O'Day Psychotherapy PLLCDBA: Maytree Therapy

Clinicians:

Chelsea O'Day-Navis, MA, LPC

Sydney Jenish, MA, LLPC, NCC (Clinically Supervised by Chelsea O’Day-Navis, LPC)

FEES AND METHODS OF PAYMENT

In return for a fee of $175 per counseling session (or another mutually agreed-upon rate), Maytree Therapy agrees to provide counseling services. Group counseling rates will be determined by group facilitators prior to the start of the group.

Credit cards and Health Savings Account (HSA) cards are accepted for payment. Payment is due at the time services are provided. Future appointments may not be scheduled until outstanding balances have been paid.

If Maytree Therapy is not a participating provider with your insurance plan, you may request a receipt for services to submit to your insurance company for possible reimbursement. Not all insurance companies reimburse for out-of-network providers. Clients are responsible for understanding their insurance benefits, including reimbursement eligibility and out-of-network coverage.

Maytree Therapy offers a limited number of reduced-fee appointments based on financial need and annual gross income. Please inquire if you would like additional information regarding reduced-fee services.

Maytree Therapy reserves the right to charge for professional services provided outside of scheduled appointments. Communications or tasks requiring more than 15 minutes of a clinician's time may be billed at the clinician's standard hourly rate. Examples include, but are not limited to, extended phone consultations, lengthy email correspondence, preparation of letters, treatment summaries, referral documents, or other professional services.

Maytree Therapy clinicians generally do not provide court testimony, custody evaluations, or legal opinions on behalf of clients. If a clinician is subpoenaed, court-ordered to appear, or otherwise required to participate in legal proceedings, Maytree Therapy reserves the right to charge for all time associated with preparation, consultation, travel, waiting time, testimony, report writing, and related professional services at the clinician's standard hourly rate. Any travel or accommodation expenses may also be billed to the client.

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INSURANCE

If you have health insurance, your policy may provide coverage for mental health services. As a courtesy, Maytree Therapy may submit claims on your behalf if you provide insurance information and authorize the practice to do so. However, you remain responsible for understanding your insurance benefits, including deductibles, copayments, coinsurance, authorization requirements, and whether Maytree Therapy is considered an in-network provider.

Insurance companies generally require a mental health diagnosis before reimbursing services. By using insurance benefits, you acknowledge that diagnostic and treatment information may be shared with your insurance company as necessary to process claims and obtain reimbursement.

Insurance companies may also request additional clinical information, treatment plans, progress summaries, or other documentation. By providing insurance information and authorizing claims submission, you permit Maytree Therapy to provide information reasonably necessary for claim processing and utilization review.

Some insurance plans require prior authorization for mental health services. If prior authorization is required but not obtained, you may be financially responsible for services rendered.

Copayments, coinsurance amounts, deductibles, and any other client-responsible balances are due at the time of service. The payment method on file may be charged unless another form of payment is provided at the time of the appointment.

If Maytree Therapy is not a participating provider with your insurance plan, a receipt may be provided for you to submit independently for possible reimbursement.

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APPOINTMENTS AND CANCELLATIONS

Please provide at least 24 hours' notice if you need to cancel or reschedule an appointment.

Appointments canceled with less than 24 hours' notice, as well as missed appointments (no-shows), will be charged a flat late cancellation fee of $80. This fee is not billable to insurance and must be paid out-of-pocket. This fee is not a penalty, but rather compensation for the time that was reserved specifically for you and cannot typically be filled on short notice.

Due to Medicaid regulations, late cancellation and no-show fees are not charged to clients covered by Aetna Better Health of Michigan. Clients with Aetna Better Health of Michigan are still expected to provide advance notice whenever possible. Repeated missed appointments may result in a discussion regarding treatment needs, reduced scheduling availability, or referral to alternative services.

If you arrive late for an appointment, the session will still end at the scheduled time and the full session fee will apply. Late arrival may result in a shortened session.

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TELEPHONE ACCESSIBILITY

If you need to contact your clinician between sessions, please use email, text message, or voicemail.

Clinicians are often unavailable while providing services to other clients; however, reasonable efforts will be made to respond within one business day whenever possible.

Maytree Therapy is not a 24-hour crisis service. Emails, text messages, and voicemail messages may not be monitored outside normal business hours. If you are experiencing a mental health emergency, call 911, go to the nearest emergency room, or contact the 988 Suicide & Crisis Lifeline by dialing 988.

Questions or concerns regarding treatment may be discussed with your clinician during scheduled appointments.

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SOCIAL MEDIA AND TELECOMMUNICATION

To protect client confidentiality and maintain professional boundaries, Maytree Therapy clinicians do not accept friend requests, follow requests, or other social networking connections from current or former clients on social media platforms.

Connecting through social media may compromise confidentiality, create unintended disclosures, and blur the boundaries of the therapeutic relationship. If you have questions regarding this policy, please discuss them with your clinician.

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PROFESSIONAL BOUNDARIES AND DUAL RELATIONSHIPS

Although therapy is a personal and collaborative process, the therapeutic relationship remains professional in nature.

Clients are best served when the relationship remains focused on treatment goals and clinical care. Communication outside scheduled appointments should generally be limited to scheduling, billing, and administrative matters.

If therapeutic content is communicated through email, text message, voicemail, or other non-session communication, your clinician may acknowledge receipt of the communication and address the content during the next scheduled session.

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TELEHEALTH SERVICES

Maytree Therapy is a telehealth-only practice. Services are provided through secure video conferencing technology. Clients are responsible for ensuring they have appropriate technology, internet access, and a private location for sessions. Additional information regarding the risks, benefits, and informed consent for telehealth services is outlined in the Telehealth Informed Consent document.

Electronic Communication

Email and text messaging may be used for scheduling, appointment reminders, billing matters, and other administrative purposes. These methods should not be used for emergencies, urgent clinical concerns, or extensive therapeutic discussions.

Maytree Therapy cannot guarantee the confidentiality of communications transmitted through email or text messaging. By choosing to communicate electronically, you acknowledge the inherent privacy risks associated with these forms of communication.

Maytree Therapy is not a 24-hour crisis service. Electronic communications may not be monitored outside normal business hours.

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MINORS

If you are a minor, your parent(s) or legal guardian(s) may be legally entitled to certain information regarding your treatment.

Your clinician will discuss confidentiality, parental access, and the limits of privacy with you and your parent(s) or guardian(s) in accordance with applicable laws and ethical standards.

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TERMINATION OF SERVICES

Ending treatment can be an important part of the therapeutic process. Whenever possible, a planned termination process is encouraged to promote closure and continuity of care.

Maytree Therapy may terminate services if treatment is no longer clinically appropriate, if psychotherapy is not being effectively utilized, if attendance is inconsistent, if payment obligations remain unmet, or for other lawful and ethical reasons.

Whenever clinically appropriate, concerns regarding termination will be discussed before services are discontinued.

If treatment is terminated or you request referral to another provider, referral options will be provided when appropriate. You are also free to seek services from another provider of your choosing.

If no appointment is scheduled or attended for three consecutive weeks, and no alternative arrangements have been made in advance, Maytree Therapy may consider the professional relationship discontinued for legal and ethical purposes.