PRACTICE POLICIES

Emergency Procedure:

If you are experiencing a mental health emergency, please call 911 or 512-472-HELP (4357), or go to your nearest hospital emergency room and ask to speak with the mental health professional on call.  Do not send me an email or leave a voice mail for me if you are in crisis as I may not receive them in a timely manner.  

Payment:

Full payment is due at the time of each counseling session.

 

I accept cash (U.S. dollars), checks, and all major credit cards. For those desiring maximum billing privacy, I also accept Bitcoin.

 

I have chosen to keep my practice small in order to give each client the personal attention they deserve. As a result, I am only enrolled with original Medicare as an in-network provider.  Due to the cumbersome and time-intensive claims payment demands imposed by private insurance carriers these days, I do not accept private insurance. Consequently, I am not listed within their networks.

 

However, many insurance plans provide out-of-network benefits. Since each plan is different, you will need to contact your insurer to determine the specifics of your plan. Upon request, I am happy to provide you with documentation from our session in order for you to file your own claim for reimbursement with your private insurer.   

 

Missed Appointment Policy:

It is important to the therapeutic process and the well-being of the client that every effort be made to attend the scheduled session at the appointed time. Should unforeseen circumstances arise and you must reschedule your appointment, please contact me no later than 48 hours prior to your appointment to avoid cancellation charges (which are the full amount of the scheduled session). Repeated missed appointments can be grounds for termination of services.  

 

Late Arrival Policy:

If you are late to the counseling session, we will conclude the session at the appointed time as a courtesy to other clients. Full payment will still be required. 

FORMS

(Adobe Acrobat Reader is required to view the PDF files, which can be downloaded here.)

 

HIPAA Notice of Privacy Practices

My Notice of Privacy Practices may be downloaded by clicking on the icon below.  The most current version of this policy will always be available here.  

Intake Questionnaire:

My intake form for new clients may be downloaded below. Please fill out this form and bring it with you to your first counseling session.

 

 

Additional Forms:

The following forms are available for review through my secure client portal.  When we speak to set up your inital visit, I will give you instructions on how to log in and access these documents.  

  • Consent for Treatment: Although we will review it together, I recommend that you read through the "Consent for Treatment" form before you come for your first session. This document discusses important office policies and guidelines that govern our therapeutic relationship.  It is important that you take the time to understand the scope and limitations of my services before we agree to work together.  

  • Consent to Release Information: This form will need to be filled out and signed if you wish for me to share your Protected Health Information (PHI) with others.  

  • Authorization for Electronic Communication: There are important things you need to know regarding the security of your PHI when choosing to communicate electronically.  This form details the risks and limitations of using e-mail and text messaging.  

  • Credit Card Authorization: This form is required if you wish to pay for our counseling session(s) with a credit, debit, or FSA/HSA card.  

Robyn Wendell, LCSW, PLLC

Austin, Texas

512-910-LCSW (5279)

© 2016 by Robyn Wendell, LCSW.

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