My intention is to enable your experience with psychotherapy to be as easy as possible, while addressing the clerical demands of record keeping and insurance billing. Towards that end my assistant and I have come up with the following guidelines to ensure that all the paper work is completed before your first office visit. (This way we get to spend more time talking about what's going on.)
Please print and complete
- New Client Information Form
- Treatment Agreement Form/Statement of Understanding
- Release of Information to notify your Primary Care Physician / you can also refuse to notify your PCP… this just needs to be documented
- Patients Rights in Psychotherapy
- Health History form
- If you have scheduled an initial appointment for your child, please call our office to receive by mail a child/adolescent developmental history questionnaire
- Insurance Questionnaire form
Your insurance/EAP benefit is one of the fruits of your labor. I participate in most major insurance plans. To facilitate informed and responsible use of your insurance benefit PLEASE, PLEASE, PLEASE call the number on your card to find out the following information:
- If I am listed in their data base as an "in-network" provider
- Your benefit including number of sessions per calendar year
- Your co-payment due at the completion of the session
- Any authorization numbers and number of sessions authorized
- Requirements for treatment plan submissions including fax numbers/or mailing addresses
- Mailing address for the submission of bills
- If your plan requires payment of a deductible and if that deductible has been met for the year
- Please let me know if you change insurance plans at any point in the course of therapy
My office is located at 11 West 33rd Street, Erie, PA It is right off of State Street on the South side of the street. Coming from the direction of the lake on State it would be a right turn onto 33rd Street, Coming from 38th Street it is a left turn onto 33rd Street. My office is located in a little grey building tucked behind the corner building (you won't see it right away when you turn onto 33rd, but it's there!). If you enter the residential part of West 33rd you have passed it. Enter via the wheel chair ramp door. My office is on the right hand side of the hallway. Come on in and make yourself at home. I look foreword to meeting you.
I try to be as accommodating as possible; I respectfully request that if you schedule an appointment you keep your appointment or notify my office at least 24 hours in advance, sooner if possible, as that robs both me and another of that time. If you have any questions please call the office at 814-456-0846.
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