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COVENANT OF UNDERSTANDING
Because I believe that all beneficial counseling takes place within a relationship of trust, I believe that it is important that I clarify what you can expect from me as well as other information about using my services.
CODE OF ETHICS AND CONFIDENTIALITY: As a Licensed Independent Clinical Social Worker, I am certified by the government of the District of Columbia Department of Health. I am a member of the National Association of Social Workers and am guided by its Code of Ethics. One aspect of this code concerns confidentiality. I want you to know that all information you share with me will be treated as a sacred trust and, since it is confidential, will not be made available to individuals or agencies without your written consent. However, information concerning the situation for which you are seeking consultation may be discussed by me with other clinicians—who are also ethically bound to maintain confidentiality—for the purpose of consultation and/or supervision. In these instances you would be identified only by a pseudonym and any indentifying information would be altered.
There are generally two instances in which confidential information can be released without your consent. Any such release would be within the context of my covenant to be a partner in caring about you, and I would release the absolute minimum amount of information required to address the situation. These rare instances are: (1) when disclosure is necessary to prevent serious, foreseeable, and imminent harm to you or another identifiable person (this includes specific reports of child abuse) or (2) if I am required to provide information by a law enforcement official or a legal or court proceeding. You will be notified of any situation that requires me to release information without your consent to another party.
CONSULTATION AND SUPERVISION: I pursue supervision and consultation in my work because I believe in the value of community. Other clinicians stand with me in my work and empower me as I attempt to stand with you and support you in the healing work you need to do for your own life process. I believe that many heads and hearts are more creative and, therefore, more helpful than just one. I also know that it requires strength to say to another, “I need help.” When necessary and appropriate, I say these words to my colleagues as you say them to me.
APPOINTMENTS AND CANCELLATIONS: I will schedule appointments directly with you and any changes or cancellations should be discussed with me. If you must cancel a scheduled session with less than 24 hours notice, you will be charged the full fee for that session. The only exceptions are a death in your family or your hospitalization. A missed appointment may be rescheduled, subject to the availability of an open appointment time. This rescheduled appointment is in addition to the next regularly scheduled appointment and is not a replacement for it.
FEES AND PAYMENT: The fee for a 50 minute session is $140; For 80 minutes the fee is $210. I generally meet with individuals for 50 minutes and couples sessions are 80 minutes, but this may vary with your situation. Effort will be made to respond to financial hardship, so please inform me of any concerns.
Insurance eligibility or availability will not affect your fee. Payment is preferred at the end of each session whether or not you are submitting insurance claims. I take Visa, MasterCard, Discover, checks, and cash. Checks should be made payable to Keith Miller, LLC.
INSURANCE: Because I am a Licensed Independent Clinical Social Worker, my professional services do qualify for patient reimbursement under most insurance plans. My fees are generally considered to be within the acceptable range (UCR) by most insurance companies, and psychotherapy is often covered by insurance. Coverage varies widely from policy to policy, so you may want to review your benefits to determine your expected reimbursement. I encourage you to call me to discuss how insurance companies may reimburse for marriage or couples therapy and I will share some important details.
My services are provided directly to you, and your payment is made directly to me at the time of each session. If you decide to use your insurance, you can file for reimbursement with your insurance carrier, using the statement I will provide.
However, before making the decision to use your insurance coverage to reimburse you for therapy, please consider the following:
Confidentiality: All insurance companies require some information about the reason for psychological treatment in order to process your claim. In addition, managed care plans often require detailed information regarding the problem for which you are seeking help, history, symptoms, family life, work life, and so on. The information is entered into increasingly large information systems, and current regulations are not strong in protecting confidentiality.
Control of Treatment: Managed care companies use the information to decide if treatment is medically necessary, what kind of therapy is approved, and, later, if it should continue. Many of the insurance company employees who make these decisions have limited training, and of course have never met with you.
Psychiatric Diagnosis: Health insurance is designed to pay for the treatment of illness. Therefore, a psychiatric diagnosis must be made before most insurance companies will pay.
Due to my commitment to confidentiality, and my belief that you deserve the best therapy, not what your insurance company decides, I do not participate in managed care plans, nor do I accept assignment of benefits.
EMERGENCIES: I do not provide emergency services. Messages left for me after 7pm may not be received by me until the following business day. Should you need immediate intervention by an emergency service, please arrange to visit your nearest hospital emergency room for evaluation. Some hospital resources are: Suburban Hospital, 301-896-3100; Georgetown University Hospital, 202-784-2118; George Washington University Hospital, 202-994-3211; or Fairfax Hospital, 703-698-3111. These numbers are for your information only, as I have no contractual arrangements, either formal or informal, with these institutions. If you use them, you will be seen and billed independently by the provider of the services.
AUTHORIZATION: Please read this Covenant of Understanding Carefully. If you are in agreement with it and are willing to authorize me to provide you with care, you will be asked to sign an Authorization for Care form.
The Counseling Therapy Process:
To grow and change in a healthy manner is usually at the center of any psychotherapeutic undertaking. While every effort will be made to reduce presenting symptoms, you should expect some difficult transition periods as you address your concerns and redefine your personal goals.
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Keith appears in The Hill newspaper
