Prior to your first appointment, please review, print, and complete the registration forms below. Bring these completed forms with you so that we can devote more time to getting to know each other. We look forward to seeing you soon.

 

 


 

 

Patient Forms

Print and complete the forms in the appropriate Registration Packet prior to your first visit.

 

Print and complete these forms as instructed by the Beech Tree staff.

 

 


 

Services Policy

Scheduling Appointments
Most appointments are considered “standing appointments.” This means you will be seen on the same weekday at the same time every week. If you’d like to receive appointment reminders by phone, text or email, please let us know.

If we ask you to confirm an appointment, simply call our office..

Cancellations
If you can’t avoid cancelling an appointment, you must give 24 hours’ notice. Simply call our office. During office hours, you can speak with any staff member. After hours, wait for the voicemail and leave your name, scheduled appointment time, and therapist’s name.

If you cancel with less than 24 hours’ notice, a fee of $50 will be charged to your account. This fee is not covered by insurance and will be due at or prior to your next session. If this fee isn’t paid in full at or before your next session, we will postpone future sessions until we receive the $50. If you believe an emergency or unavoidable circumstance prevented 24 hours’ notice, speak with your therapist as soon as possible to discuss this fee and your next session.

No-Shows
If you don’t show up to an appointment on time without notifying us in advance (a no-show), you will be charged a fee of $50 for a missed appointment, and we cannot guarantee you will be seen that day. This a fee is not covered by insurance and will be due at or prior to your next session. If this fee isn’t paid in full at or before your next session, we will postpone future sessions until we receive the $50.

After two consecutive no-show appointments, we will automatically remove your regularly scheduled appointment time from the schedule. This does not mean you are discharged from therapy; you must contact your therapist right away to discuss alternate scheduling options.

Payments
Because healthcare expenses can add up quickly, we’ve taken steps to help you maintain your accounts with us.

  • Payment in full must be made on the same day you receive a service.
  • All co-pays must be made prior to or at the start of each session.
  • Fees for late arrivals (no-shows) and late cancellations (less than 24 hours’ notice) must be paid before treatment can resume.
  • We will let you know what deductible amounts you are required to pay.
  • If you believe circumstances force you to carry a balance on your account, let us know; we can arrange a payment plan so your psychotherapy is not interrupted.
  • We file your insurance claims on your behalf.

Due to the complexities of insurance billing, we do not accept nor file claims for secondary insurance. Likewise, we will resubmit a denied claim once. If the claim is denied again, you will be responsible for the full amount due. Please remember that submitting a claim to your insurance company does not guarantee the company will pay for the claim.

If you cannot pay for services, we may postpone our work together to minimize financial strain on you and our practice. Tell us right away if you think you may have trouble paying; we may be able to work out a payment plan, but not if you are in arrears. Always let us know when you change insurance.

You will receive a monthly invoice from Beech Tree Consulting and Psychological Services. Payment in full is due within 30 days of the date on the invoice. Failure to pay your balance by the due date may force us to postpone future sessions.

Fees

  • Initial Intake $225
  • Individual Therapy $150 (30 minutes); $175 (45 minutes); $200 (60 minutes)
  • Group Therapy $75 (75 minutes)
  • Family Therapy $175 (45 minutes)
  • Psychological Assessment/Testing $250/hour
  • No Show/Late Cancellation $50
  • Non-Covered Services* $15 per 5 min increments

*Non-Covered Services include all services not typically covered by third-party payers (mental health/medical insurance). These services most often include:

  • Review of records
  • Case conferences with schools (in person, via e-mail, or via teleconference)
  • Preparation of reports or letters for other providers/legal counsel, etc.
  • Completion of documents for disability claims, extended insurance reviews, worker’s compensation, etc.
  • Duplication of medical records
  • Evaluation or treatment services not covered by your mental/medical health insurance
  • Services for diagnoses not covered by insurance companies – such as pre-existing conditions and
    some diagnostic categories

Consultations by telephone, e-mail or in person (no charge for first 5 minutes)

Service Limitations
We do not provide legal or forensically informed therapeutic services. We will be happy to refer you to qualified mental health professionals if you need these services. We also will not voluntarily provide letters to attorneys or legal counsel regarding our work together. If you are involved in a legal suit, please inform us immediately so we can develop an appropriate treatment plan and provide necessary referrals.

 


 

Crisis Information

In the event you find yourself in crisis please contact the crisis line or visit your nearest emergency room. The crisis line is available 24 hours a day, 7 days a week. If you are in crisis, please seek help immediately.

CRISIS LINE 317 251 7575