treatment. These records help ensure the quality and continuity of your care, as well as provide evidence that the services you receive meet the appropriate standards of care. Your records are maintained in an electronic health record provided by TherapyNotes. TherapyNotes has several safety features to protect your personal information, including advanced encryption techniques to make your personal information difficult to decode, firewalls to prevent unauthorized access, and a team of professionals monitoring the system for suspicious activity. TherapyNotes keeps records of all log-ins and actions within the system.

PROFESSIONAL CONSULTATION GROUP:

In order to offer the highest quality of service possible, and for the requirements of ethical practice, I consult regularly with other licensed professionals. Confidentiality and your privacy will be protected during the consultation sessions, and limited information will be shared about your treatment.

EMERGENCIES:

I am not available for after-hour emergencies. For adults experiencing a mental health emergency, please call Howard Center Mobile Crisis at (802) 488-6400. For minors experiencing a mental health emergency, please call First Call at (802) 864-7777. I am often not immediately available by telephone. I do have voice mail and email that I check frequently. I will return calls within 48 hours, with the exception of weekends and holidays. If you are difficult to reach, please leave me times you will be available.

FEES AND PAYMENT FOR SERVICES

Please feel free to discuss payment questions or problems with me if you anticipate any difficulties. You may be required to pay for services and other fees. You will be provided with these costs prior to beginning therapy, and should confirm with your insurance if part or all of these fees may be covered.

INSURANCE BENEFITS

I am an in-network provider and paneled with:

  • Vermont State Medicaid
  • Vermont State Medicare
  • Cigna/EverNorth
  • MVP Healthcare
  • Blue Cross Blue Shield of Vermont.

Sometimes other insurance companies that I currently do not contract with will also pay for sessions; you can ask me if you are unsure about out of network benefits. As an additional convenience, I could submit a claim on your behalf if I am out of network for your company or plan.

Health Insurance and Health Plans are different. Before starting therapy, you should confirm with your insurance company if: your benefits cover the type of therapy you will receive; your benefits cover in-person and telehealth sessions; you may be responsible for any portion of the payment; and your Provider is in-network or out-of-network.

Sharing Information with Insurance Companies:

If you choose to use insurance benefits to pay for services, I am sometimes required to share protected health information with your insurance company. Insurance companies keep personal information confidential unless they must share to act on your behalf, comply with federal or state law, or complete administrative work.

Informed Consent for Insurance Coverage of Services.

As your mental health counselor, it’s important for us to discuss the scope of services provided, including those that may not be reimbursable by health insurance. This section aims to clarify how services deemed not medically necessary or evidence-based may not be covered by your insurance provider.

Understanding Coverage:

In seeking mental health support, it’s crucial to comprehend the parameters of your insurance coverage. Many insurance plans, while offering comprehensive mental health benefits, may have limitations on the types of services they reimburse.

Medically Necessary and Evidence-Based Services:

Insurance providers typically cover services that are deemed medically necessary and evidence-based. These encompass treatments and interventions supported by clinical research and recognized professional standards within the mental health field. Examples include cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and psychopharmacological interventions prescribed by licensed medical professionals.

Limitations on Coverage:

It’s essential to note that some therapeutic modalities or interventions, while widely used and potentially beneficial, may not meet the criteria for insurance reimbursement. This could include alternative or complementary approaches that lack empirical support or are not recognized by mainstream medical and psychological organizations.

Non-Reimbursable Services:

Services that fall outside the realm of medical necessity or evidence-based practice may not be covered by your insurance plan. This could encompass interventions such as:

  • Holistic healing practices without empirical validation.
  • Lifestyle coaching or wellness programs that do not involve therapeutic treatment for diagnosable mental health conditions.
  • Experimental or investigational therapies lacking sufficient clinical evidence.
  • Personal growth workshops or self-improvement seminars not directly addressing diagnosable mental health concerns.
  • Court ordered attendance in therapy or counseling not directly addressing diagnosable mental health concerns.

Client Responsibility:

As part of the therapy intake and orientation process, clients are encouraged to inquire about their insurance coverage and potential reimbursement limitations. While I strive to provide comprehensive care tailored to your individual needs, it’s important to recognize that certain services may require out-of-pocket payment.

Transparency and Collaboration:

Throughout our therapeutic journey, I am committed to transparency and collaboration. If you have questions or concerns about insurance coverage or the suitability of specific interventions, please feel free to discuss them openly. Together, we can explore alternative options and make informed decisions regarding your mental health care.

Out of Network Insurance Plans:

When a Provider is in-network, they have a contract with your insurance company. Your insurance plan may cover all or part of the cost of therapy. You are responsible for any part of this cost not covered by insurance, such as deductibles, copays, or coinsurance. You may also be responsible for any services not covered by your insurance.

When a Provider is out-of-network, they do not have a contract with your insurance company. You can still choose to see your Provider; however, all fees will be due at the time of your session to your Provider. Your Provider will tell you if they can help you file for reimbursement from your insurance company. If your insurance company decides that they will not reimburse you, you are still responsible for the full amount.

By acknowledging and understanding the limitations of insurance coverage, we can navigate our therapeutic relationship with clarity and mutual respect. While insurance reimbursement is an important consideration, our primary focus remains on your well-being and personal growth. I am here to support you in accessing the most appropriate and effective interventions to facilitate your journey toward mental health and fulfillment.

Health Insurance Acknowledgement

You will be asked to complete the health insurance authorization form provided by James Fitzgerald Therapy PLLC to release information to the insurance companies you provide, in order to submit insurance claims on your behalf.

This authorization extends to the extent necessary to obtain payment for the services provided to you, and includes authorization to release information about mental health, substance use, or HIV diagnoses as required.

In consideration of the services provided to you, you assign all benefits to James Fitzgerald Therapy PLLC if accepted, and authorize your insurance companies, Medicare, or other third-party payers to make payments directly to James Fitzgerald Therapy PLLC and its affiliates.

You understand that you remain responsible for all amounts due by you, including (but not limited to) copays, coinsurance, deductible amounts, and all services not covered by my insurance plan (including those for which I fail to obtain prior authorization), and mutually agreed-upon services or fees that are deemed not medically necessary.

You agree to make payments (deductibles and copays) directly through the payment portal provided by James Fitzgerald Therapy PLLC, in a secure merchant account that accepts payment from most debit and credit cards, including for Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).

You agree that you will not make payments through a third-party portal or site linked to my health insurance company. I agree to pay for each session during each session, and that an overdue balance of more than 2 sessions is grounds for termination of the therapy agreement, unless other arrangements are made in advance.

SERVICE FEES & OTHER CHARGES

Administrative Fees

As part of this agreement, your Provider reserves the right to charge administrative fees for writing a letter or report at your request; consulting with another healthcare provider or other professional outside of normal case management practices; or for preparation, travel, and attendance at a court appearance. These fees are listed in the fee agreement. Payment is due in advance.

Balance Accrual

Full payment is due at the time of your session unless insurance billing services are arranged. If you do not have health insurance, and/or unable to pay, tell your Provider. Your Provider may offer payment plans. If not, your Provider may refer you to other low-cost or no-cost services. The Provider will share a link to the Vermont Counseling Network, Psychology Today, Good Therapy, or Therapist.net.

Any balance due will continue to be due until paid in full. If necessary, your balance may be sent to a collections service. Additional services, such as written letters or records requests may not be honored or completed until balance is paid in full.

Payment Methods

I do not accept any third-party payments (Cash-App, Venmo, Stripe, Square) unless other arrangements are made. I accept cash, checks, and most major credit cards and debit cards. My practice allows you to keep a credit or debit card on file. You may use a Health Savings Account – Flexible Spending Account Debit Card. The card on file can then be charged for the amount due at the time of service and for any fees you may accrue unless other arrangements – such as insurance billing services – have been made with the practice ahead of time. The portal has a new feature that allows for autopay with the card on file.

If you use insurance, the balance of your deductible or copay is due after the claim is processed. It is your responsibility to keep the payment and billing information up to date, including providing new information if the card information changes or the account has insufficient funds to cover these charges. A $25 fee will be charged on returned checks.

NO-SHOW AND LATE CANCELLATIONS POLICY

I certainly understand that life can sometimes throw unexpected challenges your way, making it necessary to reschedule or cancel your appointment. I deeply respect your time and circumstances, and I strive to maintain a warm, compassionate, and supportive environment for all my clients. However, as a professional counselor in private practice, not associated with a designated agency or other large business, non-profit organization, or group practice, my livelihood depends on the regular attendance and timely payment from clients. To ensure the smooth functioning of my practice and to provide the best possible care to all my clients, I have established the following cancellation policy:

Cancellation Notice: I kindly request that you provide at least 48 hours’ notice if you need to cancel or reschedule your appointment. If you find yourself unable to attend your appointment within 48 hours of the session, please contact me as soon as possible before your session. This allows us me the opportunity to offer your time slot to another client who may be in need of support.

Late Cancellations and No-Shows: I understand that unforeseen circumstances may arise, therefore, I do not charge a fee for late cancellations or no-shows. Instead, I appreciate your understanding of how these instances impact our practice. However, I do kindly ask for your cooperation in providing timely notice whenever possible.

Multiple Cancellations or Missed Appointments: In the event of 3 or more consecutive late cancellations or missed appointments, I will discuss the situation with you in a respectful and compassionate manner. I understand that life can be unpredictable, and I am here to support you through any challenges you may be facing.

Together, we will explore options to ensure that you continue to receive the care you need. This may include offering same-day appointments or adjusting the frequency of sessions to better accommodate your schedule.

Open Communication: I will openly breach the subject of any consistent patterns of no shows and cancellations in an open, respectful, and honest way. I strongly encourage open communication and I value your feedback. If you anticipate having difficulty attending your scheduled appointment or foresee any challenges in adhering to this policy, please don’t hesitate to reach out to me. I am here to work with you and find solutions that meet your needs while also respecting the needs of my practice and other clients.

No Punitive Fees Policy

I have made an ethical and regulatory informed decision not to charge fees for late cancellations and no-shows. Thank you for entrusting me with your mental health and well-being. Your commitment to attending your scheduled appointments not only supports my practice but also ensures that you receive the continuity of care necessary for your healing journey. I do appreciate your cooperation and understanding regarding the cancellation policy. Should you have any questions or concerns regarding this policy, please feel free to discuss them with me. I am here to assist you in any way I can.

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