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Information for New Patients
A package of written material discussing the following questions is provided to
clients at the time of a first appointment at the clinic:
Counseling and Psychotherapy
The purpose of counseling and psychotherapy is
to help you resolve personal problems and to learn ways to manage them more
effectively. It is the role of the therapist to listen, to understand, to employ
psychological techniques and
suggestions, and to be helpful to the fullest
extent of his or her professional training and experience. It is your
responsibility to help your therapist understand your personal situation,
behaviors, thoughts, and feelings, and to be committed to a carefully planned
program of personal change. It calls for a very active effort on your part and
you will have to work on things that are discussed both during your sessions and
at home. Your faithful attendance to all scheduled appointments is essential to
the success of the therapy as is a willingness to discuss your personal problems
openly and honestly.
The goal of the first (or “intake”) session is
to fully assess the nature of your personal
problems and your situation and to formulate an appropriate plan of treatment. A
number of personal questions will be asked in this first session and a
variety of matters relating to your personal problems will be discussed. On
occasion, this assessment process will
include psychological testing or consultation with other sources such as school
personnel, doctors or members of your family (but only with your written
permission). Once the assessment is complete, treatment recommendations will be
shared with you. Then, you and your therapist will develop an acceptable
treatment plan. If appropriate, your therapist may recommend a physical
examination by your family doctor or consultation with one of our staff
psychiatrists when medication may be helpful.
Therapy does not provide instant answers, but
sometimes situational problems can be dealt with in relatively short periods of
time. The frequency and length of your appointments should be determined during
the first few therapy sessions. The length and nature of the therapy will vary
depending upon your specific needs. Usually, after six to eight sessions, you
and your therapist will discuss your progress. Treatment goals will be reviewed
periodically and may be revised when necessary. Remember that you retain
complete control of the therapy process. You have the right at any time to
discontinue treatment whether or not your therapist agrees with your decision. Termination, however, should always be discussed with your therapist before you
decide to discontinue therapy. Because every therapy experience is unique, the
outcomes vary from person to person.
Psychotherapy can have both benefits and risks. Since therapy can involve
discussing unpleasant aspects of your life you may experience uncomfortable
feelings such as sadness, guilt, anger, frustration, loneliness and
helplessness.
Children with behavioral or emotional problems
require special care. Typically, a child’s parents are interviewed first so that
the therapist fully understands the parents’ concerns for their child. A range
of background questions will be asked. The therapist will also interview the
child. After the child has been seen the therapist will meet again with the
parents to discuss treatment recommendations.
Children may be seen individually, with their parents or with their entire
family, depending on the treatment needs. Some of what the child discloses to
the therapist may be kept in confidence. Because of the unique nature of
children’s problems most parents can expect to be actively involved in the
therapy process. Occasionally, only the child’s parents will be consulted.
Any individual who wishes to be considered for psychiatric treatment at the
Pauquette Center will need to consult first with another member of the clinical
staff who will conduct a comprehensive intake interview with the individual to
determine the need for psychiatric treatment. In addition, it is clinic policy
that every client who is consulting with a psychiatrist is also required to
maintain an ongoing relationship with another member of the clinical staff who
typically provides psychotherapy and counseling services. It is clinic policy
that every individual who is consulting with a staff psychiatrist will meet at
least once in every ninety days with his or her primary clinician. Because our
staff psychiatrists’ schedules are very busy it extremely important that any
appointment that is made with a psychiatrist be kept. Patients may be charged
for appointments that are not kept or that are cancelled without sufficient
notice. Because the psychiatrists’ schedules are so busy (and because there are
always unexpected interruptions) there may be occasions when a scheduled
appointment will be somewhat delayed; please accept our apologies if this should
occur.
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Confidentiality
Your personal and financial records at the
clinic are strictly confidential and are kept in compliance with the Health
Insurance Portability and Accountability Act. You were given a copy of our
Notice of Clinic Policies and Practices to Protect the Privacy of Health
Information form that discusses some of our policies pertaining to
confidentiality. Any information you disclose to your therapist
will not be released without your permission except as
required by law or court order State law requires disclosure of information to
responsible agencies in matters of child abuse or in matters of personal danger). Depending on your
needs, your therapist may wish to consult with other professionals in the
community such as physicians, attorneys, or school personnel. You may be asked
to sign a release of information form granting your therapist permission to do
so. You have the right to refuse to sign a release of information form if you so
desire.
Patients under eighteen years of age, and the parents of these minors, should
be aware that the law may allow parents to examine their child’s treatment
records unless the clinician decides that such access to information is likely
to injure the child. Because privacy is so important to the success of
psychological counseling, particularly with teenagers, it is our policy to
request an agreement from parents that they consent to relinquish access to
their child’s records. General information about the progress of therapy and
attendance at appointments is generally shared with parents. Before any
information is shared with parents, the matter will be discussed with the child
the clinician will do his or her best to manage any objections that the child
may have.
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Missed Appointments
Psychological clinics differ in many ways
from other medical and paramedical clinics. Unlike non-psychiatric physicians,
osteopaths, dentists, and other professionals who operate on more flexible
schedules, we commit a specific period of time (usually 45 or 60 minutes) to
each patient. Our schedules are usually crowded. Canceling or rescheduling
appointments without sufficient notice usually means a loss of a therapy
appointment for another patient, as it is difficult to reassign the time to
someone else on short notice. You may be billed for missed appointments unless
the appointment is cancelled 24 hours in advance.
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Child Care
Our waiting room can be a
very busy place. Unless your child is to be seen by a clinician we ask, if
possible, that you arrange for appropriate child care, particularly for younger
or active and energetic children. It is not possible for our clerical staff to
supervise children in any way.
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The staff of the Pauquette Center is available
for consultation during our normal business hours and by telephone after hours.
You may find that your clinician is not able to come to the telephone if you
call during business hours when he or she is with another patient. Your
clinician will make every effort to return your call as soon as is possible,
however. If you are consulting with a psychiatrist and you have a question of
your psychiatrist your question will first be directed to your primary therapist
unless the question pertains specifically to the use of medication that has been
prescribed by the psychiatrist. If an emergency arises and you wish to consult
with your therapist or with another staff member after business hours, please
dial the clinic telephone number. Our telephone messaging system lists our
clinic staff and provides their home telephone or pager numbers. Please note
that these telephone numbers are made available for the use of current patients
only. In urgent situations, if your therapist is not immediately available you
may wish to contact another member of our clinical staff. An after-hours
emergency services telephone number is also provided for non-patients or for
current patients who have been unable to reach their therapist. Please remember
that these after-hours emergency services are for use only in true emergencies.
Please conduct routine business (such as scheduling or cancellation of
appointments) during normal business hours.
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Patient Fees
The Pauquette Center is a private clinic
operated by Community Service Associates, S. C. We are licensed in the State of
Wisconsin under that name. We bill for services under that name and that name
will appear on any bill that you or your insurance carrier receives. A fee for
services is charged based on the nature of the services provided and the length of your appointments with your therapist
or doctor. There may be fees for services such as report writing and preparation
of records or treatment summaries, telephone conversations, and the time spent
performing other services that are requested of your therapist or doctor. If you have insurance, a claim will be filed with your insurance
company as a courtesy to you and at no charge. It is your responsibility to
provide us with current and accurate insurance information, including the
necessary medical referrals. A referral from your physician may facilitate
medical insurance and Health Maintenance Organization (HMO) coverage of services. We will normally bill your
insurance company or HMO on a weekly basis. After we have received payment from
your insurance company, we will then bill you for any amount not paid by the
insurance carrier. If you have a deductible, or your insurance carrier pays only
a portion of the fees, you will be billed for the balance. Payment of the
balance will be expected within 30 days. If for some reason you cannot pay your
bill on time, please inform our Billing Office and we will do our best to work
out a payment plan for you. Payment by credit card is also accepted. If
acceptable financial arrangements have not been made, Community Service
Associates reserves the right to use legal means to seek reimbursement. This may
include releasing names and addresses to an attorney or the courts. Community
Service Associates cannot accept final responsibility for collecting from your
insurance carrier or for negotiating a settlement on a disputed claim.
Remember that different insurance carriers and
HMO's pay for mental health services differently. The State of Wisconsin has
mandated that insurance policies written in Wisconsin include coverage for
mental health services but these policies do vary in extent. We would be happy
to check your insurance policy for coverage of mental health services although
it would be advisable for you to become familiar with the specific benefits and
requirements of your health insurance program.
We provide services to subscribers of the major HMO's in our area including Dean
Care,
Physicians Plus, and Unity. HMO's cover mental health services somewhat
differently than do traditional insurance companies. Some HMO’s require
referral for services from the patient's primary physician before a patient’s
first session with a therapist. Others require that the patient contact the HMO
directly before the first therapy session to obtain prior authorization for
reimbursement of services. It is the patient's responsibility to obtain such
referrals prior to obtaining service and to see that these referrals are renewed
if services are continued beyond the original referral period. Our reception
staff will be happy to answer any questions that you may have about these
requirements. Patients are typically not billed for authorized services because
HMO remittances are considered as payment in full, unless, of course, the
patient does not have the required referral or receives services beyond the
dollar limits of his or her policy.
Residents of Columbia County who do not carry
health insurance coverage or who have exhausted their health insurance benefits
may be eligible for services on a reduced-fee basis. Income guidelines are used
to determine eligibility for these reduced rates (which are funded by Columbia
County).
There may be fees for services that are not covered by your health insurance
plan. Occasionally, there may be fees for report-writing, consultation with
other professionals or for copying records. If you become involved in legal
proceedings that require your clinician's participation you may be billed for
certain expenses.
Please consult with our Billing Office if you have any questions and
for information about our fee schedule.
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Patient Rights
The Pauquette Center for Psychological Services
operates as a service of Community Service Associated, S.C. and is certified by
the State of Wisconsin
Department of Health and Family Services
to provide
outpatient mental health, outpatient alcohol and other drug abuse services and
emergency services. As part of our certification, we are required to inform our
patients of those rights that are guaranteed by Wisconsin State Statute
(s.51.61). Wisconsin State Statutes require that each patient sign an informed
consent to treatment document that will certify that any proposed treatment has
been discussed in detail. You were asked to review and sign a copy of a patient
rights and grievance procedure information sheet at the time of your intake
interview. A complete listing and explanation of these rights is available from
the receptionist.
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What to Bring to Your First Appointment
You will be asked to provide information
concerning insurance coverage so be sure to bring your insurance card with you.
If prior authorization for services is required by your HMO or insurance
carrier, please be sure to request or obtain that prior approval and bring
appropriate documentation of that authorization with you. Because these prior
authorization procedures vary considerably from one insurance carrier to the
next it would be advisable to consult with your carrier as soon as you schedule
the intake appointment.
Minor children should be accompanied by an adult
who has the legal authority to authorize services. Similarly, adults who have a
guardian should be accompanied by the guardian who can legally authorize
services.
It may be preferable to leave children at home
who are not to be seen and who may prove to be disruptive in the waiting room,
particularly if these children cannot be supervised by an adult family member.
Finally, because you will be asked to complete a
few forms, it may be advisable to bring reading glasses with you if you require
them.
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Finally...
We try our best to provide services in a
practical and flexible way. We take pride in our training, experience and
capabilities. We want you to have confidence in us. Good communication is vital.
Please tell us about problems or questions that you might have. We will be happy
to help you in any way we can.
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