{"id":21,"date":"2012-05-24T22:31:50","date_gmt":"2012-05-24T22:31:50","guid":{"rendered":"http:\/\/marioprietto.com\/?page_id=21"},"modified":"2022-01-04T18:12:22","modified_gmt":"2022-01-04T18:12:22","slug":"fees-forms","status":"publish","type":"page","link":"https:\/\/marioprietto.com\/?page_id=21","title":{"rendered":"Fees &#038; Forms 2022"},"content":{"rendered":"<h1>Fees<\/h1>\n<p>My fee for individual psychotherapy is $200 for a 50-minute hour.<\/p>\n<p>For couples work, my fee is $250 for a 50-minute hour.<\/p>\n<p>First session rates include intake and assessment, and are $220 for individual and $275 for couples.<\/p>\n<p>Payment methods accepted in the office are cash or check. I am also able to accept payment via services Zelle, Venmo or PayPal, in that order of preference.<\/p>\n<p>If patients wish to pay by credit card from home before or after a session, this can be done\u00a0via this website on the <a title=\"Make a Payment\" href=\"https:\/\/marioprietto.com\/?page_id=45\">&#8220;Make a Payment&#8221; page<\/a>. A small processing fee is charged when payments are made on the website.<\/p>\n<p>My fees and policies (including session cancellation policy) are included in the \u201cConsent for Treatment\u201d form which all new patients sign when we start working together. For telehealth patients, I customarily email these forms to patients, and require them to sign and return them before starting treatment, and patients can save a copy for themselves.<\/p>\n<p>I believe in helping people find the help and support they seek in a way that fits their life situation. If you want to request a &#8220;sliding fee&#8221; consideration, please contact me and be prepared to explain your situation.<\/p>\n<p>I will do my best to work with your situation, and if I cannot, I will be glad to share with you referrals to colleagues and relevant community resources, as I&#8217;m trained as a social worker and am dedicated to social justice.<\/p>\n<h2>Third Party Insurance<\/h2>\n<p>I am not currently working as an\u00a0in-network provider for any insurance panels.<br \/>\nFor insurance companies, I am considered an &#8220;out-of-network provider.&#8221; This means I will not seek reimbursement directly from them for the services I provide you. You can be reimbursed by them, though, and I can help you do this. As other providers do, I am used to providing my patients with a &#8220;super-bill&#8221; which is like an invoice with all the information that the insurance company will require to reimburse you for a portion of the amount you have paid. I cannot guarantee or predict what or when you will be reimbursed, but I can give you some tips and share my experience. Tell them my practice name, Mario Prietto PhD LCSW, so you can be sure they recognize me as a provider. Ask about your deductible, limits for numbers of sessions, different coverage for different illnesses\/diagnoses, and the timeframe for reimbursement.<\/p>\n<h2>New Patient Forms<\/h2>\n<p>Here is where prospective patients can download forms which will help make our first session possible. <em><strong><span style=\"color: #ff0000;\">If we have scheduled an appointment, please print all relevant\u00a0forms, fill them out, and bring them to your first session. <span style=\"text-decoration: underline;\">I may email to you forms which have been updated; please use the ones I email you.<\/span>\u00a0<\/span><\/strong><\/em><\/p>\n<p>1. Adult Intake Form. If the client is a couple, then I ask that both members of the couple fill out their own Intake form.<\/p>\n<p><strong>Adult Intake Form \u00a0 <a href=\"https:\/\/marioprietto.com\/wp-content\/uploads\/adult-intake-jan-2016.pdf\">adult-intake-jan-2016<\/a><\/strong><\/p>\n<p>2. Child Intake Form. If the patient is under 18, this form should be filled out by the patient.<\/p>\n<p><strong>Child Intake Form \u00a0 \u00a0<a href=\"https:\/\/marioprietto.com\/wp-content\/uploads\/CHILD-INTAKE-March-2016-English.pdf\">child-intake-march-2016-english<\/a><\/strong><\/p>\n<p>3. Consent for treatment. Every patient is asked to read and sign one of these before we can start work. A copy can be printed from this site at any time, or patients can ask me for a copy. This serves as our contract. It spells out limits of confidentiality, HIPAA compliance, and the rates I charge for my services.<\/p>\n<p><strong>Consent for Treatment \u00a0\u00a0<a href=\"https:\/\/marioprietto.com\/wp-content\/uploads\/CONSENT-FOR-TREATMENT-Jan-2016.pdf\">consent-for-treatment-jan-2016<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fees My fee for individual psychotherapy is $200 for a 50-minute hour. For couples work, my fee is $250 for a 50-minute hour. First session rates include intake and assessment, and are $220 for individual and $275 for couples. Payment &hellip; <a href=\"https:\/\/marioprietto.com\/?page_id=21\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-21","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/marioprietto.com\/index.php?rest_route=\/wp\/v2\/pages\/21","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/marioprietto.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/marioprietto.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/marioprietto.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/marioprietto.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21"}],"version-history":[{"count":34,"href":"https:\/\/marioprietto.com\/index.php?rest_route=\/wp\/v2\/pages\/21\/revisions"}],"predecessor-version":[{"id":499,"href":"https:\/\/marioprietto.com\/index.php?rest_route=\/wp\/v2\/pages\/21\/revisions\/499"}],"wp:attachment":[{"href":"https:\/\/marioprietto.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}