The following information is provided to help you become better acquainted with my practice. Please take time to read it carefully. I will be happy to further discuss any of these items with you.

Fees
Scheduling
Cancellation, Time Changes or Missed Sessions
Insurance Reimbursement
Client Files
Emergencies
Confidentiality

Fees:
I typically see patients once a week for a 50-minute session. The duration of your treatment and the frequency of your sessions will depend on the nature of your concerns and your individual needs. Although some clients elect to pursue long-term, open-ended treatment, many issues can be resolved in about 25 to 30 sessions, while some highly focused issues, such as phobias, can be resolved in about 12 sessions.

My regular fees are listed below. I do increase my fees periodically and you will be apprised of such increases before the new few takes effect. I ask that you pay in full for each session at the time of the session (cash or checks made out to Sabine Sell), unless we agree otherwise or unless you have insurance coverage, which requires another arrangement.

• Regular individual psychotherapy session (50 minutes) - $125
• Regular couples psychotherapy session (50 minutes) - $150
• Phone consultations, with you or with others at your request, of 15 minutes or more will be prorated based on your fee for a 50-minute session.
• Preparation of written reports, at your request will also be prorated based on your fee for a 50-minute session. There is a minimum fee of ½ hour.
• 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. Due to the difficulty of legal involvement, my fee is $150 per hour for preparation and attendance at any legal proceeding.

If my fees present a hardship for you, please let me know. I do maintain a limited number of reduced-fee spaces in my practice. It is essential that financial difficulties not prevent you from obtaining the help that you need. If I am unable to accommodate your financial limitations, I will assist you in finding alternatives.

Scheduling:
Your appointment time is very important. Regularly scheduled and predictable appointment times are essential. I have found that the more committed and consistent a person is to his or her therapy, the more successful the therapy tends to be.

I strive to accommodate the complexities of my clients’ schedules while maintaining some consistency in my own schedule. I will do my best to notify you well in advance about my vacation weeks or any need to change or cancel a scheduled appointment. I ask that you also look upon our scheduled times with respect and call well in advance to change or cancel any appointment. In this way we respect each other’s time and our mutual commitment.

Cancellations, Time Changes and Missed Sessions:
My cancellation policy involves at least 48 hours advance notice to avoid incurring a fee.

If you cancel an appointment for any reason, including illness, with less than 48 hours notice, you will be responsible for my full fee (see above) regardless of whether or not you regularly pay through insurance.

If you cancel with less than 48 hours notice, but are able to reschedule the same week, the fee will be reduced to $30.00 only.

Similarly, if I have to change or cancel your appointment within 48 hours and we are unable to re-schedule within the same week, your next appointment will be free of charge.

Insurance Reimbursement:
Given our current economic situation, I have a limited number of spaces for insurance based clients.

I am, however, a paneled provider for a select number of health insurance plans (please check with your plan or contact me directly for specifics). If I am covered under your insurance and I have room for you in my practice, all paperwork will be handled by me and you will only be responsible for your copay at each session.

If I am not paneled with your insurance, I am considered an out-of-network provider. In this case, you will be responsible for full payment at each session and will need to submit all paperwork to your insurance yourself. I will provide you with a statement at the end of each month that documents my fees, payments you have made, and a diagnosis code, which you can then submit to your insurance provider for re-imbursement. The insurance company will send the reimbursement check directly to you. Each insurance company has their own policies and it is up to the individual client to determine your coverage and whether services provided by a licensed Marriage and Family Therapist are reimbursable. I will be happy to assist you with any insurance questions you may have.

Client Files:
The laws and standards of my profession require that I keep treatment records regarding our work together. You are entitled to view these records at any time. You must make the request in writing. I will respond to you within 5 working days of your request and will provide copies of your records within 15 days. In certain situations, I may deny your request. If I do, I will tell you, in writing, my reasons for the denial and explain your right to have my denial reviewed. If you request copies of your file, I will charge you not more than $.25 for each page. Typically, a copy of your records will be provided or, if it is deemed more appropriate, a summary of your records can be prepared for you. Your file consists of professional notes and terminology and can therefore be misinterpreted or prove upsetting to untrained readers. If you wish to see your records, I recommend you review them in my presence so we can discuss the contents together. By law, your records will be kept for 7 years following termination of therapy. After 7 years, they will be destroyed in a manner that preserves your confidentiality.

Emergencies:
I wish to be helpful in times of intensified distress or difficulty. However, I may not always be available outside of our scheduled appointment time. It is important that you understand my possible limitations in this regard. In the case of an emergency, if you are unable to reach me, leave a message for me and immediately contact 911, your family physician or the nearest emergency room and ask for the psychologist or psychiatrist on call. If I am unavailable for an extended time, I will provide the name of a colleague to contact in my absence.

Thank you for the opportunity to be of service to you. Should you have any other questions or concerns regarding my office policies, please feel free to contact me by calling 415-263-6898 or e-mailing me at sabinesellmft@juno.com.

Confidentiality:
You have a right to privacy and confidentiality. This is essential to the success of our work together because it provides trust and safety within the therapeutic relationship. In fact, the law requires that I preserve your confidentiality. Your consent is required to release any information about you or your treatment. There are three important exceptions:

1.) If I have clear evidence that you are a danger to yourself or to others, confidentiality may be broken in order to protect the person from physical or psychological harm;
2.) If I learn of or suspect you or someone you tell me about, of abusing a child, an elder or a dependent adult, I am mandated by law to report my suspicions to the appropriate agencies;
3.) If I receive a court order to appear in court or to produce client notes, I may be required to provide the requested information.

These situations have rarely occurred in my practice. Should such a situation occur, I will make every effort to fully discuss it with you before taking any action.

At your request, I will give specific information to your insurance company so that you may receive reimbursement. This information may include dates of appointments, diagnosis, and a treatment plan or summary. The data submitted will become part of the insurance company files and will probably be stored on a computer. Though all insurance companies claim to keep such records confidential, I have no control over what they do once the information is in their hands.

At times it may prove helpful to me to consult with other professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my clients. The consultant is also legally bound to keep the information confidential. In general, I will not tell you about these consultations unless I feel that it is important to our work together.