Please note: If you are a new client, please complete the two forms below: Clinician Disclosure and Policy Statement and Client’s Form for Insurance.
My fee is $125/ session. I offer a sliding fee if requested, from $125 to $80. I expect payment and co-payments at each visit, by check or credit card. I use IvyPay, which stores your card (credit, debit or HSA) in a HIPAA-compliant cloud based account. We will set this up quickly in your first session.
I accept some health insurance plans, if you provide my biller, Ms. Flo Murray of FloMurray@hushmail.com, with your insurance information (see below at Forms: New Clients and Insurance). Ms. Murray will check with your provider to be sure of your deductible, co-payment amount or co-insurance amount, any need for an authorization before we meet, and how many sessions are approved.
Please bring your insurance card at our first visit. At this time I can accept:
- Medicare part B (not Medicaid, in any case)
- Great West
- Optum (UHC, UBH)
- Rocky Mountain Health Plans
- United Health Care and United Behavioral Health
- Value Options
If your insurance plan is not listed, I will provide you with a detailed statement upon payment of my fee, which you can submit to your plan for reimbursement. If you have “out of network” benefits, this is usually fast and simple.
NOTE: Insurance does not pay for extended case management I perform on your behalf, including letters, consultations with your other providers or the courts. You will be charged for my time for these and crisis phone calls over ten minutes, and for missed appointments and those cancelled too late for me to fill—usually 24 hours’ notice. Exceptions are made for one event of illness or one work obligation. In bad weather, text me right away if you are concerned about travel. We can use a HIPAA compliant video platform to have your session from your home.
HIPAA–Health Information Portability and Accountability Act
FYI:This Act instructs all health care providers to do our utmost to protect your health information from improper disclosure. Even prior to HIPAA, Psychotherapists have always practiced the principle of confidentiality, including safeguards such as keeping patient files locked away, keeping therapy notes apart from routine record keeping and progress notes, using fake names when discussing your case with colleagues, and refusing to share information about you without your written consent (except in certain situations or emergencies). You may revoke your consent in writing. You may review your file with your therapist.
Forms (we will need to use our limited session time to complete these if not done ahead of time)
- New Clients Please Download, Read, Sign and bring to first session (or scan into an email to me): Clinician Disclosure And Policy Statement
- New Clients and Insurance: Please complete and email this form – Client’s Form for Insurance – to my billing service, at least 48 business hours before your appointment, in order to avoid paying full out of pocket fee pending Ms. Murrays’ research. If you prefer, you can email the form to FloMurray@hushmail.com (other questions: 720-635-2444).
- If you have a recent therapy or hospitalization for psychiatric care, or are seeing a doctor or other prescriber for psychotropic medications, please complete this form on each:
- Client Authorization for Release of Information