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Client FAQ

 

 

What if there is an urgent matter or emergency?

At your very first appointment you are given a business card that has your clinician's immediate contact information on it (Urgent Care Line). Try not to forget this number and respect it's nature. If you lose the information, simply text (main business line) or email us (Clinician@ChangeTalkLLC.com) and we will supply it as soon as possible. The urgent care line is monitored regularly from 8am-10pm. Of course, if it's something really urgent or emergent, we encourage you to either utilize 911 services (emergency room) for a crisis clinician or 211 for the mobile crisis unit since we routinely check our phone every few hours due to inundated calls. If you are not sure if an issue is between routine and urgent, we typically ask that you attempt to make an appointment with us the next business day.

 

Unfortunately most insurance companies do not cover regular phone calls with your clinician for standard outpatient care and may hold you as being financially responsible for a second appointment in a seven-day period. Please remember "medical necessity" changes from insurance company and individual policy variations and to call them for specific answers to these related questions. Therapeutically, we want you to establish healthy relationships with support groups, sponsors, therapeutic coaches/mentors, and develop/re-establish relationships with friends and family members. Routine urgent calls to your clinician outside of normal business hours is not considered part of included standard outpatient services. 

What should I expect with my therapist?

 

Regularly you will find there are three role-levels of psychotherapists that you will come across which include students, guides, and expert professionals. Despite most therapists surely having favorite predispositions on how to operate, great therapists know that they have to be adaptable to the needs of the client. There are a multitude of social, psychological, environmental, and various other factors that affect our mental health which determine provider-role decisions by your therapist. Clinicians in Connecticut typically either hold a masters or doctoral degree in counseling or a related field (e.g., social work, family therapy, etc.) due to developing the knowledge, experience, and abstract thinking that takes years for a provider to ascertain.  

Do you offer free consultations?

We ask that you treat our service as you would most other providers/professionals and suitability/treatment questions be made during the time of your in-person intake appointment where your provider can take their time assessing the systemic nature of your current situation. This decision is also largely due to HIPAA constraints surrounding responsible record keeping. Signing our intake packet is not indicative of treatment obligation (you do not have to continue seeing us). This also means that until you sign a consent to treatment, we are not your therapist meaning that we cannot offer feedback or interventions until we are. We also understand that there are some therapists that offer this service with more open availability.  

How do appointments work?

Appointment times, frequency, and format sometimes differ based on your insurance benefits. Make sure you check out our appointments tab for more information on our location, see our next seven day availability, and other important commentary/videos. Appointment times are generally 53 minutes depending on your insurance eligibility. Our operating hours are Monday-Friday 9am to 6pm. Your initial intake appointment will be in-person for identification, assessment, payment, and documentation purposes. We also require a credit card to be placed on file for private insurances for copay, coinsurance, deductibles, and/or operating fees (e.g., case management).

 

Appointment reminders are automatic via text and still occur if you cancel that day with us since physical appointments get canceled on the day you miss it due to A) preventing online intakes from taking your recurring spot, B) documentation purposes to track your absences where a full note is generated when you actually miss your appointment, and C) not to generate double the effort if the cancellation is rescinded. We choose only a seven day window for new appointments due to the high no-show rate that begins escalating due to a large portion of intake populations choosing to book several intake appointments with multiple providers and often making their actual appointment on the basis of the first provider who is actually able to see them.

 

Do you offer weekend or late night appointments?

Due to our recurring appointment business model, missed appointments mean a disruption in your treatment plan and of course loss of income for us. We have attempted weekend appointments during two separate previous careers in counseling and experienced problems facing clients sleeping past their appointment times and of course the justified family event that usually happens on the weekends. As for late night appointments, we also love spending time with our family during this time as well! We do offer late afternoon appointments, however, client turnover during these times are extremely rare. Most individuals that work conduct therapy during their lunch break or approved company time via teletherapy. Please remember that after hours communications are for extremely urgent matters only.

What if I do not see an opening in your schedule?

It is quite common that our availability changes from week to week. Until you are one of our regular clients there is little we can do if there is not an opening that suites your needs. Unfortunately, most of our prospecting client phone calls revolve around unsuccessfully attempting to negotiate or influence future availability. Change Talk LLC does not have waiting lists due to insurance and legislative restrictions that discourages this practice and we do not schedule intakes more than a week in advance. You are welcome to still check our online availability weekly. Unfortunately, we do not condone pulling children from their classes for psychotherapy due the lack of educational sustainability, the child falling further behind, and the unnecessary high pressure it places on the clinician towards creating availability. 

 

What do I have to do if I have to miss an appointment?

 

Please note that your clinician purposely repeats all client appointments. If you are able to successfully reschedule within seven days with an opening we have, this absence does not count against our cancellation policy. Other missed appointments generally cannot be filled and consequently may likely incur a no-show fee with a cancellation frequency of two or more missed appointments every 90 (weekly) or 180 (biweekly) days. The first cancellation fee waiver may be extended with proof of illness or grouped vacations. Every effort should also be made to cancel the appointment during regular business hours, explore the possibility of a teletherapy session, or to send an email to clinician@changetalkllc.com after hours since our urgent care phone is constantly monitored for urgent matters -only-. 

 

A weekly client is allowed three EXCUSED absences every ninety days and biweekly clients are only allowed to miss ONE appointment in a 90 day period of time prior to your chart being reviewed for possible administrative discharge. Such is the price of treatment consistency and this practice choosing not to double book clients or schedule clients on a week-to-week basis. Please keep in mind that if you "no-show" (unexcused) for a single missed appointment, not arrive for two appointments in a row with communicating to us intent to reschedule, or violate our attendance policy, we reserve the right to cancel all recurring future appointments which may lead to eventual termination. Recurring appointments only recur if you make them or exhibit communicated mutual intent on making the next one.

What does insurance not cover? 

Outpatient clinical services are the lowest level of mental healthcare. Consequently, case management/forensic services are not included in MOST insurance plans! If you feel like your child needs more care, intensive outpatient, in-home, clinical day schools, or residential facilities might be your better option. Most people don't realize that most provisions for Court, Department of Children and Families, Drug Testing, Social Security, Social Security Disability, Guardian Ad Litem, School, and various other exchanges typically are not considered medical necessity by most insurance providers for standard outpatient treatment. The unfortunate reality is that in many cases either the family is responsible for these charges and/or your clinician attempts to be as efficient with their time as they can be in order not to charge you.

Unfortunately, beginning in 2015 a certain online therapy provider convoluted this process by offering "unlimited texting" to your therapist at "anytime" for additional fees where your therapist had 24 hours to respond. This à la carte style of therapy typically is not supported by your insurance providers since it can create a codependency with your therapist and insinuates that a client cannot function without them. In fact, a good majority of insurance companies require prior authorization just for you to see your therapist a second time in a seven day period of time and most certainly don't write "blank checks" for additional services. Therapists generally get paid only when you conduct a psychotherapy appointment with them. 

Can I see two therapists at the same time?

The short answer is "it depends." The safe answer is to always check with your clinician first since they are in charge of your treatment. Most insurances do not cover redundant services that have the same billing codes. However, couples counseling, EMDR, medication management, group psychotherapy, and other modalities MAY be accepted treatment opportunities by both your insurance company and provider. However, this is as much an insurance thing as it is a liability thing. Always consult with your primary therapist. Historically, concealing seeing another provider leads to automatic discharge in most psychotherapy practices due to liability concerns (e.g., who's treatment plan do I follow?), it being a treatment plan violation, and of course the disruption in the therapeutic alliance (e.g., trusting each other). Don't forget, in any great relationship, both individuals answer to one another. 

Is there a preferred type of therapy (in-person vs. teletherapy)?

Teletherapy requires a phone/computer/tablet with a quad-core processor with a minimum usable and consistent 1.5 mbps UPLOAD (not download) speeds or greater. We generally see much better results with 5 mbps upload speeds. The faster your device and upload speeds the better the experience (resolution). Your therapist wishes for you to experience the greatest benefit from your time with this office. In a weird twist of reality, behaviors are much like addiction where we develop these recursive habitual cycles that are often hard to break. For a person with depression or anxiety, this often means difficulty leaving the house. For a person that has ADHD, this means difficulties with focused attention. This is perhaps the most influential reason why we do not allow teletherapy for adolescents. The general secret surrounding your striving towards your mental health goals is that most change begets more changes. Teletherapy also has various risks concerning your HIPAA rights ranging from the propensity of computers to be "hacked" to family members listening in on your session. Due to these and many more constraints, in-person psychotherapy is generally the preferred method for most psychotherapeutic interventions. 

Can I call or text my therapist?

Currently, there are very few provisions for very select insurance plans that even cover any and all phone calls or texts with your therapist (scheduled therapy portal teletherapy does not apply). Your clinician will be there to support you during URGENT matters and in times of need. Not for routine matters, or issues that can wait until the next business day when you can schedule an online/in-person appointment with your clinician. This includes anxiety provoking matters that may be routinely encountered by a reasonable person (e.g., traffic ticket, etc.). This is typically a very hard notion to convey considering the nature of the work we do and this being an relationship-driven business. This is just as much as a fee-for-service related decision as it is a boundary related decision that promotes autonomy and repels codependency with our clients since we are trying to teach you how to manage uncomfortable feelings vs. avoiding them. This practice also prevents practitioner burnout and compassion fatigue since therapists also need to focus on their mental health and family.

 

As a general rule of thumb, if we have to ask ourselves "is this an urgent matter?" that it typically means it likely can wait. 211 or your local emergency department are a great resource for emergency/urgent matters where a professional will either actually show up to your home (mobile crisis unit) or a crisis clinician will perform an initial evaluation in a hospital setting that we will collaborate with. We ask that cancellations be emailed to clinician@changetalkllc.com with at least 48 hours notice for routine matters. Texts are permitted during regular business hours to both of our urgent/nonurgent business lines. Urgent communications will be responded to within 1-8 hours which means if you need someone right that very moment to choose either 211 or 911 options. Texts should not be used as a "check-in" and are usually logistical or administrative (e.g., late, last-minute openings, etc.). Even our Urgent private line is inundated with telemarketing, prospecting client, and other nonurgent communications which is why we limit our cell phone exposure. Telemarketers alone constitute thousands of calls annually originating outside of the country.

Does Adam treat Adolescents?

YES! We do see 12+ years old children and young adults. Problem is that 3-6pm availability rarely has any openings and there seldom is a remedy for that! So please, do not make intake appointments for children that are not sustainable (school, sports, etc.) understanding that the intake time you are choosing is the continuing appointment time you will likely be offered. Lastly, everything is included in your child's one hour session. This includes updates from parents or brief case management opportunities that will be conducting during your child's appointment. These processes does not "interrupt" your child's session and is very much a part of it. If you want additional time, please schedule a separate appointment. For children over the age of 12 we generally require your child to be present during their intake session. 

 

Are there other treatment options?

There are a multitude of factors that either lead to successful or unsuccessful treatment plan terminations. Typically, if you are on-time with your payments, followed the rules of this office, and showed up to your scheduled appointments most of these clients remain in "good standing" with this office and can return to this practice outside of ninety-day period of time upon discharge. After your termination we are no longer your therapist. This means if there is a urgent mental health care item you would like resolved you can either schedule another intake appointment with us, find another therapist, speak to your primary care physician, dial 211 (mobile crisis unit), or go to the emergency room/dial 911. If we believe you need a higher level of care (e.g., intensive outpatient, etc.) we will let you know during your discharge or in writing. Future referrals and/or brief phone calls after discharge constitutes a level of post-psychotherapy influence that is discouraged by most governing bodies we follow (implies active treatment). 

 

How do therapist vacations/cancellations work?

 

We love our vacations as much as you do! With that said, vacations/holiday/absences will be posted on our "home" or "landing" website page three months to a year in advance. We also typically observe most major holidays. During our absence, we would like you to utilize either 211 or 911 for most urgent/emergent needs and ask that you respect our well-earned days to ourselves although we will monitor all communications for safety purposes. This includes cancellations, case-management, and most other routine matters. If it really can't wait ore be sent by a scheduled text/email feel free to text us, however, it might be some time before we can respond due to geographical limitations.

 

When it comes to storms, we do our best to predict safety, communications, and power grid obstacles. This means if we don't think that we will have cell service for the following day, we will try to be proactive and cancel in advance of losing this capability (communicating) which includes teletherapy options. Thusly, we also attempt to reasonably predict our client's behaviors as well, and if we believe that four or more clients have/will cancel on us, typically take the stance of taking the whole day off much like the four hour work stipulations of most agencies regarding storms. Of course in-person psychotherapy is preferred, but in inclement weather or if you conduct frequent business trips, we ask you also consider teletherapy options.

Birthdays, graduations, funerals, fundraising, weddings, etc. 

We are honored that you think of us for your important occasions and events in your life. Unfortunately, with our well over 40 client caseload, this means our time is already strapped with all the outside work logistics your care requires. This often takes the form of speaking to state officials, lawyers, other mental health providers, continuing education, physicians, and of course your insurance company.  Just like we are discouraged (professional boundaries) to connect with you on our nonprofessional social media page, if we were to attend such an event please keep in mind it would be as a official capacity ONLY. When it comes to asking us to contribute to whatever cause you are currently supporting, please keep in mind we conduct our own charitable efforts for our adolescent clients in the form of positive reinforcement gifts and food, and also gifts for our adult client's birthdays, special accomplishments, and/or Christmas once per year. 

How do I make payments? (No third-party payments please)

Payments are required during time of service. For private insurances, a credit card will be required to be kept in your file for all incurred fees. 

For outstanding balances please send cash, check, or credit card information to:

Change Talk LLC

251 Essex Plaza

Essex CT, 06426

Checks: Should be made out to "Change Talk LLC"

Credit Cards: Information should include Card Holder Name, Account Number, Expiration Date, three digit security code, and billing zip code

AUTO PAY: The standard option. We accept all major credit cards that will be placed securely and encrypted in your electronic file. 

THIRD PARTY PAYMENTS: Both violate our "payment due at time of service" policy and greatly complicate/delay the reimbursement process and will not be accepted at the practice. This is even further confused by insurance companies offering third-party provider payment options.

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